Summary of Benefits Question

Researched by Thomas DeMichele Published - January 15, 2015
Last Updated - January 15, 2015

Under ACA are health care insurers required to provide full plan documents prior to enrollment deadline? I found that the Summary of Benefits documents do not disclose enough about coverage and my insurance company refused to provide full documentation until after I enrolled.

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William Ahrens

my insurance does not have a summary of benefits for my bronze plan. I am through with any needed health services and want to pay my bills. it is very unclear on coventry’s website and my claims. i cannot meet my deductible with my share of out of cost pocket at approximately $5800 dollars with my out of pocket maximum is $6450.I was out of network and coventry authorized emergency,hospital stay,and tests. the total bill is about $21,000.
How is the process remediated by insurance?

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