Right to Submit Grievance Regarding Cancellation, Rescission, or Nonrenewal of Your Plan Enrollment, Subscription, or Contract

OPTION (1) - YOU MAY SUBMIT A GRIEVANCE TO YOUR PLAN.

You can submit a grievance to EYEXAM of California through this website by clicking below.

You may also submit a grievance to EYEXAM of California by calling 1-888-439-3392 or by mailing your written grievance to:

EYEXAM of California, Inc.
P.O. Box 2756
Mission Viejo, CA 92690

You may want to submit your grievance to EYEXAM of California first if you believe your cancellation, rescission, or nonrenewal is the result of a mistake. Grievances should be submitted as soon as possible. EYEXAM of California will resolve your grievance or provide a pending status within three (3) calendar days. If you are not satisfied in any way with the Plan's response, you may submit a grievance to the Department as detailed under Option 2 below.

OPTION (2) - YOU MAY SUBMIT A GRIEVANCE DIRECTLY TO THE DEPARTMENT OF MANAGED HEALTH CARE.

You may submit a grievance to the Department without first submitting it to the Plan or after you have received the Plan's decision on your grievance. You may submit a grievance to the Department on the internet website at: www.dmhc.ca.gov.

You may submit a grievance to the Department by mailing in your written grievance to:

HELP CENTER
DEPARTMENT OF MANAGED HEALTH CARE
980 NINTH STREET, SUITE 500
SACRAMENTO, CALIFORNIA 95814-2725

You may contact the Department of Managed Health Care for more information on filing a grievance at
PHONE: 1-888-466-2219, TDD: 1-877-688-9891, or FAX: 1-916-255-5241

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Right to Submit Grievance Regarding Cancellation, Rescission, or Nonrenewal of Your Plan Enrollment, Subscription, or Contract