Question:
I work for a police department and we are self insured. My insurance company advised

in order to change the exclusion the policy the city has to change it. I had a meeting with the Personel Director and the Assistant City Manager. I secretly recorded the meeting and they both stated that they will not change the policy because they dont believe that the other employees should have to pay more money on another policy just because I want a particular surgery. They told me it had to be medicaly necessary but were very vauge on what that ment excactly. I showed them a doctors letter stated all my co morbidies and they simply did not care. What do I do now!!!    — DONNA H. (posted on June 21, 2001)

June 21, 2001
Make sure that your doctor's statement includes a statement that specifically says "medically necessary" and/or life threatening. Then address a letter to your employer asking them to go outside the contract based on the medical necessity. You might also want to include statements in your letter about ADA (Amercian Disability Act) Accommodation. Hope this helps!
   — Sharon R.

June 21, 2001
I was told to file a complaint with my states insurance commisioner. So I filed with OCI of wisconsin..funny thing is I just found out that my insurance company has some "new" information on me and the appeal comittee is reviewing my case again! My husband works for the police department here and they were understanding and stepped in to try to help! I am not sure if this will help you but just thought I would let you know what I had to do! Best of luck...
   — WIBlueyes