walmart

Does anyone here work for Wal*MArt or did work for them when they got or tried to get WLS? I currently do, and they seem to have an Employer exsclusion in their health plans they offer.  I live and work in Maryland and they offer us BC/BS of illinois.  Bc/Bs of Illinios do have some plans that cover WLS, but Wal*Mart has so generously opted out of that coverage.   I had recieved a e-mail back stating some eroneous facts about, not a good option, high mortality rate,experimental..bla bla bla...So, I am currently putting together a letter with current REAL facts about WLS and how it could better benefit us, rather then pay for high blood pressre,diabetes, medicine... I think if there are anymore of us out there we should pull together and if nothing else, ask them for a rider option. Let us choose if we want to pay more for the services we get! Your thoughts???

My nephew works for Wal-Mart and wanted to do it too but was told they don't cover it. :(

As a general rule the state of Md requires insurance co to pay for WLS . It is a state law.  Of course there is always an exception to the law...   I think if the plan is "self funded"  or the company is too small .  Check with  a lawyer before you give up.

I had the same problem with my former employer. What the insurance company told me was that if the plan was written in MD, the MD law applies.  Since WalMarts plan is written in IL, IL law would apply.  My former employers plan was written in AZ, not MD.  Also, it was a self funded plan, which I believe can exclude things like WLS, since the larger insurance company is only an underwriter, and not the plan payor. You can appeal through your HR.  Get all your ducks in a row.  I hope you are successful at getting them to pay for it! I wish I had more info to help.

good luck they can do 2 dollar rx and not cover wls for their employees to better their health

Sounds like Wlmart is running a "self funded" policy.   Doesn't matter where the policy is issued at. The plan falls under ERISA guidelines which clearly state that as long as a company excludes something across the board with no exceptions they can do whatever they want. So one year they could decide no transplant coverage or no cancel coverage. Gotta love those laws which protect big-business . You're almost better off on Welfare. I had to quit my last job because of their &((^$% ERISA plan.

Updating my last post.......

I did some research and yes Walmart is an ERISA heath plan.

They used ERISA to defend the recent MD court case for fair-share spending.

Here's one quote from the court findings... ERISA establishes comprehensive federal regulation of employers' provision of benefits to their employees. It does not mandate that employers provide specific employee benefits but leaves them free, "for any reason at any time, to adopt, modify, or terminate welfare plans." Curtiss-Wright Corp. v. Schoonejongen, 514 U.S. 73, 78 (1995). Instead, ERISA regulates the employee benefit plans that an employer chooses to establish, setting "various uniform standards, including rules concerning reporting, disclosure, and fiduciary responsibility." Shaw v. Delta Air Lines, Inc., 463 U.S. 85, 91 (1983).

 

 

 

Well, I am off today to get my Psych. consult, have attended  Dr.'s Seminar and will be...Self pay I thought about the options and considered the price of a mid size car is some where in the range of $25-30,000  and those are only good for 4-5 years before we get tired of them or trade them in.  And I AM SO WORTH MORE THEN A CAR.  Plus I will get an  better trade in...A new body and A new life!   SO,  I will berefinancing our home with  cash out,   and I will be on my way...Anyone else out there have to self pay?