INSURANCE GRIEVANCE PROCEDURE S.B. 1308:
FLOOR SUMMARY
Senate Bill 1308 (as reported without amendment) (as enacted)
CONTENT
The bill would amend the Insurance Code to revise requirements for the grievance procedure that a health insurer or health maintenance organization (HMO) must establish.
The Code requires each insurer and HMO to establish an internal formal grievance procedure for individuals covered under a policy, certificate, or contract. The procedure must provide for the right of an insured or enrollee to appear before the board of directors or a designated committee, or the right to a managerial level conference, to present a grievance.
The bill would eliminate the references to the board of directors and a managerial level conference. Instead, the grievance procedure would have to provide for the right of an insured or enrollee to appear before a designated person or committee.
("Grievance" means a complaint on behalf of an insured or enrollee submitted by an insured or enrollee concerning any of the following:
-- The availability, delivery, or quality of health care services.
-- Benefits or claims payment, handling, or reimbursement for health care services.
-- Matters pertaining to the contractual relationship between an insured or enrollee and the insurer or HMO.)
MCL 500.2213 Legislative Analyst: Julie Cassidy
FISCAL IMPACT
The bill would have no fiscal impact on State or local government.
Date Completed: 11-28-12 Fiscal Analyst: Josh Sefton
This analysis was prepared by nonpartisan Senate staff for use by the Senate in its deliberations and does not constitute an official statement of legislative intent.