FILING A FORMAL COMPLAINT AGAINST YOUR MEDICAL PLAN

If you have a problem with your medical plan (insurance) regarding coverage or with payments, you should call the Benefits Office at 1-650- 723-5734 or click here to email them with the particulars. You can also speak with one of the Benefits Specialists in person, Monday through Friday from 0900 to 1700 in their Satellite Office across the hall from the Stanford Hospital and Clinic Gift Shop. In addition, you can call the CRONA office 650 366 0156 or
contact us by email.

If after all these steps, there remains an unresolved issue, you can file a formal complaint.

If you need to file a formal complaint about your medical plan, follow the following steps:

Write a letter of complaint to the medical insurance carrier, i.e. CIGNA or Kaiser. If the insurance carrier does not respond within thirty (30) days, or if you are not satisfied with their response, contact:

The Department of Managed Health Care
980 9th Street, Suite 500
Sacramento, CA. 95814

Or

Calling the Help Line at 1-888-466-2219

Or

Downloading the Consumer Complaint Form at www.dmhc.com.gov

• Click on “Getting Help With Your HMO”
• Click on “Consumer Complaint Form”
• Attach Additional pages, if necessary.
• Mail the complaint form to the above address or Fax 1-916-229-0465.

You will receive a letter from the Department of Managed Health Care confirming receipt of your complaint. A case number will be assigned to your complaint. A second letter will be sent to you within thirty (30) days with the outcome of your complaint.