ERISA Appeal Letter (Employer Coverage)
Builds an employer-plan appeal that asserts the claimant's ERISA review rights.
Open the tool → Runs in your browser. Data leaves only if you deliberately send a problem report from the interactive tool.
Example
- Date the denial was received
- 2026-09-01
- Kind of claim
- Pre-service (approval before care)
- Claimant name
- Pat Doe
- Member ID
- X123
- Claim or reference number
- C-1
- Plan name
- Acme Plan
- Service, drug or item denied
- an MRI
- Letter date
- 2026-09-20
Result: The plan must accept the appeal through at least February 28, 2027. 1 blank left to fill before sending.
The tool opens with these values already filled in. Replace them with your own.
What you enter
- Date the denial was received (YYYY-MM-DD)
- Kind of claim
- Claimant name
- Member ID
- Claim or reference number
- Plan name
- Service, drug or item denied
- Letter date (YYYY-MM-DD; blank for today)
How this is calculated
Citation
29 CFR 2560.503-1(h): at least 180 days to appeal a group health denial; comments and documents considered; free copies of everything relevant; review without deference by someone not involved; consultation with a health care professional; experts named. Read the source ↗
A reference and educational tool. Not medical, legal, or financial advice, and not a substitute for clinician judgment.