Consumer Protection in Private Health Insurance: The Role of Consumer Complaints. Appendix 3 - Interview Questionnaire Employers


1. Do you get involved when your employees have a specific complaint about a health plan, as distinct from general information inquiries about benefit coverage or eligibility?

2. What is the nature of your involvement in employee complaints about health plans? Do you ring, write or fax the health plan? Is there a nominated contact in the health plan with whom you deal specifically regarding employee complaints?

3. What data or records do you keep on employee complaints about health plans? Do you have any information about the most common types of complaints? Do you have any complaint log templates which indicate the type of data you collect?

4. Do you follow up unusual levels of patterns of complaints about health plans?

5. What selection of plans is currently available to employees? What is the nature of the plans - insured or self-funded? How often can employees switch plans? What data do you keep on disenrollment?

6. Is any information on health plan complaints management, including internal grievance procedures, considered in choosing plans which will be offered to employees?

7. Do you circulate any information to employees concerning health plans' grievance procedures?