We're at Exchange 2007 for our US BES and moving that direction for the other 3.
There is a bug in SP6 MR4 that is supposed to be fixed in SP7 as well. We have random users who will suddenly be unable to receive email - but they can send and their PIM syncs fine. I called RIM last week and they found the bug 'footprint' in the log files and said I needed to go to SP7.
EDIT: Found the KB for the issue I'm having:
KB18549.