Appeals & Grievances

Use this secure form to file a grievance or appeal a dental benefits decision. Note: Please refer to the vision appeals packet for information on submitting DeltaVision Administered by EyeMed appeals.

Important Information

Questions?

Hours:
Monday - Thursday: 7:30 A.M. - 5 P.M.
Friday: 7:30 A.M. - 4:30 P.M.

Toll-free Phone:
800.352.6132