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If you feel an adverse decision regarding your coverage has been made by BenefitHelp Solutions, you (or your authorized representative) have the right to appeal the decision.

First Level 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 your coverage termination.
  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 state and federal guidance regarding retiree and self pay coverage. Your chances of a successful appeal are greater if you familiarize yourself with your SPD and applicable state and federal laws 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 made by the first level appeal process, you are provided 60 days to file another written appeal for reconsideration. The BHS Appeals Committee will review all elements of your situation 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 level appeal, you have the right to file an action with the appropriate court challenging the decision.

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