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If you feel a claim has been inappropriately denied by BenefitHelp Solutions, you (or your authorized representative) have the right to appeal.

Informal Appeal

If your claim was denied due to a substantiation error, please resubmit your claim with the necessary documents to our customer service team at the address below. If you do not understand why your claim was denied, you may contact our customer service team for a more detailed explanation.

BenefitHelp Solutions
Attn: Claims
PO Box 67230
Portland, OR 97268

First Level Written Appeal

If you are not satisfied with the outcome of your informal appeal or your claim was denied due to ineligibility please submit a formal written appeal. For your convenience, please use the following form: Appeal Form

  1. Your appeal must be submitted in writing and mailed, emailed or faxed to:

    BenefitHelp Solutions
    Attn: BHS Appeals
    PO Box 67230
    Portland, OR 97268

  2. Your appeal must be received within 180 days of the date you received notification of the adverse decision to your account.

  3. Please include an explanation of why you disagree with the decision you are appealing. BHS is required to administer your plan as described in the Summary Plan Documents (SPD) provided by your employer and all Internal Revenue Service (IRS) regulations governing pretax benefit programs. Your chances of a successful appeal are greater if you familiarize yourself with your SPD and the IRS regulations and use them as the basis for your appeal.

  4. You may request copies of all documents and information related to your benefits at no cost to you.

Appeal review process

Second Level Written Appeal

If you disagree with the decision to uphold the denial of your claim, you are provided 60 days to file another written appeal for reconsideration. The BHS Appeals Committee will review all elements of your claim to ensure your appeal has been handled properly. A decision will be made within 30 days of the receipt of your additional written request. A letter will be provided regarding the outcome of the BHS Appeals Committee decision within 30 days of the receipt of your additional written request. If you disagree with the decision made in the second appeal, you have the right to file an action with the appropriate court challenging the decision.

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