Know Your Plan
Self-funded or fully insured, ERISA or state law: the one fact about your coverage that decides which rules protect you and who enforces them.
- Know Your Plan Federal External Review Process or Your State's: Which One Your external review goes to a state agency, to your own insurer, or to a contractor in Pittsford, New York. Three questions decide which, and few letters say.
- Know Your Plan Form 5500 Search: Look Up Your Employer's Health Plan Your employer's health plan files a public annual report with the Labor Department. Here is how to find it on EFAST2 and read the two boxes that matter.
- Know Your Plan SPD vs SBC: Which Plan Document Governs The summary says covered. The denial cites a section nobody ever sent you. Which paper actually binds the plan, and how to make them hand it over.
- Know Your Plan Self-Funded vs Fully Insured: How to Find Out for Sure Your state insurance department may have no power over your plan at all. One sentence in the plan documents decides that, and you can demand it in writing.