If Eligibility Is Denied
To participate in a benefit plan, you and your dependents must meet the eligibility requirements and enroll or change your enrollment in the time frames specified by the plan. Before filing an eligibility claim, you may call the PG&E Benefits Service Center first to see if the eligibility issue can be resolved informally.
If you are not satisfied with the outcome of your contact with the PG&E Benefits Service Center, you may file an eligibility claim with the Plan Administrator by writing to:
Pacific Gas and Electric Company
Benefits Department, 7th Floor
Plan Administrator Appeals
1850 Gateway Boulevard
Concord, CA 94520
If the Benefits Department denies your claim, you will receive written notice of the denial within 90 days of receipt of the initial claim unless, due to special circumstances, an additional 60 days is required. Such notification will set forth:
  • the specific reason(s) for the denial of the claim;
  • a reference to the Plan provisions which apply to the denial;
  • a description of any additional material or information necessary for a participant or beneficiary to perfect the claim and an explanation of why such material or information is necessary; and
  • a description of the Plan's review procedures and the time limits applicable to such procedures.
Eligibility Appeals
If you are not satisfied with the Benefit Department's decision, you may then submit a written appeal for review (within 60 days of receiving the Benefits Department's notice of denial) to the Employee Benefit Appeals Committee (EBAC), the final adjudicator in the appeals process, stating the reasons for your appeal and enclosing all documentation and any additional information to support your appeal.
No special form or format is required in submitting a written appeal; you may submit written comments, documents, records, and other information relating to your claim. You may also request, free of charge, access to, or copies of, all documents, records, and other information relevant to your claim for benefits. The review will take into account all comments, documents, records, and other information submitted by you relating to your claim, without regard to whether such information was submitted or considered at the initial benefit determination.
Send your appeal to:
Pacific Gas and Electric Company
Benefits Department
EBAC Appeals
Benefits Department
1850 Gateway Boulevard
Concord, CA 94520
You will receive a final ruling from EBAC within 60 days of EBAC's receipt of your appeal unless, due to special circumstances, EBAC requires additional time to respond, up to another 60 days.
If EBAC denies your appeal, you will receive a written response which will include:
  • the specific reason(s) for the denial of the claim;
  • a reference to the specific Plan provision(s) on which the denial is based; and
  • a statement that 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 your claim for benefits.