Submit an Appeal

Please complete the form below if you have an appeal related to your benefits (not including a Reduced Deductible). If you recently had a Life Event that would impact your Reduced Deductible status (i.e., divorce, marriage, etc.), please complete the Reduced Deductible Appeal Form.

Provide complete information and attach any supporting documentation that can assist in making a determination. You will receive a letter via US mail once a determination is made. Please allow up to 30 days for your appeal to be processed.

Begin Your Benefits Appeal