The group major medical certificate of coverage (ACA compliant coverage), which I forwarded to the insured EE, has instructions on how to appeal a carrier decision. I am interested in how often this is successful in your experience as benefits professionals. This group includes about 30 EE's,some are personal friends. Not that I would do any differently, but it's a sensitive matter. The carrier has declined to approve the annual scan for recurrence of cancer that my client has been used to receiving for the last at least 2 years. I assume the carrier has some internal guidelines they follow, and either they have tightened them up, or it's after so many years of remission, they spread out the approval of rechecks. Thanks in advance.