Group Health ERISA Question
Alright, I made another post about Aetna denying a claim for not medically necessary. This after 3 different doctors recommended surgery (who all 3 do not know each other and work at different practices).
I have been doing a ton of research and have some questions:
The plan is based on California (my company uses a PEO), but I’m based in Florida. Do I file a grievance with the state insurance commission in Florida (where I live) or (California (where the plan is located from)?
Also I’ve been interviewing ERISA lawyers. Not super easy to find. They want $5-$7500 to get started. My question is does it actually make sense to hire a lawyer? And if so at what point does it make sense to hire one?
Realistically (until we maybe file a suit) what can a lawyer do that I can’t? Or are they just more likely to take me seriously?
Thanks!