Who Do I Contact?

Contacts


Who Do I Contact?

Find contact information for all retiree health program questions. 

Appeals

Find process and contact information for appeals. 

  • State Health Benefits Program Appeals

    The State Health Benefits Program has a specific appeals procedure for retirees in self-funded plans administered by Anthem Blue Cross Blue Shield (Advantage 65, Advantage 65 – Medical Only, Option I, Option II) to review claims.

    • Request a review within 60 days of Anthem’s denial of a claim.
    • If you are not satisfied with the results, you can pursue two levels of appeals with the Claims Administrator.
    • If still unsatisfied, a final appeal can be requested in writing to the Commonwealth of Virginia Department of Human Resources Management
    • In situations requiring immediate medical care, Anthem provides a separate expedited emergency appeals process. Resolution will be provided within one business day of receipt of all information.

    Review and Two Levels of Appeals through Anthem BC/BS
    Anthem Blue Cross/Blue Shield
    804.355.8506 (in Richmond)
    800.552.2682 (outside Richmond)
    www.anthem.com

    Final Appeal
    Claims must be $300+ to be eligible for this process. Within 60 days of the 2nd level appeals decision, submit your final appeal in writing to:
    Dept. of Human Resource Management
    Office of State and Local Health Benefits
    101 N. 14th Street, 13th floor
    Richmond, Virginia 23219

  • UVA Health and Dental Plan Appeals

    UVA Health Plan has specific appeals procedures to review claims. You can request two levels of appeals with the Claims Administrator (Aetna).

    • OptumRx performs appeals for prescription drug coverage.
    • UCCI performs appeals for the UVA Dental Plan.

    If you are not satisfied with the decision of the Claims Administrator, you may pursue the decision further by requesting external review. In emergency or urgent circumstances, you may request an expedited emergency appeals procedure. Resolution will be provided within one business day of receipt in situations requiring immediate medical care.

    UVA Health and Dental Plan Appeals Process

    Two Levels of Appeals through Aetna
    Aetna
    888.975.9557
    www.aetna.com

    Final Appeal through Aetna
    Appeals addressing medical decisions may be pursued further. Within 123 days of receiving a 2nd level appeals decision, submit your request to Aetna at 888.975.9557.

    Submit Dental Appeals through UCCI
    www.ucci.com
    866.215.2354

    External Review through UCCI
    Within 4 months of 2nd level appeals decision, submit your final appeal in writing to:
    UCCI Appeals
    P.O. Box 69420
    Harrisburg, PA 17110