Do you know about - Shared Cost assurance Policies Carry Erisa Preemption Risks for Employees
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The Washington Post recently published an description discussing the trend toward shifting assurance costs from owner to worker in an exertion to lower expenses ("Employers shift disability assurance costs to workers and trim benefits" - published Sept. 19, 2011). Though useful, the description omits the particular most prominent piece of information relating to employer-based insurance. Namely; that employer-based assurance strips you of all your ownership and protections against unfair or fraudulent assurance practices.
What I said. It is not outcome that the real about Kaiser Permanente. You see this article for info on a person want to know is Kaiser Permanente.How is Shared Cost assurance Policies Carry Erisa Preemption Risks for Employees
The U.S. Consummate Court has held that employer-based assurance is governed by federal law, not by state law. The qoute with this is that the Federal Government is prohibited from regulating assurance enterprise practices and therefore any, and all, ownership that you have as a buyer are in case,granted by state protections, such as the uniform unfair claims practices act, which has been adopted by most states.
Violations of these state laws resulting in damage to the buyer such as foreclosure and bankruptcy are actionable under state assurance protections. In other words, you can sue if you have lost your life's savings as a supervene of being cheated or defrauded by your assurance company. You have a right to a jury trial, under state law, and you have a right to recover for all damages suffered as the supervene of wrongful or bad faith guide by your assurance company.
Under Federal law you have None of these rights. Therefore, under Federal law you have no leverage to plainly force your assurance enterprise to pay valid claims. Without this leverage you have no ability to force your assurance enterprise to do what is required under the terms of its own policy.
This doctrine of the abolition of your state ownership and law is called Erisa preemption. It is the particular most outrageous law in the history of assurance regulation.
Congress has refused to rectify this qoute because of the power of the assurance lobby, and because 95% of the collective knows nothing about the problem.
The bottom line is that if you have an Erisa preempted policy, your assurance enterprise can deny even the most valid claim. And although the carriers use fancy language in their denial letters, the bottom line is that even if they told you "your claim is legitimate and we owe you 0,000s in future benefits" you couldn't even sue them for that. And even if you lost your life savings because of the wrongful denial you still couldn't sue them for that loss.
By the way, one of the largest institutional proponents of Erisa preemption in the country is Kaiser Permanente, the "collaborator" with the Wa post.
If you ever have a choice in the middle of buying an private procedure vs. An employment endorsed policy, buy the private policy. Even if your owner isn't paying the premiums, a procedure which has your employer's stamp of approval on it, is probably Erisa preempted, stay away from it.
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