Appeals
If you disagree with the way a claim has been handled, you can request an appeal or grievance review within 60 days of the initial decision. However, if the specific service requested is specifically stated as non-covered in your Benefit Booklet, the claim decision cannot be appealed.
Appeals Form (PDF, 28KB)
Use this form to appeal a decision or request a grievance review.
Appeals Form (PDF, 28KB)
Use this form to appeal a decision or request a grievance review.
