Category: <span>Employer’s responsibility to provide coverage</span>

Categories

• Accredited/ approved hospital (5)
• Alcoholism and drug abuse (21)
• Alcoholism and drug abuse – court ordered treatment (1)
• Anesthesia (5)
• Anesthesia – dental services (4)
• Anesthesia – obstetrical charges (1)
• Back pay award (1)
• Cardiac rehabilitation (2)
• Co‑payment for physician visits during hospitalization (2)
• Contract mining agreement with another company (4)
• Dental procedures, outpatient hospitalization for (11)
• Emergency room – acute medical symptoms (72)
• Emergency room – acute symptoms of chronic condition (7)
• Emergency room – dental vs. medical conditions (4)
• Emergency room – forty‑eight (48) hour limitation on benefits (46)
• Emergency room – inappropriate setting (1)
• Emergency room – injured during criminal activity (1)
• Emergency room – instead of physician’s office or outpatient facility (13)
• Emergency room – medical necessity (17)
• Employer sells to, becomes or merges with another employer – alter ego (2)
• Employer sells to, becomes or merges with another employer – merger (2)
• Employer sells to, becomes or merges with another employer – transfer of ownership (2)
• Employer’s responsibility to provide coverage (44)
• Employer’s responsibility to provide coverage (2)
• Financial status of employer (4)
• Injured during criminal activity (1)
• Insurance carrier – bankrupt/insolvent (22)
• Insurance carrier – coverage implemented through an insurance carrier (3)
• Insurance plan – implementation of/method of payment (4)
• Insurance plan – payment of claims in timely manner (4)
• Insurance plan – substandard plan (20)
• Insurance plan – substandard plan (2)
• Insurance premiums – nonpayment of (12)
• Insurance premiums – reimbursement of premiums paid by employees (7)
• Lapses in coverage (3)
• Laser surgery procedure (1)
• Length of stay‑dispute unnecessary hospitalization days (11)
• Maternity benefits, change of employers (4)
• Medical necessity (9)
• Mental illness, coverage for (9)
• Mental illness, coverage for – continuing inpatient treatment for medical symptoms (1)
• Mental illness, coverage for – over 30 days of inpatient care (1)
• Mental illness, coverage for – over 60 days of inpatient care (1)
• Mental illness, coverage for – over 90 days of inpatient care (4)
• No longer in business (NLIB) determination under 1974 Benefit Plan and Trust (1)
• Obesity, surgery for (3)
• Obstetrical charges – excessive fee (2)
• Obstetrical charges – pregnancy discrimination act (3)
• Oral surgical/dental services (31)
• Oral surgical/dental services – age of patient (5)
• Oral surgical/dental services – impacted wisdom teeth (6)
• Oral surgical/dental services – noncovered procedures (25)
• Oral surgical/dental services – orthodontic (2)
• Oral surgical/dental services – periodontal disease treatment in relation to other illness (1)
• Oral surgical/dental services – preexisting medical condition (14)
• Oral surgical/dental services – situational anxiety (7)
• Oral surgical/dental services – temporomandibular joint dysfunction (12)
• Physical therapy (1)
• Pre‑admission certification (2)
• Private room charges (3)
• Private room charges – medical necessity (7)
• Psychiatric hospitalization, group therapy (1)
• Room and board, leave of absence (1)
• Self‑inflected injury (1)
• Semi‑private room (2)
• Venipuncture (1)