How Can I Obtain a Copy of the Health Insurance Plan I Was Covered By?

Health insurance plan members should have access to their coverage information -- past and present. Under the Employee Retirement Income Security Act (ERISA), members have the right to information about their health benefit plans, if enrolled in an ERISA-sponsored plan. You can get health insurance plan information from your employer, union trust, plan administrator or the plan carrier. If you are unsuccessful, per ERISA rules, the U.S. Department of Labor can assist you in obtaining plan information.

Instructions

• 1

  Go to the web site of the health plan carrier and log into the member portal. Even if you are no longer a member, you still may be able to log into the site to obtain plan information and claims history. A printable listing of benefits should be accessible on the member portal. Print these out and review.

• 2

  Review the benefits materials you received from your human resources department. Often, these will include a benefit summary, a grid summarizing your health insurance options. The summary will list services, co-pays, deductibles, out-of-pocket costs and limitations. These materials are typically distributed at open enrollment time. If you purchased insurance through a broker, contact your broker to obtain this information.

• 3

  Ask your human resources or your union's welfare trust for a copy of the health insurance summary plan description. The summary plan description is a comprehensive document that details all benefits, services and exclusions of the health insurance plan. Many employers do not distribute this document due to the size, instead sending easier-to-read summaries. Your employer may post the SPD on its web site or intranet site.

• 4

  Call the health plan carrier directly and request information about your health insurance. The representative can provide specific information about benefits, quote coverage levels and answer specific questions about your coverage. Ask them to mail, email or fax you information about your health insurance.

• 5

  Contact the U.S. Department of Labor to obtain a summary plan description if you are unable to get it from your employer, past employer, union, broker or plan administrator. Request a copy in writing to EBSA, Public Disclosure Room, Room N-1513, 200 Constitution Avenue, N.W., Washington, D.C. 20210. There will be a fee. Include your name, address and phone number on the request so EBSA can contact you if necessary and send the document.