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ARTICLE · 13 JULY 2001

New Claims Procedure Rules - Drastic Changes For Group Health Plans And Disability Plans

United StatesEmployment and HR
Klio Moore
Klio Moore

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.

CURRENT RULES

Type of Claim

Initial Benefit Determination

Appeal of Adverse Benefit Determination

Any welfare plan or any pension plan

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