My company recently switched to a new insurance situation this year where a third party handles communication (Accolade) with the insurance company (BCBS) and I cannot contact the insurance company directly. Accolade has been extremely unresponsive.

1) For example I filed claims late April, still haven’t gotten a response, and for over two weeks now accolade is still “working on figuring out way these haven’t been processed.” The insurance app confirms the claims were received (I filed them through their website). 2) Also have cases where I have several denied medical claims so I asked for the claim file so I can better understand the details, because the EOB has very little information — nothing received, after multiple requests.
3) I sent in a medical appeal late April (first appeal). Still haven’t gotten a response and I confirmed with Accolade the claim had been received by BCBS

Based on my limited review it seems the plan is clearly failing to meet ERISA standards for timely responses.

What can I do from here? Since it’s an employer sponsored plan I assume I cannot go to my state insurance board, so does this mean I should contact EBSA and try to file a complaint from there? Anyone have experience doing this or have other recommendations?

Thanks in advance for any help or ideas!

submitted by /u/StarFire82
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