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New regulations make it clear that ERISA plans may not require mandatory arbitration.  However, Kaiser is likely to ignore these regulations and refer to the contractual provisions that require arbitration, so it is important that you be very clear about your ERISA rights so that you can enforce them.

If you have Kaiser insurance  through your employer, it is an ERISA plan,and effective January 1 of this year, 2003, you cannot be forced into arbitration.

    The Department of Labor can clarify any questions about under ERISA plans. Their hotline
is 866-275-7922

    The specific regulation section is 29 CFR 2560.503-1:

(c) Group health plans.
The claims procedures of a group health plan will be deemed to be reasonable only if, in addition to complying with the requirements of paragraph (b) of this section-
. . .
    (4) The claims procedures do not contain any provision for the mandatory arbitration of adverse benefit determinations, except to the extent that the plan or procedures provide that:
           (i) The arbitration is conducted as one of the two appeals described in paragraph (c)(2) of this section and in accordance with the requirements
applicable to such appeals; and
          (ii) The claimant is not precluded from challenging the decision under section 502(a) of the Act or other applicable law.


 

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