For employers with self-insured group health plans, responsibility for complying with the claims and appeals rules generally falls on the employer as plan administrator. While many employers turn to third-party claims administrators to carry out some or all of these functions, the employer retains legal responsibility.
Join our instructors for an analysis of the legal framework as well as strategies for managing the practical challenges. We’ll also include the DOL’s newly revised rules applicable to disability plans.
By the end of this webinar, you should be able to: Describe key challenges — and compliance strategies — associated with the “full and fair review” requirement; list the potential consequences of noncompliance with the claims and appeals rules; explain how lessons learned from recent court cases can help protect claim denials from being reversed in court; identify common contractual issues in outsourcing claims administration for self-insured group health plans; and describe the claims and appeals rules applicable to disability plans.
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