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#1
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Does anyone here have any experience ERISA opinions with regards to superseding state laws and insurance companies' rules for participation, etc. ?
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#2
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Not really sure what your wanting, here. I'm no expert, but I'll give you my thoughts on ERISA.
When I worked insurance claims, ERISA rules seemed to be very insurance company friendly. ERISA laws only apply to self-funded plans. Patients' coverage in self-funded plans used to be a minority, but over the years, more and more patients' plans became self-funded and therefore subject to ERISA. All of the rules/laws the State would adopt to protect policyholders became more and more useless because ERISA always preempts State law. Virtually the only way to dispute a incorrect claim payment or whatnot would be in Federal court. Who is going to do that? Even when a court precendence was adopted in ERISA cases siding with the patient, no insurance company would recognize that precedence. Additionally, insurance companies started encouraging businesses to become self-funded to avoid the more-stringent state laws. The insurance company would only administer the benefits on behalf of the business, which absolved the insurance company of any financial responsibility or accountability to state claims-paying laws. In my typically cynical estimation, ERISA was created to make some politicians look good and let the lawyers to get richer.
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#3
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Quote:
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#4
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They aren't vague... people just don't know about it because they've been swallowing the "group insurance is king" koolaid for so long, they don't know they have other options.
99.9% of all agents glaze over when I even mention Section 105 plans... unless of course they think it's just self funding...which is even more funny.
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