2018 Wyoming Statutes
TITLE 26 - INSURANCE CODE
CHAPTER 34 - HEALTH MAINTENANCE ORGANIZATIONS
SECTION 26-34-111 - Information to enrollees; claims to be accepted or rejected; attorney's fees.
26-34-111. Information to enrollees; claims to be accepted or rejected; attorney's fees.
(a) Each health maintenance organization shall:
(i) Provide promptly to its enrollees notice of any material change in the operation of the organization that will directly affect those enrollees;
(ii) Provide to its subscribers a list of providers, upon enrollment and reenrollment;
(iii) Notify an enrollee in writing of the termination of the primary care provider who provided health care services to that enrollee, and provide assistance to the enrollee in transferring to another participating primary care provider;
(iv) Provide to subscribers information on how services may be obtained, where additional information on access to services can be obtained and a telephone number where the enrollee can contact the organization at no cost to the enrollee.
(b) Any claim for a benefit under a health insurance policy shall be rejected or accepted and paid by the health maintenance organization in accordance with W.S. 26-15-124(a) and (c).
