{"id":4370,"date":"2017-11-23T11:32:18","date_gmt":"2017-11-23T19:32:18","guid":{"rendered":"http:\/\/hr.uw.edu\/benefits\/?page_id=4370"},"modified":"2018-01-16T17:18:43","modified_gmt":"2018-01-17T01:18:43","slug":"gaip-appeal-coverage-claims","status":"publish","type":"page","link":"https:\/\/hr.uw.edu\/benefits\/insurance\/health\/graduate-appointees\/gaip-appeal-coverage-claims\/","title":{"rendered":"GAIP: Appeal coverage or claims"},"content":{"rendered":"

You may appeal your eligibility for GAIP coverage, the eligibility of your dependents, or a denied claim.<\/p>\n

Appeal your coverage<\/h4>\n

The University has the authority to determine benefit eligibility under this plan. Benefits are paid only if you meet the eligibility and participation requirements.<\/p>\n

If you have eligibility questions or if you\u2019ve had a claim denied on grounds of ineligibility, contact the Benefits Office at uwgaip@uw.edu or 206-543-4444 to verify your eligibility status.<\/span><\/p>\n

If you are or were ineligible for coverage because of the delayed entry of your position and\/or distribution information, your department is responsible for filing an appeal for coverage. You must notify your department\u2019s graduate appointee coordinator within two working days of being informed that you do or do not have coverage.<\/span><\/p>\n

Please keep in mind that if you did not start working for the University on or before the first date of the quarterly coverage period, your insurance effective date may be delayed.<\/span><\/p>\n

Appeal dependent coverage<\/h4>\n

LifeWise Assurance Company (LifeWise)<\/a>, as the plan administrator, has the authority to determine benefit eligibility for dependents under this plan. Benefits are paid only if eligibility and participation requirements are met.<\/p>\n

If you have dependent eligibility questions or a family member has had a claim denied on grounds of ineligibility, contact LifeWise at 1-800-971-1491 (toll-free) or 1-800-842-5357 (TDD for hearing-impaired). A customer service representative will help you resolve the eligibility issue, eliminating the need to file a formal appeal.<\/p>\n

If you\u2019d rather communicate in writing or your eligibility issue can\u2019t be resolved with a phone call, you may file a written appeal. You have 90 days after receiving an eligibility determination notice (from the plan administrator) to submit a written appeal. The appeal must include:<\/p>\n