Sec. 9720.4. Notice of determination after reconsideration

Latest version.

(a) After having reviewed an action, or failure to act, which denied, discontinued, suspended or reduced coverage pursuant to the mandatory reconsideration process provided for in Part 9630 of this Title, the contractor shall issue a written notice of determination after reconsideration to the applicant or participant requesting the reconsideration.
(b) The notice shall be issued within three days of the determination and mailed to the applicant's/participant's designated address.
(c) The notice shall clearly state the determination made, the basis and specific reasons for the determination, the action to be taken and the effective date of the action, and shall include information concerning the right to a fair hearing.

                    
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