When a Health Plan Says No!

The Washington Insurance Commissioner (OIC) just published an online guide for consumers to appeal a health plan denial of benefits. While the guide provides valuable information for consumers, the guide also reveals much about Washington law and regulatory enforcement.

Using funds available from HHS under federal health care reform, the OIC created a step by step analysis of actions that health plan beneficiaries may take to appeal decisions made by insurers. Unlike many other similar publications, the OIC guide combines several important elements of insurance regulation so that the public understands not just the “what” but also the “why” of these rules.

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