Question:
Policy Exlcusion Questions - I don't see any

I looked at my benefits guide and it says nothing about exclusions for obesity. My company is self-insured, using Benefit Administrators and now we have a ppo with Beach Street. Benefit Administrators say they will not pay, period. What should I do now? I haven't even seen the surgeon yet, but I wanted to get this insurance stuff all settled beforehand. BTW, they say they'll pay for my visits to the surgeon, just not the surgery...HELP!!! Thanks!    — Pamela P. (posted on August 13, 2001)

August 13, 2001
You need to check your booklet that shows covered benefits and look for exclusions/limitations. If they say its not covered ask them where you can find that documented or tell them to send the exclusion to you in writing. I wish you luck.
   — Dawn R.

August 13, 2001
I am an HR Manager with the company I work for and we were self-insured last year. I would suggest going to your HR Manager/Director and asking them. As a company, they can elect to have this paid for because your company is paying for all of it by being self-insured.
   — [Anonymous]

August 13, 2001
Often the book you get as an employee is just a summary. You have the right to ask to see the entire contract, which probably somewhere does exclude it. Good luck.
   — Rosie P.

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