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Text of EBSA Advisory Opinion 2005-16A
Employee Benefits Security Administration [EBSA], U.S. Department of Labor [DOL]Link to more items from this source
[Official Guidance]
June 17, 2005

Excerpt: "[DOL was asked its opinion r]egarding the claims procedure regulation at 29 CFR 2560.503-1(h)(3) which requires the plan's named fiduciary deciding an appeal of a group health claim denied based on a medical judgment to consult with a physician or other health care professional that is licensed, accredited or certified to perform specified health services consistent with State law."

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