Request help from the Department of Labor
Ask the federal agency that oversees employer health plans to look at how your plan handled your claim and tell you your next steps.
- Private: nothing leaves this tab
- A template, not legal advice
This one is for a specific kind of coverage
It is written for the coverage tagged above. If you have a different kind (for example Medicare or Medicaid instead of a job-based or individual plan), it may cite the wrong rules. Check what kind of coverage you have and use the letter written for it.
When to use this, and what it is not
When to use this. When your coverage comes through a private employer or a union and the plan has mishandled your claim or appeal. It matters most when your employer pays claims itself (a self-funded plan), because the state insurance department usually cannot act. A request for help does NOT stop an appeal deadline: keep filing your appeal and your external review request on time.
This is a template, not legal advice. Read it, change anything that is not true for you, and send it only when you are satisfied. Your notice and your plan document control.
Fill in the letter
Your letter
[Your name] [Your address]
13 November 2026
[Name and address of the Employee Benefits Security Administration office you are writing to]
Re: Request help from the Department of Labor Plan: [Name of the health plan] Member ID: [Member ID] Claim or reference number: [Claim or reference number]
To whom it may concern:
I am asking the Employee Benefits Security Administration (EBSA) at the United States Department of Labor for help with my employer health plan. I am covered by [Name of the health plan] through [Your employer's name]. My member identification (ID) number is [Member ID] and my claim number is [Claim or reference number].
The plan denied [The care or drug that was denied] on [Date on the denial notice]. The care was provided or requested on [Date of the care] by [Doctor, hospital or pharmacy].
What the plan did: [What the plan did]
What I have already done, with dates: [What you already did, with dates]
I ask EBSA to: 1. Look at whether the plan followed the federal claims and appeal rules in handling my claim. 2. Contact the plan about the problem I describe above. 3. Tell me which steps I have left, and in what order. 4. Tell me in writing, or by phone at [A phone number where you can be reached], what you decide to do.
I have enclosed copies of the denial notices and my appeal, so that you can see the dates. Please tell me if you need anything else from me. I understand that this request does not stop my appeal deadlines, and I will keep to them.
Enclosures: 1. Copy of the denial notices 2. Copy of your appeal letter, with proof of the date you sent it 3. Your written request for plan documents, if you made one 4. Your log of calls and letters
Sincerely, [Your name]
Before you send it
Call EBSA Benefits Advisors at 1-866-444-3272, or use the Ask EBSA form on the Department of Labor website, and ask how to send this letter and your papers. Ask for a reference number and write down the name of the person you speak with.
What to enclose
- Copy of the denial notices
- Copy of your appeal letter, with proof of the date you sent it
- Your written request for plan documents, if you made one
- Your log of calls and letters
What happens next
- Keep every deadline. For most job-based plans you have at least 180 days after receiving a denial notice to appeal, and at least four months after a final denial to request external review. Check the date on your notice, which controls.
- Ask EBSA what it can do in your case and how long it expects to take. Do not assume it will change the plan's decision.
- To find out whether your plan is self-funded, read your summary plan description. It must identify any insurance company and say whether benefits are guaranteed by an insurance contract.
- A self-funded plan uses the federal external review process run by private independent review organizations. Your denial notice should say how to ask.
- If you are writing for someone else, tick "I am writing for someone else". The office you are writing to may require its own authorization form. See the letter "Name someone to act for you".