If your health plan is with an insurance company and your coverage is still denied after the external review process, you can file a complaint with the Minnesota Department of Commerce. Your complaint should include the following information:

  • The name, address, email address, and telephone number of the person filing the complaint (“Complainant”);
  • The Complainant’s relationship to the insured individual;
  • The name of the insured individual, if different than the Complainant;
  • The name and address of the insurance company;
  • The policy number, group number, certificate number, claim number, and date of loss/treatment;
  • The name of the employer, if a group plan;
  • The reason for the complaint; and
  • A description of the problem.[34]

You should submit the following documents as supporting information:

  • A copy of your insurance card; copies of coverage denials or adverse benefit determinations from your insurer;
  • Copies of any determinations made by internal and external reviewers;
  • Any materials submitted with prior appeals and complaints;
  • Supporting documentation from your doctor;
  • A copy of your insurance policy; and
  • All responses from your insurer.[35]

You can find a copy of the complaint form here. You can also submit your complaint and supporting documents online here or mail them to:[36]

Minnesota Department of Commerce
Attn: Consumer Protection & Education Division
85 7th Place East, Suite 500
St. Paul, MN 55101