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Insurance Code | |
Administration of the Insurance Laws | |
Section 216 | Office of Consumer Health Assistance. |
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31A-2-216. Office of Consumer Health Assistance. (1) The commissioner shall establish: (a) an Office of Consumer Health Assistance before July 1, 1999; and (b) a committee to advise the commissioner on consumer assistance rendered under this section. (2) The office shall: (a) be a resource for health care consumers concerning health care coverage or the need for such coverage; (b) help health care consumers understand: (i) contractual rights and responsibilities; (ii) statutory protections; and (iii) available remedies; (c) educate health care consumers: (i) by producing or collecting and disseminating educational materials to consumers, health insurers, and health benefit plans; and (ii) through outreach and other educational activities; (d) for health care consumers that have difficulty in accessing their health insurance policies because of language, disability, age, or ethnicity, provide services, directly or through referral, such as: (i) information and referral; and (ii) adverse benefit determination process initiation; (e) analyze and monitor federal and state consumer health-related statutes, rules, and regulations; and (f) summarize information gathered under this section and make the summaries available to the public, government agencies, and the Legislature. (3) The office may: (a) obtain data from health care consumers as necessary to further the office's duties under this section; (b) investigate complaints and attempt to resolve complaints at the lowest possible level; and (c) assist, but not testify or represent, a consumer in an adverse benefit determination, arbitration, judicial, or related proceeding, unless the proceeding is in connection with an enforcement action brought under Section 31A-2-308. (4) The commissioner may adopt rules necessary to implement the requirements of this section.
Amended by Chapter 308, 2002 General Session |
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