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What are the claims administration/appeals procedures time frames for?

All benefits need to provide the time frames for claims administration or appeals notifications. If these procedures are stated within any benefit policy, certificate or booklet, those time frames take precedent over the information in the Wrap plan. If there is a situation where a particular benefit does not state the time frames for the claims administration or appeals notifications, the Wrap plan would govern this information. Almost all employers use the federal maximums in their Wrap plan.

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