How to File a Complaint with a Self-funded Health Plan
How to know if you’re in a self-funded health plan:
Look at your health plan ID card. If the card does not have “TDI” or “DOI” on it, it means your health plan is self-funded.
Many large employers have self-funded plans. A self-funded health plan is one in which the employer pays claims itself. The employer may hire an insurance company, HMO, or someone else to handle claims and paperwork. For more information, read TDI's publication Understanding Employer Self-Funding of Employee Health Benefits.
Self-funded plans are regulated by federal law and are under the jurisdiction of the U.S. Department of Labor.
Self-funded Plan Offered by Government or Church Employers
Follow the complaint procedures in your benefits booklet and other plan documents.
Self-funded Plans Offered by Private-sector Employers or Unions
File your complaint with the Dallas Regional Office of the U.S. Department of Labor’s Employee Benefits Security Administration:
525 South Griffin St, Room 900
Dallas, Texas 75202
Not sure what kind of plan you have?
Look at your plan documents or talk to the benefits administrator where you work.
For more information, contact:
Last updated: 02/23/2017