Health plan & appeal guide

America's Family Health & Welfare Fund

Williamsville, NY · Form 5500 filing, plan year 2024

Both kinds America's Family Welfare Fund · 405 people

This employer has both kinds of coverage. The company on your insurance card decides which rules apply to you.

How we know · medium confidence
  • The filing lists stop-loss insurance (Hm Life Insurance Company Of New York). Employers buy stop-loss only when they pay claims out of their own money.
  • Medical insurance bought from Highmark is on file, covering about 8 people.
  • The filing says all benefits are paid through insurance contracts.
  • We ignored 1 low-cost supplemental policy(ies) such as accident or hospital cover; they don't decide how your medical claims are handled.
  • Medical insurance is on file, but the plan also pays benefits from the employer's own money, so some options are likely self-funded.
  • The insured options cover only about 2% of the 405 participants, so most people in this plan are in the self-funded part.

Double-check in 30 seconds: “Self-funded”, “administered by” or “ASO” on your card or plan summary means self-funded. “Insured by” or “underwritten by” means insured.

  1. Which company is on your insurance card?

    It’s printed on the front of the card. The filing shows which companies sell insured options here and which ones run the self-funded plan.

  2. Send your appeal here

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  3. Know your deadlines

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  4. What happens next

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