Indiana § 27-13-9-4 Information on services and filing grievances; telephone number

Indiana Statutes

§ 27-13-9-4 — Information on services and filing grievances; telephone number

Indiana § 27-13-9-4

Title 27INSURANCE

Art. 13HEALTH MAINTENANCE ORGANIZATIONS

Ch. 9Information to Enrollees or Subscribers

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Bluebook

Ind. Code § 27-13-9-4 (2026).

Text

A health maintenance organization shall provide to each enrollee and subscriber:

(1)information on:

(A)how services can be obtained;

(B)where additional information on access to services can be obtained;

(C)how to file a grievance under IC 27-13-10 and IC 27-13-10.1;

(D)the health maintenance organization's:

(i)structure;

(ii)health care benefits and exclusions; and

(iii)criteria for denying coverage; and

(E)costs for which the enrollee or subscriber is responsible; and

(2)a toll free telephone number through which the enrollee can contact the health maintenance organization at no cost to the enrollee to obtain information and to file grievances. The information under this section must be provided to a potential enrollee of the health maintenance organization upon request.

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A health maintenance organization shall
provide to each enrollee and subscriber:
(1) information on:
(A) how services can be obtained;
(B) where additional information on access to services can be
obtained;
(C) how to file a grievance under IC 27-13-10 and IC 27-13-10.1;
(D) the health maintenance organization's:
(i) structure;
(ii) health care benefits and exclusions; and
(iii) criteria for denying coverage; and
(E) costs for which the enrollee or subscriber is responsible;
and
(2) a toll free telephone number through which the enrollee can
contact the health maintenance organization at no cost to the
enrollee to obtain information and to file grievances.
The information under this section must be provided to a potential
enrollee of the health maintenance organization upon request.