Appeal ID#
    Employee Name
    Summary
    Date Received
    Trust Meeting Date
    Trust Meeting Date
    Trust Meeting Date
     
               
    03-001

    (02502-old)
    Monica Turner Waiver of Age Restriction (Medical Coverage)
    01/23/03
    01/27/03
       
    03-002

    (03841-old)
    Mickie Gundersen STD Refund  
    02/24/03
       
    03-003

    (03269-old)
    Sheri Ambacher Incorrect COBRA notice
    02/20/03
    02/24/03
       
    03-004
    Holly Hye Y Im-Hamper Dependent coverage  
    03/31/03
    04/28/03
     
    03-005
    Sakinah Aziza Nowbar Doctor's visit - wrong plan  
    03/31/03
    05/19/03
     
    03-006
    Lynne Rohling Dental Coverage Cancellation  
    03/31/03
       
    03-007
    Tracy Dickinson Change of Medical Plan
    03/21/03
    04/28/03
      OK  
    03-008
    Rick Robinson Enrollment of Spouse
    04/16/03
    04/28/03
      OK  
    03-009
    Connie King PAC - Alternative Care Treatment
    04/15/03
    04/28/03
      OK  
    03-010
    Rosalie Whetstone Othothics Reimbursement
    08/15/03
    08/25/03
    OK  
    03-011
    Nancy Miller Physical Therapy Visist  
    09/29/03
    OK  
    03-012
    Amy Garber Specialized testing for son  
    12/15/03
      01/26/04  
    04-001
    Forlander STD information not rec'd  
    03/15/04
    OK  
    04-02
    Elavsky, Edna Exec. Session (mental health claims-Non Network provider)
    07/07/04
    08/16/04
    OK  
    04-003
    Gundersen, Mickie Exec. Session (ex-spouse medical coverage)  
    08/16/04
    OK  
    04-004
    Elliott, Brien baby late to be signed up
    06/17/04
    08/16/04
    OK  
    05-001
    Rosemary Macauley plan exception (physical therapy)
    02/07/05
    02/28/05
       

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    Note:  Dottie brought an appeal (no number) to 9/27/04 trust meeting. No action was taken because the service isn’t covered under PPO plan & can’t be appealed .