33-32-217. Disclosure. (1) In the certificate of coverage and member handbook provided to covered persons, a health insurance issuer shall include a clear and comprehensive description of its utilization review procedures, including the procedures for obtaining review of adverse determinations, and a statement of the rights and responsibilities of covered persons with respect to those procedures.
(2) In the outline of coverage provided to covered persons, a health insurance issuer shall include a statement indicating the section of the member handbook containing the information required in subsection (1).
(3) A health insurance issuer shall print on its membership cards a toll-free telephone number to call for utilization review and benefit determinations.
History: En. Sec. 9, Ch. 428, L. 2015.
Structure Montana Code Annotated
Title 33. Insurance and Insurance Companies
Chapter 32. Health Utilization Review
Part 2. Utilization Review -- Conduct
33-32-202. Commissioner not to approve or disapprove plans
33-32-205. Corporate oversight of utilization review program
33-32-206. Responsibility for contracted services
33-32-207. Health insurance issuer duties for utilization review
33-32-208. Operational requirements
33-32-209. and 33-32-210 reserved
33-32-211. Procedures for standard utilization review and benefit determinations -- notices
33-32-212. Procedures for expedited utilization review and benefit determinations