Reasons to Send an Appeal to the Health Benefits Trust Appeals Committee

1. Your health coverage eligibility or enrollment was denied.

You Have Three Ways to Submit an Appeal

1. Email: SEIU775BG-caregiver@magnacare.com.
2. Fax: 516-723-7395
3. Mail a letter to:

SEIU 775 Benefits Group
PO Box 24811
Seattle, WA 98124

What to Include in Your Appeal

1. Personal information including full name, date of birth and address.
2. Details around the decision you will appeal, including dates and names of anyone you have already spoken to.
3. Helpful documents, written comments or other information to support your appeal.

What to Expect

• Within 5 days of receipt, you will be provided a written notification acknowledging receipt of the appeal.
• Within 45 days, you will be notified in writing the outcome.
• All decisions made by the Health Benefits Trust Administrative Review Committee and Appeals Review Committee are final.

Questions?

Call (877) 606-6705.