Property of Bind Benefits, Inc., d/b/a Surest. All rights reserved © 2026. 57 8. What Do I Do If My Claim Is Denied? If your Pharmacy Claim is Denied See Section 13 (Outpatient Prescription Drugs). If Your Medical Claim is Denied If a medical Claim for Benefits is denied in part or in whole, you are encouraged to call Surest Member Services before requesting a formal appeal. If Surest Member Services cannot resolve the issue to your satisfaction over the phone, you have the right to file a formal appeal as described below. To submit a medical Claim appeal: 1. Contact Surest Member Services to request a medical Appeal Filing Form or refer to the medical Appeal Filing Form included with your Explanation of Benefits. 2. Complete the medical Appeal Filing Form. 3. Submit the completed medical Appeal Filing Form along with your denial notice and any supporting documentation to: Surest Consumer Affairs (Member Appeals) P.O. Box 31270 Salt Lake City, UT 84131 Review of a Medical Appeal Surest will conduct a full and fair review of your medical Claim appeal. You can send written comments, documents, records, and any other information you think will help decide the medical Claim appeal. You are entitled to receive, upon request and free of charge, reasonable access to and copies of all documents, records, and other information relevant to the Participant’s medical Claim for Benefits. “Relates to” means at least one of the following: • That we used the information to make the Benefit determination. • The information was submitted, used, or created while making the Benefit determination. • The information shows that we made the Benefit determination based on your Plan documents and made the same decision for other Plan Participants in the same situation. • The information is one of our policies or guidance. When Surest reviews your medical Claim appeal, Surest will take into account all comments, documents, records, and other information you give, even if we did not have that information when we denied the medical Claim. Surest adheres to the following review practices: • The appeal will be reviewed by an appropriate individual(s) who did not make the initial Benefit determination and who does not report to the person who did make the initial Benefit determination.