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DOL Issues Proposed Regs Implementing ACA Protections for Disability Claims
The Wagner Law GroupLink to more items from this source
[Guidance Overview]
Dec. 4, 2015

"Claims and appeals must be adjudicated in a manner designed to ensure the independence and impartiality of the person involved in making the decision. Benefit denial notices must contain a full discussion of why the plan denied the claim and the standards behind the decision. Claimants must have access to their entire claim file and be allowed to present evidence and testimony during the review process.... Claimants are deemed to have exhausted administrative remedies if the plan does not adhere to all claims processing rules.... Notices must be written in a culturally and linguistically appropriate manner."

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