What is and is not covered is set by your employer. That is the “plan design” they either choose entirely (for self funded plans) or pick a group’s plan to join

What is and is not covered is set by your employer. That is the “plan design” they either choose entirely (for self funded plans) or pick a group’s plan to join (group plans) The surprise third party provider bills are kind of a separate issue, in that it was a scam every insurance company did. we’re mostly protected by the “no surprises act” that went into effect jan ‘22