Ask Your Dentist...

by James Michaels D.D.S.

You Have a Right to Know

The Aug. 2 American Health Line reports the U.S. Department of Labor has ruled that private-sector health plan participants have a right to know the formulas used to calculate their benefits, reports Reuters news service.

"No right is more valuable than that of giving workers access to information about plan benefits," said Oelna Berg, assistant secretary for the Pensions and Welfare Administration. "The ruling is an important step in preserving rights to plan information which may protect them from unnecessary loss of benefits."

Many health plans offer benefits based on established fees or schedules but without specifics on other information used to determine health insurance benefits, the report said. The Labor Department ruling states that plan documents which serve as the basis for determining benefit amounts must be disclosed when requested. Denying access to this information violates the federal Employee Retirement Income Security Act.

Schedules for formulas used to calculate pension benefits must be similarly disclosed, the report says.


Please submit your questions to:

James Michaels, DDS., 819 Summit Ave., Oconomowoc, WI 53066

or Email: drmike@execpc.com