ERISA Claims and Appeal Procedure Regulations - Resource Materials

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On July 1, 2002, the U.S. Department of Labor, under authority granted by the Employee Retirement Income Security Act of 1974 (ERISA), put into effect new regulations covering claims procedures for employer-based health plans.  The following materials are designed for consumer health assistance programs serving consumers who may be enrolled in plans covered by these new regulations.  The regulations contain new rights and disclosure provisions important to consumers with disputed claims.  Click the title of the resource to view it.

Overview of ERISA Claims Procedure Regulations

Summary of Main Provisions of Claims and Appeals Procedures

Glossary of Terms

Urgent Service Claim Timeline

Pre-Service Claim Timeline

Post-Service Claim Timeline

The Health Assistance Partnership hosted a conference call related to these new regulations.  Registered users of this site can access a summary of that call by clicking HERE.  If you are a staff member in a consumer health assistance program and are not yet registered with the Health Assistance Partnership, REGISTER NOW.