The health care reform rollout continues. Last week, the Obama administration unveiled new regulations addressing insurance appeals procedures.

The provisions of the rules state that new health plans – self-funded as well as fully insured – must offer an internal appeals process with clear instructions on how individals can start the procedure. If the internal appeal is denied, an individual can request an external review, the outcome of which is binding. These and other appeals provisions do not apply to “grandfathered” plans.

For most MedBen clients, the new regulations vary little from their current appeals process. Fully-insured groups in Ohio and all self-funded public employer plans in Ohio and Kentucky already have similar protections in place. Moreover, our experience working with various external review entities should allow us to seamlessly adapt to other state’s procedurals. As such, this will not be a difficult transition for MedBen or its fully-insured clients in Indiana and West Virginia, or its self-funded private employers in any state.