Your appeal
The claims administrator
Send it to the appeal address on your denial letter or the back of your card. This filing doesn't name the administrator; your card does.
Health plan & appeal guide
Lincoln National Corporation C/o Health & Welfare Benefits
Both kinds
Lincoln National Corporation Employees Life, Health & Accident Plan · 9,767 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 (Aetna). Employers buy stop-loss only when they pay claims out of their own money.
- The filing says benefits are paid from a trust the plan controls.
- Medical insurance bought from HMSA (Blue Cross Blue Shield of Hawaii) is on file, covering about 0 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 0% of the 9,767 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.
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.
Send your appeal here
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Know your deadlines
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What happens next
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Get free help
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Not clear yet
LNC Employees' Hospital Indemnity Ins Plan · 3,632 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.
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?”
Send your appeal here
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Know your deadlines
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What happens next
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Get free help
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Self-funded · federal rules
Lincoln National Corporation Employees Health Care Expense Account · 1,866 people
Your employer pays the claims from its own money, so federal law (ERISA) applies — not your state’s insurance rules.
How we know · medium confidence
- The filing says benefits are paid from the employer's general assets.
- No medical insurance contract is on file (Schedule A).
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.
Send your appeal here
Plan documents, and a copy of your appeal
The plan administrator
LINCOLN NATIONAL CORPORATION BENEFITS COMMITTEE
ATTN: PLAN ADMINISTRATOR
150 N. RADNOR CHESTER RD
MAIL STOP D2-210
RADNOR, PA 19087The plan administrator is legally responsible for the plan. Ask in writing for the Summary Plan Description and the plan document. The plan administrator must send them within 30 days, or a court can add a penalty of up to $110 a day.
Know your deadlines
- Internal appeal to the plan180 days from the denial
- Independent external review4 months from the final denial
Dates you enter stay on this device.
What happens next
File in writing within 180 days of the denial notice. Ask for your complete claim file and the criteria they used. They must give it to you free. They decide within 30 days for care you haven't had yet, 60 days for care you already received.
If they say no again, request external review within 4 months of that final denial. The plan must send it to an independent review organization it contracts with. Some states let self-funded plans use the state's program instead. Your denial letter has to tell you where to send it. A reviewer outside the plan decides, usually within 45 days, and the plan must follow the decision.
If waiting could seriously harm your health, say so in writing. The plan must decide within 72 hours, and you can ask for expedited external review at the same time.
Call the Department of Labor's benefits advisors. They enforce these rules for employer plans and can contact the plan for you, free. After the appeals are finished, a lawyer can sue under ERISA if the denial was wrong.
Get free help
External review covers denials based on medical judgment ("not medically necessary", "experimental"), cancelled coverage, and surprise-billing disputes. A flat plan exclusion usually isn't eligible, but you can still file the internal appeal.
If your plan documents say the plan is "grandfathered" (unchanged since March 2010), the external-review rules may not apply.
Self-funded · federal rules
Lincoln National Corporation Life and Health Plan for Retired Employees · 1,848 people
Your employer pays the claims from its own money, so federal law (ERISA) applies — not your state’s insurance rules.
How we know · medium confidence
- The filing says benefits are paid from a trust the plan controls.
- No medical insurance contract is on file (Schedule A).
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.
Send your appeal here
Your appeal
The claims administrator
Send it to the appeal address on your denial letter or the back of your card. This filing doesn't name the administrator; your card does.
Plan documents, and a copy of your appeal
The plan administrator
LINCOLN NATIONAL CORPORATION
ATTN: PLAN ADMINISTRATOR
150 N RADNOR CHESTER RD
MAIL STOP D2-210
RADNOR, PA 19087The plan administrator is legally responsible for the plan. Ask in writing for the Summary Plan Description and the plan document. The plan administrator must send them within 30 days, or a court can add a penalty of up to $110 a day.
Know your deadlines
- Internal appeal to the plan180 days from the denial
- Independent external review4 months from the final denial
Dates you enter stay on this device.
What happens next
File in writing within 180 days of the denial notice. Ask for your complete claim file and the criteria they used. They must give it to you free. They decide within 30 days for care you haven't had yet, 60 days for care you already received.
If they say no again, request external review within 4 months of that final denial. The plan must send it to an independent review organization it contracts with. Some states let self-funded plans use the state's program instead. Your denial letter has to tell you where to send it. A reviewer outside the plan decides, usually within 45 days, and the plan must follow the decision.
If waiting could seriously harm your health, say so in writing. The plan must decide within 72 hours, and you can ask for expedited external review at the same time.
Call the Department of Labor's benefits advisors. They enforce these rules for employer plans and can contact the plan for you, free. After the appeals are finished, a lawyer can sue under ERISA if the denial was wrong.
Get free help
External review covers denials based on medical judgment ("not medically necessary", "experimental"), cancelled coverage, and surprise-billing disputes. A flat plan exclusion usually isn't eligible, but you can still file the internal appeal.
If your plan documents say the plan is "grandfathered" (unchanged since March 2010), the external-review rules may not apply.
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