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Appeals

If you disagree with a decision about a claim or a request for coverage, you have the right to an appeal. Also, if you have a complaint regarding the plan, the care, or the courtesy received from a contracting provider, or his or her staff, you have the right to a review.

You begin by calling GEMGroup at 1-(800) 424-2707 and they will do their best to resolve the matter as quickly as possible.

Appeals and grievances procedures

If GEMGroup is unable to resolve your problem or concern to your satisfaction, you may write a letter of Appeal to the Board of Trustees. All letters must include the following: Members name Identification number Description of the issue All relevant dates Names of Physicians, other medical providers, or administrative staff involved with the case Details of any attempts to resolve the case Address the letter to: Board of Trustees Beverage and Brewery Drivers Health and Welfare Fund c/o GEMGroup The Constellation Centre One 6009 Oxon Hill Road, Suite 416 Oxon Hill, MD 20745

The Fund must receive your appeal:

• Within one year of the date of treatment;
• Within 30 days of when you were told of the service or claim denial.

The Trustees will investigate the case and contact you in writing of the decision.  The Fund will will make every effort to review appeals quickly for health care services you're receiving now or plan to receive. You will receive a letter from the Fund Office letting you know of the Boards decision.

Important Notice: This website provides only a brief explanation of the Health and Welfare Plan under the Beverage and Brewery Local 67 Health and Welfare Trust Fund. It is not a summary plan description. If there are any inconsistencies between this explanation and the Plan document, the Plan document shall control. Also, please refer to the Summary Plan Description for additional information about the benefits available and procedures of the Beverage and Brewery Local 67 Health and Welfare Trust Fund or contact the Welfare Fund Office.

Copyright 2007 Teamsters Local 67. All Rights Reserved
2120 Bladensburg Rd., NE
 Washington, DC 20018