Health plan rules must explain how to obtain benefits and must include written procedures for processing claims. Claims procedures must be described in the Summary Plan Description.
You should submit a claim for benefits in accordance with the plan's rules for filing claims. If the claim is denied, you must be given notice of the denial in writing generally within 90 days after the claim is filed. The notice should state the reasons for the denial, any additional information needed to support the claim, and procedures for appealing the denial.
You will have at least 60 days to appeal a denial and you must receive a decision on the appeal generally within 60 days after that.
Contact the plan administrator for more information on filing a claim for benefits. Complete plan rules are available from employers or benefits offices. There can be charges up to 25 cents a page for copies of plan rules.
Copyright 2007 COBRA Insurance
.com - COBRA Insurance Information Source. All rights
reserved.
Important
Disclaimer: COBRA is a law (It is not an endorsed
insurance plan or company). Answers and comments provided
on
Cobra insurance .com website are general information,
and are not intended to substitute for informed professional
medical, psychiatric, psychological, tax, legal, investment,
accounting, governmental, or other professional advice.
Cobra
insurance .com does not endorse, and expressly disclaims
liability for any product, manufacturer, distributor,
service, health plan, or service provider mentioned or any
opinion expressed in the website. Replies, comments, or
information gathered on
Cobra
insurance .com website may not be accurate but are
intended to be helpful.
Search COBRA Insurance Questions
Browse by Category
Print this page
Email this page
Post a comment
Subscribe me
Add to favorites
