The PEBB Program cannot assist you in this area. You will need to contact your plan. Review your health plan's Certificate of Coverage for an explanation of the process. If you have already filed an appeal with your plan and are not satisfied with the decision, contact your plan about further appeal rights.
If you have not received a response from your plan within the appeals timelines or have exhausted your plan's appeals process and still disagree, you may request an independent third-party review. Information on how to appeal a health care insurance decision is available from the state Office of the Insurance Commissioner at 1-800-562-6900 and online in the agency's Guide for Consumers.