2005 Minnesota Statutes - 62Q.71 — Notice to enrollees.

     62Q.71 Notice to enrollees. 


    Each health plan company shall provide to enrollees a clear 
 and concise description of its complaint resolution procedure, 
 if applicable under section 62Q.68, subdivision 1, and the 
 procedure used for utilization review as defined under chapter 
 62M as part of the member handbook, subscriber contract, or 
 certificate of coverage.  If the health plan company does not 
 issue a member handbook, the health plan company may provide the 
 description in another written document.  The description must 
 specifically inform enrollees:  


    (1) how to submit a complaint to the health plan company; 


    (2) if the health plan includes utilization review 
 requirements, how to notify the utilization review organization 
 in a timely manner and how to obtain certification for health 
 care services; 


    (3) how to request an appeal either through the procedures 
 described in sections 62Q.69 and 62Q.70 or through the 
 procedures described in chapter 62M; 


    (4) of the right to file a complaint with either the 
 commissioner of health or commerce at any time during the 
 complaint and appeal process; 


    (5) of the toll-free telephone number of the appropriate 
 commissioner; and 


    (6) of the right to obtain an external review under section 
 62Q.73 and a description of when and how that right may be 
 exercised. 


    HIST: 1999 c 239 s 37; 2003 c 2 art 1 s 8