Health plan & appeal guide

Consolidated Edison Company of New York, Inc. (ein 13-5009340) and

Pearl River, NY · Form 5500 filing, plan year 2024

Both kinds The Consolidated Edison, Inc. Master Health Plan Covers Employees Within the Cei Erisa Controlled Group · 14,197 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 (Cigna). Employers buy stop-loss only when they pay claims out of their own money.
  • The filing says benefits are paid from the employer's general assets.
  • Medical insurance bought from Aetna, Emblemhealth, Mvp Healthcare is on file, covering about 2,650 people.
  • 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 19% of the 14,197 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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  5. Get free help

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Both kinds The Consolidated Edison Retiree Health Program for Weekly Employees · 6,067 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 says benefits are paid from the employer's general assets.
  • The filing says benefits are paid from a trust the plan controls.
  • Medical insurance bought from Aetna, Emblem Health is on file, covering about 192 people.
  • 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 3% of the 6,067 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

    Unlocks after you answer the question above

  3. Know your deadlines

    Unlocks after you answer the question above

  4. What happens next

    Unlocks after you answer the question above

  5. Get free help

    Unlocks after you answer the question above

Both kinds The Consolidated Edison Retiree Health Program for Management Employees · 4,529 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 says benefits are paid from the employer's general assets.
  • The filing says benefits are paid from a trust the plan controls.
  • Medical insurance bought from Aetna, Emblem Health is on file, covering about 95 people.
  • We ignored a small insurance contract with Oxford Health Plans (Ny) covering about 1 people; it is too small to be the main plan.
  • 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 4,529 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

    Unlocks after you answer the question above

  3. Know your deadlines

    Unlocks after you answer the question above

  4. What happens next

    Unlocks after you answer the question above

  5. Get free help

    Unlocks after you answer the question above

Not clear yet Supplemental Medical Plan - Retired Officers · 196 people

The filing doesn’t settle it. One question about your insurance card will.

How we know · low confidence
  • No medical insurance contract is on file (Schedule A).
  • 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.

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. Is your plan insured or self-funded?

    Look at your card or plan summary, or ask HR: “Is our medical plan fully insured or self-funded?”

  2. Send your appeal here

    Unlocks after you answer the question above

  3. Know your deadlines

    Unlocks after you answer the question above

  4. What happens next

    Unlocks after you answer the question above

  5. Get free help

    Unlocks after you answer the question above

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