Medical Provider Informational Memorandum

Disputes involving Self-insured Non-Governmental Plans should be referred to the:

U.S. Department of Labor

* Employee Benefit Security Administration
1000 S. Pine Island Road, Suite 100
Plantation, FL 33324
Toll Free Helpline: 1-866-275-7922 or Direct: 954-424-4022

* NOTE: As per the U.S. Department of Labor, complaints must be filed by the patient/insured or his/her legal representative).

Disputes involving Federal Employee Plans should be referred to the:

U.S. Office of Personnel Management

Federal Employee Health Benefit Programs
Insurance Review Division, #1
1900 E. Street NW
Washington, DC 20415-3500
Telephone Number: (202) 606-0727

Disputes involving Tricare (Military) Claims should be referred to the:

Palmetto Government Benefits Administration

Tricare Claims Department
PO Box 7031
Camden, SC 29020-7031
Toll Free Number: 1-800-403-3950 South Region or
Web site Address: www.tricare.osd.mil