How to address a concern or appeal a decision

Find out the steps you can take if you have a concern about how the plan rules were applied.


Understanding how to address a concern

Concerns you can raise using the formal review process

You can use the formal review process to address your concerns about how the plan rules were applied in a decision that personally affects you.

You cannot use the process to suggest a change to the pension plan rules. You also cannot use it to address concerns about something that happened to someone else. However, you may represent someone else in this process.

Options if you disagree with the principle of the plan rule

If you disagree with the principle of the plan rule, you can write to the board about your concern. Although the board cannot act immediately on the issues you raise, your experience may help identify the need for future changes to the plan.

Addressing concerns about your retirement health and dental coverage

Coverage or claims
Contact Pacific Blue Cross directly to address your concerns about your extended health and dental coverage or claims.

You cannot use the plan’s formal review process to address decisions made by Pacific Blue Cross about coverage or claims. Pacific Blue Cross has its own process for addressing members’ concerns.

Enrolment
If you disagree with a decision made by the corporation about your eligibility to enrol in the extended health and dental plan, contact the plan.

Choosing to have someone act on your behalf

Although the process is designed to use on your own, you may choose to have someone act on your behalf. The board will not reimburse any costs you incur by having another person act on your behalf.

Getting legal advice or guidance about the review process

The board does not provide legal advice, guidance or recommendations about the review process. You may seek the advice of legal counsel at your own expense.


Related content for how to address a concern or appeal a decision

Appeal process

Plan rules

External links for how to address a concern or appeal a decision

Pacific Blue Cross

Office of the Ombudsperson