#6 Appeal - Independence Blue Cross

#6 Appeal Self Insured/Non-Grandfathered Subject to Health Care Reform PA HMO, PPO, POS, Trad IBC is claim fiduciary IBC does the entire Appeal process Group is claim fiduciary - IBC does the entire Appeal process ; Group has the final determination (08/2016) I M P O R T A N T I N F O R M A T I ON I F Y O U C H O O S E T O AP P E A L We want to help you understand your benefits and the reasons for this determination. Please contact a Member Services Representative at the number on the back of your plan ID card to discuss your questions and concerns. If you are dissatisfied with this decision, you, or someone you name to act for you as your authorized representative (designee), including an attorney, have the right to Appeal the denial.

#6 Appeal Self Insured/Non-Grandfathered – Subject to Health Care Reform PA – HMO, PPO, POS, Trad IBC is claim fiduciary – IBC does the entire appeal process Group is claim fiduciary - IBC does the entire appeal process; Group has the final determination

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