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Court Finds Denial of Health Claim Reasonable and Plan's Appeal Process Sufficient
HR Daily Advisor Link to more items from this source
June 6, 2012

"Because an employer health plan gave a full and fair review resulting in a reasonable benefits decision, a federal court upheld the plan's lifetime limit on obesity services and its prohibition on payments to treat complications from earlier gastric bypass surgeries. The plan also weathered an allegation that it was not properly segregating plan funds." (Wesson v. Phillips Medical Center Employee Group Healthcare Plan, 2012 WL 1536458 N.D. Okla., April 30, 2012)

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