Background And Effective Date
The Department of Labor ("DOL") recently finalized the claims procedure rules, which are similar, but not identical, to the proposed claims procedure rules from 1998.
The new claims procedure rules are applicable for claims filed under a plan on or after January 1, 2002, and focus on claims under group health plans and disability plans.
Summary Of The Timing Under New Claims Procedure Rules
The following charts summarize the major differences between the current claims procedure rules and the new claims procedure rules.
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CURRENT RULES |
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Type of Claim |
Initial Benefit Determination |
Appeal of Adverse Benefit Determination |
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Any welfare plan or any pension plan |