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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;

(6) of the telephone number of the office of consumer assistance, advocacy, and information; and

(7) 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

* NOTE: This section, as added by Laws 1999, chapter 239, *section 37, is effective April 1, 2000, and applies to contracts *issued or renewed on or after that date. Upon request, the *commissioner of health or commerce shall grant an extension of *up to three months to any health plan company or utilization *review organization that is unable to comply with Laws 1999, *chapter 239, sections 1, 3 to 42, and 43, paragraphs (a) and (c) *by April 1, 2000, due to circumstances beyond the control of the *health plan company or utilization review organization. Laws *1999, chapter 239, section 44.

Official Publication of the State of Minnesota
Revisor of Statutes