Allen v. SC Public Employee Benefit Authority

Appellant Jeffrey Allen, on behalf of his daughter, appealed the Administrative Law Court's (ALC) order affirming the Appeals Committee of the South Carolina Budget and Control Board Employee Insurance Program's (EIP Appeals Committee) decision to deny Appellant's insurance claim for his daughter's diabetes educational training session. Blue Cross's Appeals Review Committee upheld the denial of benefits on the basis that diabetes educational training was excluded under the State Health Plan, and that section 38-71-46 of the South Carolina Code, did not apply to the State Health Plan. Upon review, the Supreme Court reversed the ALC's decision that section 38-71­46 of the South Carolina Code did not apply to this matter. The EIP was mandated to promptly determine and pay the benefits that were due for Appellant's daughter under the State Health Plan. View "Allen v. SC Public Employee Benefit Authority" on Justia Law