Section 58-17C-82 - Grievance procedures--Filing with director required--Certificate ofcompliance--Contact information required.
58-17C-82. Grievance procedures--Filing with director required--Certificate of compliance--Contact information required. Except as specified in this chapter, a health carrier shall use written procedures for receiving and resolving grievances from covered persons, as provided in §§ 58-17C-83 to 58-17C-98, inclusive. A health carrier shall file with the director a copy of the procedures required under this section, including all forms used to process requests made pursuant to §§ 58-17C-83 to 58-17C-98, inclusive. Any subsequent material modifications to the documents also shall be filed. The director may disapprove a filing received in accordance with this section that fails to comply with this chapter or applicable rules. In addition, a health carrier shall file annually with the director, as part of its annual report required by §§ 58-17C-80 and 58-17C-81, a certificate of compliance stating that the health carrier has established and maintains, for each of its health benefit plans, grievance procedures that fully comply with the provisions of this chapter. A description of the grievance procedures required under this section shall be set forth in or attached to the policy, certificate, membership booklet, outline of coverage, or other evidence of coverage provided to covered persons. The grievance procedure documents shall include a statement of a covered person's right to contact the Division of Insurance for assistance at any time. The statement shall include the telephone number and address of the Division of Insurance.
Source: SL 2003, ch 250, § 33.