Complaints, Grievances & Appeals

You have the right to file a suggestion, complaint or grievance
about Aetna, your plan, or a health care service, provider or
professional.

Use the Appeal, Formal Complaint or Suggestion Form to send your comments to Aetna.

Get help from your state

Your state insurance office can help you if you don’t agree with a decision made by your health plan or if you decide to appeal a decision.

  • Choose the state you live in if your medical plan is self-funded.
  • Choose the contract state if your medical plan is insured.

If you are not sure, ask your employer or call the toll-free number on the back of your medical plan ID card to find out which type of plan you have.


Get help from the federal government

The Health Care Reform law includes rules about appeals. Many plans have to follow these rules. If your plan is covered by the law*, you can contact the Employee Benefits Security Administration for help at 1-866-444-EBSA (3272).


Living outside the United States?

You may have a medical plan that covers you or your family while you’re living outside
the United States. If it's subject to the U.S. health care reform law, choose the state where the plan sponsor has its main place of business. Call the toll-free number on the back of your medical plan ID card if you're not sure.

Alabama

Alabama Department of Insurance
(334) 241-4141
http://www.aldoi.gov/

Alaska

Alaska Division of Insurance
(907) 269-7900 or 1-800- 467-8725 (In-state only)
http://www.commerce.state.ak.us/insurance/

American Samoa

Office of The Governor
011- (684) 633-4116

Arizona

Arizona Department of Insurance
(602)364-2499 or 1-800-325-2548 (in Arizona but outside Phoenix)
http://www.id.state.az.us/

Arkansas

For Insured Plans Only

Arkansas Insurance Department
1-800-852-5494 or (501) 371-2640
http://insurance.arkansas.gov/
Additional Consumer Assistance for Plans Subject to Health Care Reform Law*

Arkansas Insurance Department, Consumer Services Division
1200 West Third St.
Little Rock, AR 72201
(855) 332-2227
Insurance.consumers@arkansas.gov

* This generally applies to most insured and self-funded Medical plans effective or renewed on or after September 23, 2010.

This generally does not apply to:

  • Dental-only plans
  • Vision-only plans
  • Retiree-only plans
  • Medicare Advantage plans
  • Medicare Part D plans
  • Medicare Supplement plans

California (Traditional Plans)

For Insured Plans Only

California Department of Insurance
Consumer Hotline at 1-800-927-HELP
http://www.insurance.ca.gov/
Additional Consumer Assistance for Plans Subject to Health Care Reform Law*

California Consumer Assistance Program Operated by the California Department of Managed Health Care and Department of Insurance
980 9th Street, Suite #500
Sacramento, CA 95814
(888) 466-2219
http://www.HealthHelp.ca.gov

* This generally applies to most insured and self-funded Medical plans effective or renewed on or after September 23, 2010.

This generally does not apply to:

  • Dental-only plans
  • Vision-only plans
  • Retiree-only plans
  • Medicare Advantage plans
  • Medicare Part D plans
  • Medicare Supplement plans

California (HMO/DMO Plans)

For Insured Plans Only

California Department of Managed Health Care
980 9th Street, Suite 500
Sacramento, CA 95814
(888) 466-2219
http://www.healthhelp.ca.gov helpline@dmhc.ca.gov
Additional Consumer Assistance for Plans Subject to Health Care Reform Law*

California Consumer Assistance Program Operated by the California Department of Managed Health Care and Department of Insurance
980 9th Street, Suite #500
Sacramento, CA 95814
(888) 466-2219
http://www.HealthHelp.ca.gov

* This generally applies to most insured and self-funded Medical plans effective or renewed on or after September 23, 2010.

This generally does not apply to:

  • Dental-only plans
  • Vision-only plans
  • Retiree-only plans
  • Medicare Advantage plans
  • Medicare Part D plans
  • Medicare Supplement plans
California Processes
  • CA DMO Dental Grievance Form  (PDF, 73 KB)
  • California HMO/DMO Grievance Form - California residents can use this electronic form to file an HMO or DMO grievance, appeal or complaint. Printable versions (in PDF format) of this grievance form are available in:
  • A one-page printable document with information about member rights and responsibilities, as well as complaint and appeal procedures, is available:

Colorado

Colorado Division of Insurance
1-800- 930-3745 - Toll Free
http://www.dora.state.co.us/insurance/

Connecticut

For Insured Plans Only

Connecticut Department of Insurance
1-800-203-3447 or (860) 297-3900
http://www.ct.gov/cid/site/default.asp?ctportalPNavCtr=|27192|#45066
Additional Consumer Assistance for Plans Subject to Health Care Reform Law*

Connecticut Office of the Healthcare Advocate
P.O. Box 1543
Hartford, CT 06144
(866) 466-4446
www.ct.gov/oha
healthcare.advocate@ct.gov

* This generally applies to most insured and self-funded Medical plans effective or renewed on or after September 23, 2010.

This generally does not apply to:

  • Dental-only plans
  • Vision-only plans
  • Retiree-only plans
  • Medicare Advantage plans
  • Medicare Part D plans
  • Medicare Supplement plans
Connecticut Processes
  • Connecticut External Appeal Consumer Guide  (PDF, 100 KB)
  • Right to Appeal: For your information, you have the right to appeal to the Connecticut Insurance Commissioner after you have exhausted all appeals provided by Aetna. Your appeal to the Insurance Commissioner would have to be filed within 30 days of your having received notice of a final determination from Aetna. The Insurance Commissioner's address is P.O. Box 816, Hartford, CT 06142, and the telephone number is (860) 297-3910.

Delaware

For Insured Plans Only

Delaware Insurance Department
Call 1-800-282-8611 in Delaware or (302) 674-7310
http://delawareinsurance.gov/
Additional Consumer Assistance for Plans Subject to Health Care Reform Law*

Delaware Department of Insurance
841 Silver Lake Blvd
Dover, DE 19904
(800) 282-8611
consumer@state.de.us

* This generally applies to most insured and self-funded Medical plans effective or renewed on or after September 23, 2010.

This generally does not apply to:

  • Dental-only plans
  • Vision-only plans
  • Retiree-only plans
  • Medicare Advantage plans
  • Medicare Part D plans
  • Medicare Supplement plans

District of Columbia (DC)

For Insured Plans Only

District of Columbia Department of Insurance, Securities and Banking
(202) 727-8000
http://disr.dc.gov/disr/site/default.asp
Additional Consumer Assistance for Plans Subject to Health Care Reform Law*

DC Office of the Health Care Ombudsman and Bill of Rights
899 North Capitol Street,
NE, 6th Floor, Room 6037
Washington, DC 20002
(877) 685-6391
healthcareombudsman@dc.gov

* This generally applies to most insured and self-funded Medical plans effective or renewed on or after September 23, 2010.

This generally does not apply to:

  • Dental-only plans
  • Vision-only plans
  • Retiree-only plans
  • Medicare Advantage plans
  • Medicare Part D plans
  • Medicare Supplement plans

Florida

Florida Office of Insurance Regulation
1-877-693-5236 or (850) 413-3140
http://www.floir.com/

Georgia

For Insured Plans Only

Georgia Office of Insurance and Safety Fire Commissioner
(404) 656-2070 or (800) 656-2298
http://www.gainsurance.org/
Additional Consumer Assistance for Plans Subject to Health Care Reform Law*

Georgia Office of Insurance and Safety Fire Commissioner
Consumer Services Division
2 Martin Luther King, Jr. Drive
West Tower, Suite 716
Atlanta, Georgia 30334
(800) 656-2298
http://www.oci.ga.gov/ConsumerService/Home.aspx

* This generally applies to most insured and self-funded Medical plans effective or renewed on or after September 23, 2010.

This generally does not apply to:

  • Dental-only plans
  • Vision-only plans
  • Retiree-only plans
  • Medicare Advantage plans
  • Medicare Part D plans
  • Medicare Supplement plans

Guam

For Insured Plans Only

Guam Department of Revenue and Taxation
(671) 635-1817
https://www.guamtax.com/
Additional Consumer Assistance for Plans Subject to Health Care Reform Law*

Guam Department of Revenue and Taxation
1240 Army Drive
Barrigada, Guam 96921
(671) 635-1844

* This generally applies to most insured and self-funded Medical plans effective or renewed on or after September 23, 2010.

This generally does not apply to:

  • Dental-only plans
  • Vision-only plans
  • Retiree-only plans
  • Medicare Advantage plans
  • Medicare Part D plans
  • Medicare Supplement plans

Hawaii

Hawaii Department of Commerce & Consumer Affairs
Toll free numbers:
Kauai 274-3141, extension 73222;
Maui 984-2400;
Big Island 974-4000;
Molokai and Lanai 1-800-468-4644
http://hawaii.gov/dcca/ins/

Idaho

Idaho Department of Insurance
In Boise and the surrounding area phone: (208) 334-4250 or
Toll Free (in-state only) : 1-800-721-3272
http://www.doi.idaho.gov/

Illinois

For Insured Plans Only

Illinois Department of Insurance
Consumer Assistance Hotline toll-free number 866-445-5364
http://www.insurance.illinois.gov/
Additional Consumer Assistance for Plans Subject to Health Care Reform Law*

Illinois Department of Insurance
320 W. Washington St, 4th Floor
Springfield, IL 62727
(877) 527-9431
http://www.insurance.illinois.gov
DOI.Director@illinois.gov

* This generally applies to most insured and self-funded Medical plans effective or renewed on or after September 23, 2010.

This generally does not apply to:

  • Dental-only plans
  • Vision-only plans
  • Retiree-only plans
  • Medicare Advantage plans
  • Medicare Part D plans
  • Medicare Supplement plans

Indiana

Indiana Department of Insurance
consumer hotline at 1-800-622-4461
http://www.in.gov/idoi/

Iowa

For Insured Plans Only

Iowa Insurance Division
(515) 281-5705 or Toll Free: 877-955-1212
http://www.iid.state.ia.us/
Additional Consumer Assistance for Plans Subject to Health Care Reform Law*

Iowa Consumer Advocate Bureau
330 Maple St
Des Moines, IA 50319
(877) 955-1212
http://www.insuranceca.iowa.gov
consumer.advocate@iid.iowa.gov
* This generally applies to most insured and self-funded Medical plans effective or renewed on or after September 23, 2010.

This generally does not apply to:

  • Dental-only plans
  • Vision-only plans
  • Retiree-only plans
  • Medicare Advantage plans
  • Medicare Part D plans
  • Medicare Supplement plans

Kansas

For Insured Plans Only

Kansas Insurance Department
(785) 296-3071, Toll-free: 1-800-432-2484 (in Kansas only)
http://www.ksinsurance.org/
Additional Consumer Assistance for Plans Subject to Health Care Reform Law*

Kansas Insurance Department
Consumer Assistance Division
420 SW 9th Street
Topeka, KS 66612
(800) 432-2484 (in state)
785-296-7829 (all others)
http://www.ksinsurance.org
CAP@ksinsurance.org

* This generally applies to most insured and self-funded Medical plans effective or renewed on or after September 23, 2010.

This generally does not apply to:

  • Dental-only plans
  • Vision-only plans
  • Retiree-only plans
  • Medicare Advantage plans
  • Medicare Part D plans
  • Medicare Supplement plans

Kentucky

For Insured Plans Only

Kentucky Department of Insurance
1-800-595-6053 (option 1) or (502) 564-6034
http://insurance.ky.gov/
Additional Consumer Assistance for Plans Subject to Health Care Reform Law*

Kentucky Department of Insurance, Consumer Protection Division
P.O. Box 517
Frankfort, KY 40602
(877) 587-7222
http://insurance.ky.gov
DOI.CAPOmbudsman@ky.gov

* This generally applies to most insured and self-funded Medical plans effective or renewed on or after September 23, 2010.

This generally does not apply to:

  • Dental-only plans
  • Vision-only plans
  • Retiree-only plans
  • Medicare Advantage plans
  • Medicare Part D plans
  • Medicare Supplement plans

Louisiana

Louisiana Department of Insurance
1-800- 259-5300 -or- (225) 342-5900
http://www.ldi.la.gov/

Maine

For Insured Plans Only

Maine Bureau of Insurance
toll-free in Maine at 1-800-300-5000 or (207) 624-8475
http://www.maine.gov/pfr/insurance/
Additional Consumer Assistance for Plans Subject to Health Care Reform Law*

Consumer for Affordable Health Care
12 Church Street, PO Box 2490
Augusta, ME 04338-2490
(800) 965-7476
www.mainecahc.org
consumerhealth@mainecahc.org

* This generally applies to most insured and self-funded Medical plans effective or renewed on or after September 23, 2010.

This generally does not apply to:

  • Dental-only plans
  • Vision-only plans
  • Retiree-only plans
  • Medicare Advantage plans
  • Medicare Part D plans
  • Medicare Supplement plans

Maryland

For Insured Plans Only

Maryland Insurance Administration
(410) 468-2244 or 1-800-492-6116
http://www.mdinsurance.state.md.us/sa/jsp/Mia.jsp
Additional Consumer Assistance for Plans Subject to Health Care Reform Law*

Maryland Office of the Attorney General
Health Education and Advocacy Unit
200 St. Paul Place, 16th Floor
Baltimore, MD 21202
(877) 261-8807
http://www.oag.state.md.us/Consumer/HEAU.htm
heau@oag. state.md.us

* This generally applies to most insured and self-funded Medical plans effective or renewed on or after September 23, 2010.

This generally does not apply to:

  • Dental-only plans
  • Vision-only plans
  • Retiree-only plans
  • Medicare Advantage plans
  • Medicare Part D plans
  • Medicare Supplement plans

Massachusetts

For Insured Plans Only

Massachusetts Consumer Affairs & Business Regulation
(617) 521-7794 or (877) 563-4467 (Toll Free)
http://www.mass.gov/doi
Additional Consumer Assistance for Plans Subject to Health Care Reform Law*

Massachusetts Consumer Assistance
30 Winter Street, Suite 1004
Boston, MA 02108
(888) 211-6168
www.massconsumerassistance.org

* This generally applies to most insured and self-funded Medical plans effective or renewed on or after September 23, 2010.

This generally does not apply to:

  • Dental-only plans
  • Vision-only plans
  • Retiree-only plans
  • Medicare Advantage plans
  • Medicare Part D plans
  • Medicare Supplement plans

Michigan

For Insured Plans Only

Michigan Department of Licensing and Regulatory Affairs
1-877-999-6442
http://www.michigan.gov/dleg/0,1607,7-154-10555---,00.html
Additional Consumer Assistance for Plans Subject to Health Care Reform Law*

Michigan Health Insurance Consumer Assistance Program (HICAP)
Michigan Office of Financial and Insurance Regulation
P.O. Box 30220
Lansing, MI 48909
(877) 999-6442
http://michigan.gov/ofir
ofir-hicap@michigan.gov

* This generally applies to most insured and self-funded Medical plans effective or renewed on or after September 23, 2010.

This generally does not apply to:

  • Dental-only plans
  • Vision-only plans
  • Retiree-only plans
  • Medicare Advantage plans
  • Medicare Part D plans
  • Medicare Supplement plans

Minnesota

Minnesota Department of Commerce Insurance Gateway
(651) 296-2488 or statewide toll free at 1-800-657-3602
http://www.state.mn.us/portal/mn/jsp/home.do?agency=Insurance

Mississippi

For Insured Plans Only

Mississippi Department of Insurance
1-800-562-2957 or (601) 359-3569
http://www.mid.state.ms.us/

Missouri

For Insured Plans Only

Missouri Department of Insurance, Financial Institutions & Professional Registration
1-800-726-7390
http://insurance.mo.gov/
Additional Consumer Assistance for Plans Subject to Health Care Reform Law*

Missouri Department of Insurance
301 W. High Street, Room 830
Harry S. Truman State Office Building
Jefferson City, MO 65101
(800) 726-7390
www.insurance.mo.gov/
consumeraffairs@insurance.mo.gov

* This generally applies to most insured and self-funded Medical plans effective or renewed on or after September 23, 2010.

This generally does not apply to:

  • Dental-only plans
  • Vision-only plans
  • Retiree-only plans
  • Medicare Advantage plans
  • Medicare Part D plans
  • Medicare Supplement plans

Montana

For Insured Plans Only

Montana Office of the Commissioner of Securities and Insurance
(406) 444-2040
http://www.csi.mt.gov/
Additional Consumer Assistance for Plans Subject to Health Care Reform Law*

Montana Consumer Assistance Program
840 Helena Ave.
Helena, MT 59601
(800) 332-6148 (in-state only)
http://www.csi.mt.gov/

* This generally applies to most insured and self-funded Medical plans effective or renewed on or after September 23, 2010.

This generally does not apply to:

  • Dental-only plans
  • Vision-only plans
  • Retiree-only plans
  • Medicare Advantage plans
  • Medicare Part D plans
  • Medicare Supplement plans

Nebraska

Nebraska Department of Insurance
(402) 471-2201
http://www.doi.ne.gov/

Nevada

For Insured Plans Only

Nevada Division of Insurance
Carson City - (775) 687-0700 or Las Vegas - (702) 486-4009
http://www.doi.nv.gov/
Additional Consumer Assistance for Plans Subject to Health Care Reform Law*

Office of the Governor, Consumer Health Assistance
555 East Washington Ave #4800
Las Vegas, NV 89101
(702) 486-3587
(888) 333-1597
http://www.govcha.state.nv.gov
cha@govcha.state.nv.gov

* This generally applies to most insured and self-funded Medical plans effective or renewed on or after September 23, 2010.

This generally does not apply to:

  • Dental-only plans
  • Vision-only plans
  • Retiree-only plans
  • Medicare Advantage plans
  • Medicare Part D plans
  • Medicare Supplement plans

New Hampshire

For Insured Plans Only

New Hampshire Department of Insurance
(603) 271-2261 Consumer Hotline 1-800-852-3416
http://www.nh.gov/insurance/
Additional Consumer Assistance for Plans Subject to Health Care Reform Law*

New Hampshire Department of Insurance
21 South Fruit Street, Suite 14
Concord, NH 03301
(800) 852-3416
consumerservices@ins.nh.gov
http://www.nh.gov/insurance/

* This generally applies to most insured and self-funded Medical plans effective or renewed on or after September 23, 2010.

This generally does not apply to:

  • Dental-only plans
  • Vision-only plans
  • Retiree-only plans
  • Medicare Advantage plans
  • Medicare Part D plans
  • Medicare Supplement plans

New Jersey

For Insured Plans Only

State of New Jersey Department of Banking & Insurance
(609) 292-7272 or our Consumer Hotline 1-800-446-7467
http://www.state.nj.us/dobi/index.html
Additional Consumer Assistance for Plans Subject to Health Care Reform Law*

New Jersey Department of Banking and Insurance
20 West State Street, PO Box 329
Trenton, NJ 08625
(800) 446-7467
(888) 393-1062 (appeals)
http://www.state.nj.us/dobi/consumer.htm
ombudsman@dobi.state.nj.us

* This generally applies to most insured and self-funded Medical plans effective or renewed on or after September 23, 2010.

This generally does not apply to:

  • Dental-only plans
  • Vision-only plans
  • Retiree-only plans
  • Medicare Advantage plans
  • Medicare Part D plans
  • Medicare Supplement plans

New Mexico

For Insured Plans Only

New Mexico Public Regulation Commission
(505) 827-4548 or Toll Free 1-888-427-5772
http://www.nmprc.state.nm.us/id.htm
Additional Consumer Assistance for Plans Subject to Health Care Reform Law*

NM-PRC Insurance Division
Health Insurance Consumer Assistance Program
1120 Paseo De Peralta
Santa Fe, NM 87504
(855) 857-0972 or (888) 427-5772
(505) 476-0326 (fax)
http://www.nmprc.state.nm.us/id.htm (website)
mchb.grievance@state.nm.us (email)

* This generally applies to most insured and self-funded Medical plans effective or renewed on or after September 23, 2010.

This generally does not apply to:

  • Dental-only plans
  • Vision-only plans
  • Retiree-only plans
  • Medicare Advantage plans
  • Medicare Part D plans
  • Medicare Supplement plans

New York

For Insured Plans Only

New York State Department of Financial Services
1-800-342-3736, 212-480-6400, or (518) 474-6600
http://www.dfs.ny.gov/insurance/dfs_insurance.htm
Additional Consumer Assistance for Plans Subject to Health Care Reform Law*

Community Service Society of New York, Community Health Advocates
105 East 22nd Street, 8th floor
New York, NY 10010
(888) 614-5400
http://www.communityhealthadvocates.org/ cha@cssny.org

* This generally applies to most insured and self-funded Medical plans effective or renewed on or after September 23, 2010.

This generally does not apply to:

  • Dental-only plans
  • Vision-only plans
  • Retiree-only plans
  • Medicare Advantage plans
  • Medicare Part D plans
  • Medicare Supplement plans

North Carolina

For Insured Plans Only

North Carolina Department of Insurance
1-800-546-5664 (In-state only) or (919) 807-6750
http://www.ncdoi.com/
Additional Consumer Assistance for Plans Subject to Health Care Reform Law*

Mailing Address

North Carolina Department of Insurance
Health Insurance Smart NC
1201 Mail Service Center
Raleigh, NC 27699-1201
(877) 885-0231
http://www.ncdoi.com/Smart/

Delivery Service/Physical Address:

North Carolina Department of Insurance
Health Insurance Smart NC
430 N. Salisbury Street
Raleigh, NC 27603


* This generally applies to most insured and self-funded Medical plans effective or renewed on or after September 23, 2010.

This generally does not apply to:

  • Dental-only plans
  • Vision-only plans
  • Retiree-only plans
  • Medicare Advantage plans
  • Medicare Part D plans
  • Medicare Supplement plans

North Dakota

North Dakota Insurance Department
1-800.247.0560
http://www.nd.gov/ndins/

Ohio

Ohio Department of Insurance
consumer hotline at 1-800-686-1526
http://www.insurance.ohio.gov/Pages/default.aspx

Oklahoma

For Insured Plans Only

Oklahoma Insurance Department
1-800-522-0071 (in-state only) or (405) 521-2828
http://www.ok.gov/oid/
Additional Consumer Assistance for Plans Subject to Health Care Reform Law*

Oklahoma Insurance Department
Five Corporate Plaza
3625 Northwest 56th Street, Suite 100
Oklahoma City, OK 73112
(800) 522-0071 (in-state only)
(405) 521-2991
http://www.ok.gov/oid/Consumers/Consumer_Assistance/index.html

* This generally applies to most insured and self-funded Medical plans effective or renewed on or after September 23, 2010.

This generally does not apply to:

  • Dental-only plans
  • Vision-only plans
  • Retiree-only plans
  • Medicare Advantage plans
  • Medicare Part D plans
  • Medicare Supplement plans

Oregon

For Insured Plans Only

Oregon Insurance Division
(503) 947-7984 or toll-free 1-888-877-4894
http://www.cbs.state.or.us/external/ins/index.html
Additional Consumer Assistance for Plans Subject to Health Care Reform Law*

Oregon Health Connect
1435 NE 81st Ave. Suite 500
Portland, OR 97213-6759
(855) 999-3210
oregonhealthconnect.org
healthconnect@211info.org

* This generally applies to most insured and self-funded Medical plans effective or renewed on or after September 23, 2010.

This generally does not apply to:

  • Dental-only plans
  • Vision-only plans
  • Retiree-only plans
  • Medicare Advantage plans
  • Medicare Part D plans
  • Medicare Supplement plans

Pennsylvania

For Insured Plans Only

Pennsylvania Insurance Department
Consumer Hotline: 1-877-881-6388
http://www.insurance.pa.gov/portal/server.pt/community/insurance_department/4679
Additional Consumer Assistance for Plans Subject to Health Care Reform Law*

Pennsylvania Department of Insurance
1209 Strawberry Square
Harrisburg, PA 17111
(877) 881-6388
www.insurance.pa.gov

* This generally applies to most insured and self-funded Medical plans effective or renewed on or after September 23, 2010.

This generally does not apply to:

  • Dental-only plans
  • Vision-only plans
  • Retiree-only plans
  • Medicare Advantage plans
  • Medicare Part D plans
  • Medicare Supplement plans

Puerto Rico

For Insured Plans Only

Puerto Rico Office of the Commissioner of Insurance
(787) 304-8686
http://www.ocs.gobierno.pr/ocspr/
Additional Consumer Assistance for Plans Subject to Health Care Reform Law*

Puerto Rico Oficina de la Procuradora del Paciente
1215 Ponce de Leon
PDA 18
Santurce, PR 00907
(800) 981-0031
www.pacientes.gobierno.pr
querellas@opp.gobierno.pr

* This generally applies to most insured and self-funded Medical plans effective or renewed on or after September 23, 2010.

This generally does not apply to:

  • Dental-only plans
  • Vision-only plans
  • Retiree-only plans
  • Medicare Advantage plans
  • Medicare Part D plans
  • Medicare Supplement plans

Rhode Island

For Insured Plans Only

Rhode Island Department of Business Regulation
(401) 462-9500
http://www.dbr.state.ri.us/
Additional Consumer Assistance for Plans Subject to Health Care Reform Law*

Rhode Island Consumer Assistance Program
Rhode Island Parent Information Network, Inc.
1210 Pontiac Avenue
Cranston, RI 02920
(855) 747-3224
www.RIREACH.org

* This generally applies to most insured and self-funded Medical plans effective or renewed on or after September 23, 2010.

This generally does not apply to:

  • Dental-only plans
  • Vision-only plans
  • Retiree-only plans
  • Medicare Advantage plans
  • Medicare Part D plans
  • Medicare Supplement plans

South Carolina

For Insured Plans Only

South Carolina Department of Insurance
(803) 737-6160 or 1-800-768-3467
http://doi.sc.gov/Pages/default.aspx
Additional Consumer Assistance for Plans Subject to Health Care Reform Law*

South Carolina Department of Insurance
Consumer and Individual Licensing Services Division
P.O. Box 100105
Columbia, SC 29202
(800) 768-3467
http://www.doi.sc.gov
consumers@doi.sc.gov

* This generally applies to most insured and self-funded Medical plans effective or renewed on or after September 23, 2010.

This generally does not apply to:

  • Dental-only plans
  • Vision-only plans
  • Retiree-only plans
  • Medicare Advantage plans
  • Medicare Part D plans
  • Medicare Supplement plans

South Dakota

South Dakota Division of Insurance
(605) 773-3563
http://dlr.sd.gov/insurance/default.aspx

Tennessee

For Insured Plans Only

Tennessee Department of Commerce and Insurance
(615) 741-2241
http://www.state.tn.us/commerce/insurance/
Additional Consumer Assistance for Plans Subject to Health Care Reform Law*

Tennessee Department of Commerce and Insurance
500 James Robertson Pkwy
Davy Crockett Tower, 4th floor
Nashville, TN 37243-0574
(615) 741-2218 or
(800) 342-4029
(615) 532-7389 (Fax) www.tn.gov/commerce/insurance/


* This generally applies to most insured and self-funded Medical plans effective or renewed on or after September 23, 2010.

This generally does not apply to:

  • Dental-only plans
  • Vision-only plans
  • Retiree-only plans
  • Medicare Advantage plans
  • Medicare Part D plans
  • Medicare Supplement plans

Texas

For Insured Plans Only

Texas Department of Insurance
1-800-578-4677 or (512) 463-6169 in Austin
http://www.tdi.state.tx.us/
Additional Consumer Assistance for Plans Subject to Health Care Reform Law*

Texas Consumer Health Assistance Program
Texas Department of Insurance
Mail Code 111-1A
333 Guadalupe
P.O. Box 149091
Austin, TX 78714
(855) 839-2427 (855-TEX-CHAP)
www.texashealthoptions.com
chap@tdi.state.tx.us

* This generally applies to most insured and self-funded Medical plans effective or renewed on or after September 23, 2010.

This generally does not apply to:

  • Dental-only plans
  • Vision-only plans
  • Retiree-only plans
  • Medicare Advantage plans
  • Medicare Part D plans
  • Medicare Supplement plans

Utah

Utah Insurance Department
Salt Lake City area: (801) 538-3800 or In-state toll-free: 1-800-439-3805
http://www.insurance.utah.gov/

U.S. Virgin Islands

For Insured Plans Only

Virgin Island Office of the Lieutenant Governor
St. Thomas Complaints: (340) 774-7166
St. Croix Complaints: (340) 773-6459
http://ltg.gov.vi/
Additional Consumer Assistance for Plans Subject to Health Care Reform Law*

U.S. Virgin Islands Division of Banking and Insurance
1131 King Street, Suite 101
Christiansted
St. Croix, VI 00820
(340) 773-6459
http://ltg.gov.vi/

* This generally applies to most insured and self-funded Medical plans effective or renewed on or after September 23, 2010.

This generally does not apply to:

  • Dental-only plans
  • Vision-only plans
  • Retiree-only plans
  • Medicare Advantage plans
  • Medicare Part D plans
  • Medicare Supplement plans

Vermont

For Insured Plans Only

Vermont Department of Financial Regulation
at 1-800-631-7788 or (802) 828-3301
http://www.bishca.state.vt.us/
Additional Consumer Assistance for Plans Subject to Health Care Reform Law*

Vermont Legal Aid
264 North Winooski Ave.
Burlington, VT 05402
(800) 917-7787
www.vtlegalaid.org

* This generally applies to most insured and self-funded Medical plans effective or renewed on or after September 23, 2010.

This generally does not apply to:

  • Dental-only plans
  • Vision-only plans
  • Retiree-only plans
  • Medicare Advantage plans
  • Medicare Part D plans
  • Medicare Supplement plans

Virginia

For Insured Plans Only

Virginia State Corporation Commission
1-877-310-6560 or (804) 371-9691
http://www.scc.virginia.gov/division/boi/index.htm
Additional Consumer Assistance for Plans Subject to Health Care Reform Law*

Virginia State Corporation Commission
Life & Health Division, Bureau of Insurance
P.O. Box 1157
Richmond, VA 23218
(877) 310-6560
http://www.scc.virginia.gov/boi
bureauofinsurance@scc.virginia.gov

* This generally applies to most insured and self-funded Medical plans effective or renewed on or after September 23, 2010.

This generally does not apply to:

  • Dental-only plans
  • Vision-only plans
  • Retiree-only plans
  • Medicare Advantage plans
  • Medicare Part D plans
  • Medicare Supplement plans

Washington

For Insured Plans Only

Washington State Office of the Insurance Commissioner
1-800-562-6900 or (360) 725-7080
http://www.insurance.wa.gov/
Additional Consumer Assistance for Plans Subject to Health Care Reform Law*

Washington Consumer Assistance Program
5000 Capitol Blvd
Tumwater, WA 98501
(800) 562-6900
http://www.insurance.wa.gov/
cap@oic.wa.gov

* This generally applies to most insured and self-funded Medical plans effective or renewed on or after September 23, 2010.

This generally does not apply to:

  • Dental-only plans
  • Vision-only plans
  • Retiree-only plans
  • Medicare Advantage plans
  • Medicare Part D plans
  • Medicare Supplement plans

West Virginia

For Insured Plans Only

West Virginia Office of the Insurance Commissioner
1-888-TRY WVIC (888-879-9842)
http://www.wvinsurance.gov/
Additional Consumer Assistance for Plans Subject to Health Care Reform Law*

West Virginia Office of the Insurance Commissioner
Consumer Service Division
P.O. Box 50540
Charleston, WV 25305
(888) 879-9842
http://www.wvinsurance.gov/

* This generally applies to most insured and self-funded Medical plans effective or renewed on or after September 23, 2010.

This generally does not apply to:

  • Dental-only plans
  • Vision-only plans
  • Retiree-only plans
  • Medicare Advantage plans
  • Medicare Part D plans
  • Medicare Supplement plans

Wisconsin

Wisconsin Office of the Commissioner of Insurance
toll-free number at 1-800-236-8517 (within Wisconsin) or (608) 266-3585 (outside of Wisconsin)
http://oci.wi.gov/

Wyoming

Wyoming Insurance Department
(307) 777-7401 or In-state toll free: 1-800-438-5768
http://insurance.state.wy.us/

Important information for members who reside in a state other than New York
Learn More

If you are a member who lives in a state other than New York, please see this important information.

* This generally applies to most Medical plans effective or renewed on or after September 23,   2010.

This generally does not apply to:

  • Dental-only plans
  • Vision-only plans
  • Retiree-only plans
  • Medicare Advantage plans
  • Medicare Part D plans
  • Medicare Supplement plans

Legal Notices

Health Care Reform
Health Care Reform
How does health care reform affect you & your family? We've mapped out what you need to know.