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Text of Revised Model Notice of Adverse Benefit Determination, from EBSA
Employee Benefits Security Administration [EBSA], U.S. Department of Labor [DOL] Link to more items from this source
[Official Guidance]
Sept. 22, 2010
Microsoft Word document; 2 pages. Excerpt: [Q:] The Departments' regulations make changes to shorten the times for making initial determinations with respect to urgent care claims, but did not make any changes to the times for making internal appeals decisions. The Departments' model notice of adverse benefit determination issued on August 23, 2010, was unclear as to which times have been shortened. What is the rule? [A:] Only the times for making the initial benefit determination were changed. The Departments have revised the model notice to eliminate confusion. The revised notice includes a header that reads, 'Revised as of September 20, 2010.'

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