Claim Appeal Procedures
If your claim is denied in whole or in part, or if you
disagree with the decision made on a claim, you may ask
for a review. Your request for review must be made in
writing to the Claim Administrator responsible for making
the initial determination within 180 days after you receive
notice of denial. Appeals should be made to the address
indicated on the notice you receive from the Claim
Administrator. Appeals involving Urgent Care Claims may
be made orally by calling the applicable Claim Administrator
at the number listed on the back of your ID card. Currently, Cigna and Cigna Behavioral Health maintain a two-level appeal procedure. CVS Caremark maintains a one-level appeal procedure. If you request a review for a claim’s denial due to an assertion that you or your dependents were not eligible for a benefit, such a request should be made to:
Board of Trustees
MILA Managed Health Care Trust Fund
55 Broadway, 27th Floor
New York, NY 10006
Telephone number: (212) 766-5700>
Fax number: (212) 766-0844/0845
E-mail: info@milamhctf.com