INSURANCE GRIEVANCE PROCEDURE S.B. 1308:
COMMITTEE SUMMARY
Senate Bill 1308 (as introduced 9-25-12)
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.
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.