Employer Plan Claim and Appeal Clock (ERISA)
Employer health plan claim and appeal deadline under ERISA.
Open the tool → Runs in your browser. Data leaves only if you deliberately send a problem report from the interactive tool.
Example
- Kind of claim
- Pre-service (approval before care)
- Claim or appeal
- The plan is deciding the claim
- Plan received it
- 2026-10-01T09:00
- Claims only
- No
Result: 29 CFR 2560.503-1(f)(2)(iii)(A): decision due October 16, 2026 (15 days after receipt).
The tool opens with these values already filled in. Replace them with your own.
What you enter
- Kind of claim
- Claim or appeal
- Plan received it (YYYY-MM-DD, or YYYY-MM-DDTHH:MM for urgent and concurrent care)
- Claims only: plan took its 15-day extension
- Date of the extension notice (YYYY-MM-DD)
- Appeals only: one or two levels
- Date the denial was received (YYYY-MM-DD)
How this is calculated
Citation
29 CFR 2560.503-1: urgent care 72 hours; concurrent care 24 hours; pre-service 15 days and post-service 30 days, each with one 15-day extension; appeals at least 180 days to file, decided in 72 hours, 30 or 15 days (pre-service) and 60 or 30 days (post-service). Read the source ↗
A reference and educational tool. Not medical, legal, or financial advice, and not a substitute for clinician judgment.