Stronger Appeal Process also Rejected

Similarly, some commenters requested that OPM hear appeals of insurability decisions made by the carrier. OPM said it believes the current process “ensures that individuals with adequate training are able to conduct the proper review of appeals. In addition, appeals that go beyond the internal review processes of Long Term Care Partners are handled by an independent, third party vendor, approved by OPM. We believe it is in the best interest of the Federal Long Term Care Insurance Program to leave insurability decisions to trained underwriters, as we do with the Federal Employees’ Group Life Insurance Program.” However, OPM did adopt a suggestion to clarify that any appeal of the carrier’s reconsideration decision is to be made directly to the carrier and not OPM.