This section provides information about the appeals processes in each state.  The General Information and Internal Plan Review section for each state includes basic information about the state's appeal procedures and state requirements that health plans must follow for internal appeals.  The external review procedures for the states are shown in tables that present an outline of the state's process and contact information, current as of August 2004.  Notice that states typically require you to go through your health plan's internal appeal process before you can begin the external review process.  If you have questions, call the state agency or go to the state web site listed at the bottom of each state's table.

If you have an employer-sponsored health plan, federal law may provide you with additional or alternative appeal rights.  Federal law requires that employer-sponsored health plans must have internal appeal processes that meet federal standards.  These federal requirements may add to the rights that you have under state law.  To learn more about federal internal appeal procedures for employer-sponsored plans, contact the Department of Labor’s Employee Benefits Security Administration (EBSA) by calling 1-866-444-3272, or locate an EBSA regional office at http://www.dol.gov/ebsa/aboutebsa/org_chart.html#section13.  If you are covered through an employer-sponsored health plan that is self-funded, you generally will not be entitled to use your state’s external review process.  Check with your state or with the Department of Labor to be sure.