My health insurance company has not paid my claim. What is the time frame for a company to process the claim?
If it is a fully insured group plan, then a claim should be either paid or denied within 60 days of receipt of all information needed to process the claim. • I have group coverage, and I have been covered for several years. They withhold $200 from my check. I have decided that it is too much to be coming out of my check right now, so I asked my employer to cancel my coverage. He says he can’t do that until January 1. Why? Apparently, your employer is deducting your insurance premiums from your paycheck prior to assessing income taxes. There are only certain situations in which the Federal Government allows you to make changes in your deductions, except at the beginning of your new tax year. If you wish to have the specifics on this situation, please call the Federal IRS at 1-800-829-1040. That is a tax regulation, not an insurance regulation. • What is a “self-insured” plan? An employer may choose to “self-insure” by paying out benefits from its own funds. Typically, an insurance compa
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