Coventry Health Insurance of Georgia (GA) | Health Insurance Georgia | Who Regulates State Health Insurance Georgia Plans?

Health Insurance Georgia

Who Regulates State Health Insurance Georgia Plans?

State health insurance Georgia policies come under strict regulations from the government. However, there are different government agencies that oversee certain state health insurance Georgia plans, depending on the type.

If you obtain your state health insurance Georgia policy through an employer or an organization-in other words, if it's a group health plan-it is regulated by the state government of Georgia. In Georgia, it is the Georgia Department of Insurance and Safety Fire that oversees group state health insurance Georgia plans. Currently, John Oxendine is the commissioner of that government agency. If you have a complaint or a problem that requires governmental involvement, and you have already appealed to your particular state health insurance Georgia plan administrators, then you can contact the Georgia Department of Insurance and Safety Fire commissioner. Be sure that you first check with your health maintenance organization or preferred provider organization, to try to successfully resolve your dispute. Also, note that the federal government does not oversee or regulate state health insurance Georgia group policies.

In Georgia, the Georgia Department of Insurance and Safety Fire oversees both Health Maintenance Organization (HMO) and Preferred Provider Organization (PPO) state health insurance Georgia group plans. In other states, there may be different agencies that oversee those two different types of plans. Please be aware that if you have Medicare, a different government agency will regulate those plans. In Georgia, the Department of Community Health, and specifically the Medical Assistance division, oversees Medicare state health insurance Georgia plans. That is who you need to contact if you need assistance, or need help solving a dispute, or want to voice a complaint.

Individual or family state health insurance Georgia policies that an individual purchases from the private market and are not connected to an employer group are regulated by Georgia. These types of state health insurance Georgia plans also fall under the jurisdiction of the Georgia Department of Insurance and Safety Fire, and Mr. Oxendine. As a side note, Mr. Oxendine is planning to run for Georgia governor later this year. He is currently also overseeing Georgia's plans to comply with new health reform requirements. However, at this time, he has opted to allow the federal government to set up the planning process, and therefore, be financially responsible for new plans that need to be established. This is part of Georgia's resistance to the health reform acts and how it will affect state health insurance Georgia plans.

When the employer funds and provides the state health insurance Georgia benefit plans, then the United States Department of Labor regulates those employers and their plans. The U.S. Department of Labor is also who you would need to contact if you have questions about COBRA or the Family and Medical Leave Act.

It can be complicated to determine which government agency oversees which type of state health insurance Georgia plan. There are some that are regulated by the federal government, such as COBRA, and self-funded plans. There are some that are regulated by the state government. In Georgia's case, this is done by the commissioner of the Department of Insurance and Safety Fire, Mr. John Oxendine's office.

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