How to file a claim

Claims should be filed with the claims administrator
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COVID-19 Extension for Filing Claims and Appeals

Due to the COVID-19 Pandemic and Declaration of National Emergency, the US Departments of Labor (DOL) and Treasury/IRS have provided revised guidance that extends deadlines related to filing claims and appeals under ERISA plans. The guidance states that every affected individual gets an extension to take actions based on when their claims event occurred. This extension applies to the following deadlines discussed in this claims section:
  • Filing a claim;
  • Appealing a claim denial;
  • Requesting an external review; and
  • Filing information needed to complete/perfect an external review request.
The extension pauses the deadline to take the above actions until the “Outbreak Period” for that individual is over. For each claims event, the Outbreak Period ends on the earlier of:
  • One year after the period starts for that event; or
  • 60 days after the Declaration of National Emergency ends. (The Declaration was recently extended and is still ongoing.)
Essentially, the claims and appeals deadlines for the actions listed above are extended (delayed) until the earlier of one year after the Outbreak Period starts for that event, or 60 days after the emergency declaration ends. The normal deadlines then apply. Here is an example:

Assume the National Emergency does not end until November 30, 2022. Kendrick submits a claim on August 1, 2021. The claim is denied on August 5, 2021. Under the plan, Kendrick would normally have 180 days to appeal the claim. However, Kendrick’s Outbreak Period for his appeal does not start until he receives his claims denial. Kendrick’s Outbreak Period will end on August 4, 2022. He will have 180 days after that to submit his appeal.

The rules for these extensions are complex and subject to change. Please contact the bp Benefits Center for assistance. However, since the end of the extension period is currently unknown, please do not delay submitting your claim or appeal in a timely manner.

To request benefits, contact John Hancock for a Certification Form. Complete the form and return it to John Hancock. You must be certified for benefits and meet the qualification period requirement before any benefits can be paid for covered services.

You may receive long-term care benefits in a check mailed to your home, or you may have them deposited directly into your bank account. Alternatively, you may elect to have your benefits paid directly to your caregiver.

 

Publication date: April 2017

 

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