Guide

Indiana: Start Here

Who regulates your plan (IDOI vs DOL), what changes by plan type, and which Indiana guides to open next.

2 min read

Who regulates appeals in Indiana

Indiana Department of Insurance (IDOI): Generally regulates fully insured Indiana health policies and HMOs—grievances, many internal appeals, and state external review when eligible.
U.S. Department of Labor (EBSA): Many self-funded employer and union plans under federal ERISA—not IDOI external review.
Medicaid / Medicare: Separate appeal systems (CMS, FSSA, managed care organizations).

Grievance vs. appeal, Indiana timelines and statutes, filing deadlines by plan type, and external review.

When independent review applies, 120-day filing window, standard vs expedited timelines, and self-funded exceptions.

What ERISA self-funded plans are, how they differ from fully insured coverage, and how to appeal denials and build a strong record.

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