A lawsuit filed in the United States District Court for the District of New Jersey, alleges that CIGNA, an employee benefits company, denied its beneficiaries correct out of network benefits.
It alleges that CIGNA violated its obligations under the Employee Retirement Income Security Act ("ERISA") by improperly reducing payments for services received from providers who are out of network ("ONET"), or who do not participate in CIGNA's network of providers. As well, the suit claims CIGNA used inappropriate policies to reduce reimbursements for ONET services.
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In 2006 I had a sound natural tooth knocked out in a sports accident, I immediately started treatment. According to my "open access plus" plan, the resulting procedures should be covered under my medical insurance at an in network rate, but instead have been paid as an out of network dental claim. Procedures have totaled over $8000 so far.
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