EyeMed Vision Care

Find your appeal rights based on your state below.

State of California

Your request for a review of an adverse benefit determination must be submitted within 180 days of the date of your Explanation of Payment.

A copy of the specific rule, guideline, or protocol relied upon in the adverse benefit determination will be provided free of charge upon request by you or your authorized representative. You may also review the documents relevant to your claim.

You may seek review by the California Department of Insurance of a claim that an insurer has contested or denied by contacting the California Department of Insurance Consumer Communications Bureau, 300 South Spring Street, South Tower, Los Angeles, CA 90013, or call the Consumer Hotline at 800.927.HELP (4357), 213.897.8921 for out-of-state callers, TDD at 800.482.4TDD (4833) or online at www.insurance.ca.gov.

You have a right to enter into the dispute resolution process described in Section 10123.13 of Article 1. General Provisions – California Insurance Code.

You may have other alternative dispute resolution options, such as mediation. One way to find out what may be available is to contact your local U.S. Department of Labor office and the California Department of Insurance.

State of Delaware

You have the right to seek review of our decision regarding the amount of your reimbursement. The Delaware Insurance Department provides claim arbitration services which are in addition to, but do not replace, any other legal or equitable right you may have to review of this decision or any right of review based on your contract with us. You can contact the Delaware Insurance Department for information about arbitration by calling the Arbitration Secretary at 302-674-7322 or by sending an email to: DOIarbitration@state.de.us. All requests for arbitration must be filed within 60 days from the date you receive this notice; otherwise, this decision will be final.

State of Illinois

If you are not satisfied with a coverage decision, you are entitled to a review (appeal) of the benefit determination.  To obtain a review, you or your authorized representative should submit your request in writing to:

Member Appeals Coordinator
EyeMed Vision Care
4000 Luxottica Place
Mason, OH  45040

Your request for a review of an adverse benefit determination must be submitted within 180 days of the date of your Explanation of Payment.

A copy of the specific rule, guideline, or protocol relied upon in the adverse benefit determination will be provided free of charge upon request by you or your authorized representative.  You may also review the documents relevant to your claim.

Notice of Availability:  Part 919 of the Rules of the Illinois Department of Insurance requires that our company advise you that, if you wish to take this matter up with the Illinois Department of Insurance, it maintains a Consumer Division in Chicago at 122 S. Michigan Ave., 19th Floor, Chicago, Illinois 60603 (312-814-2420) and in Springfield at 320 West Washington Street, Springfield, Illinois 62767 (217-782-4515) or contact the Illinois Department of Insurance at http://insurance.illinois.gov/.

You may have other alternative dispute resolution options, such as mediation.  One way to find out what may be available is to contact your local U.S. Department of Labor office and the Illinois Department of Insurance.