The SHBP appeals process is a transaction between the employee and SHBP that should never involve the Employer. Therefore, Employers should never file an appeal on behalf of an employee.
The appeals process allows your employees an opportunity to have decisions reviewed regarding their SHBP coverage. Therefore, it is extremely important that your employees act within the timeframes provided so they do not miss their opportunity to file an appeal.
Frequently Asked Questions
Should Employers Discourage Employees from Filing an Appeal?
The Employer may provide supporting documentation to the employee to submit to SHBP with their appeal. However, Employers should never advise their employees against filing an appeal.
What If an Employer Discourages an Employee From Filing an Appeal?
The employee will be responsible for any negative impact to their coverage, including the missed opportunity to have a coverage decision reviewed by SHBP, due to their reliance on misinformation from their employer.
What Should an Employer Do If SHBP Directs the Employer to Advise an Employee Submit an Appeal?
Immediately contact the employee and provide them the link to the Appeals section of our website by clicking here.
What Should Employers Do If an Employee is Unhappy with a Decision SHBP Has Made Regarding Their Coverage?
Direct the employee to the Appeals section of our website by clicking here.