Question
Can I appeal on the basis or parity? Also, what do I do if Cigna has not sent me a written explanation for my reduction in benefits?
I recently had my benefits reduced from 300 to 100. Doesn’t sound like much but I’m also on federal disability and every penny counts. The main reason I was given was that I had been on their disability for 24 months at which time, based on my diagnosis of bipolar, my benefits were to be reduced. Please keep in mind that they just put me through two full days of testing for IQ etc. Close to the time I went on their benefits I had to appeal as they were again going to take away my benefits I have two doctors strongly in my corner. My question is… do I have grounds to appeal on the basis of parity in Pa.? Another point to mention is that I received absolutely no written explanation about the reduction, so when the smaller check arrived, I was forced to call. I called several times before reaching the case manager. I look forward to any advice.
Answer
Susan, My only suggestion at this point would be to request in writing an explanation as to the reduction in benefits. Typically, $100.00 is the minimum benefit under an ERISA governed disability policy, so it might be due to some offset for “Other Income.” Additionally, since you indicate how important every penny is- the majority of Cigna disability policies I have reviewed have a maximum of twenty-four (24) months of benefits for a mental health condition. If you do not have a copy of your policy I would strongly recommend you obtain a copy.
