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- Title
DENIAL OF COVERAGE.
- Abstract
In the case of "Donna Coe Winters v. Costco Wholesale Corp.," the U.S. Ninth Circuit Court of Appeals explained that the health plan administrator did not abuse its discretion in denying coverage of a participant's gamete intrafallopian transfer procedure where company's self-insured ERISA health benefits plan explicitly excluded in vitro fertilization procedures but failed to mention gamete procedures. The Court noted that, because the employer was the administrator, a conflict of interest exists, and it ruled that a more stringent abuse of discretion standard must be imposed.
- Subjects
UNITED States; LEGAL judgments; UNITED States. Court of Appeals (9th Circuit); WINTERS, Donna Coe; COSTCO Wholesale Corp.; HEALTH planning laws; SELF-insurance; HEALTH insurance; HUMAN artificial insemination -- Law &; legislation; ACTIONS &; defenses (Law)
- Publication
Benefits Quarterly, 1996, Vol 12, Issue 3, p89
- ISSN
8756-1263
- Publication type
Article