Employee Benefits Blog

Why Isn’t My “Free” Preventive Health Care Free?

In my opinion, one of the best changes made by the Affordable Care Act is the mandate that requires health plans to provide certain specified preventive services without imposing any cost sharing. This is sometimes referred to as “free” preventive care. As a result of this mandate, deductibles, copays, coinsurance, and other cost sharing may […]

June 21, 2017 | 3 min read | Tagged: ACA, employers, free, free preventive care, high deductible health plan, in network, out of network, preventive care, provider

Nancy K. Campbell Of Counsel

Dealing with Long-Winded Out-of-Network Provider Nuisance Letters

Over the past couple years, more and more of my clients with self-funded plans have received letters from out-of-network providers appealing denied claims. The letters are usually 20 to 30 pages long, not very specific, and make various accusations against the plan and its fiduciaries. Most of the letters follow a standard approach. They start […]

October 11, 2016 | 4 min read | Tagged: anti-assignment, due diligence, ERISA, fiduciary, fiduciary duty, out of network, out of network provider, provider

Nancy K. Campbell Of Counsel