Procedures for Federal External Review and Model Notices Relating to Internal Claims and Appeals and External Review under the Patient Protection and Affordable Care Act

Affordable Care Act Internal Claims and Appeals and External Review Procedures for ERISA Plans

OMB: 1210-0144

IC ID: 194302

Documents and Forms

Document Name Document Type
updated-model-notice-of-adverse-benefit-determination_1.17.25_clean.docx www.dol.gov/agencies/ebsa/employers-and-advisers/plan-administration-and-compliance/health-plans Other-Model
updated-model-notice-of-final-internal-adverse-benefit-determination_1.17.25_clean.docx www.dol.gov/agencies/ebsa/employers-and-advisers/plan-administration-and-compliance/health-plans Other-Model
updated-model-notice-of-final-external-review-decision_1.17.25_clean.docx www.dol.gov/agencies/ebsa/employers-and-advisers/plan-administration-and-compliance/health-plans Other-Model