Frequently Asked Questions

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BENEFITS TOPICS



BENEFITS APPEALS PROCESS


  • How do I file an appeal regarding my eligibility for benefits coverage, participation or contributions?

Emory will make all determinations about written claims/appeals relating to eligibility for coverage, participation, contributions, or other administrative aspects of the Plan. Emory may require you to provide any information deemed necessary to make a decision about your claim/appeal. View Appeal Procedures.

  • How do I file an appeal regarding individual claims payments?

For appeals related to claims payments under the health, dental and flexible spending accounts, Emory’s contracted claims administrators have been delegated authority to accept first and second level appeals, review them and render decisions about claims payments relating to benefits paid or payable under the Plan. View Appeal Procedures.