Consumer Protection in Private Health Insurance: The Role of Consumer Complaints. Appendix 4 - List of NAIC and State Attachments

Attachments - NAIC

1. National Association of Insurance Commissioners, Consumer Complaint White Paper, Draft of 13 March 2000

Attachments – California

1. California Department of Insurance, Ombudsman Projects, Downloaded on 14 March 2000. http://www.insurance.ca.gov/EXECUTIVE/OMBUDSMAN/Projects.htm
2. Consumers Union and Center for Health Care Rights, Manage to Care: How California Can Better Inform Consumers about Managed Care, June 1999
3. The Lewin Group, Inc., Evaluation of the First 18 Months of Operation of the Health Rights Hotline: A Pilot Independent Assistance Program of the Center for Health Care Rights, January 2000, http://www.kff.org/content/2000/1569/OmbudsEvaluationReport.PDF
4. Managed Health Care Improvement Taskforce, Improving Managed Health Care in California, Findings and Recommendations, Volume 2, pgs13-41, January 1998
5. California Department of Corporations, Health Care Service Plan Complaint Data, 1998 Requests for Assistance, July 1999,http://www.corp.ca.gov/pub/98rfa/98rfa.htm
6. Center for Health Care Rights, Real Problems and Real Solutions: Making the Voices of Health Care Consumers Count, December 1999, Available at: http://www.hrh.org/99_rpt.pdf
7. California Department of Insurance, Commissioner Quackenbush releases new consumer complaint study on insurance companies, 28 October 1998 http://www.insurance.ca.gov/PRSarchive/PRS1998/Pr150-98.htm

Attachments - Maryland

1. Department of Health and Mental Hygiene and Maryland Insurance Administration, Memorandum of Understanding
2. Maryland Health Care Access and Cost Commission, Comparing the Quality of Maryland HMOs: A Guide for Consumers, 1999, Available at: http://www.mhcc.state.md.us/hmo/hmoreport99.pdf
3. Maryland Insurance Administration, Report on the Health Care Appeals & Grievance Law, April 2000

Attachments - New York

1. New York Insurance Department, Circular Letter No 5, Re: Managed Care Grievance and Utilization Review Appeal Data, 19 February 1999, Available at: http://www.ins.state.ny.us/c199_05.htm
2. New York Department of Insurance, New York Consumer Guide to Health Insurers, September 1999, Available at:http://www.ins.state.ny.us/hgintro.htm
3. New York Department of Insurance, Annual Ranking of Health Insurance Complaints, 1998, Available at: http://www.ins.state.ny.us/hrk97.htm
4. New York State Insurance Department, Levin Announces Availability of State's Premier Consumer Guide to Health Insurers, 17 November 1999, Available at: http://www.ins.state.ny.us/p9911173.htm
5. New York State Insurance Department, Department Releases Annual Health Complaint Ranking - New report shows most consumers are winning battles with NY HMOs, 15 December 1998, Available at: http://www.ins.state.ny.us/p9812151.htm

Attachments - Oregon

1. Oregon Department of Consumer & Business Services, Consumer Guide to Oregon Insurance Complaints, Complaints from Calendar Year 1998, 1999, Available at: http://www.cbs.state.or.us/external/ins/docs/consumer/2311.pdf
2. Oregon Department of Consumer & Business Services, Sample Insurance Company Annual Reports, 1998, Available at: http://www.cbs.state.or.us/external/ins/docs/sb21/sb21_reports.htm
3. Oregon Insurance Division, 1998 Complaint Report Part II, 1999
4. Oregon Insurance Division, Bulletins: 1998-1999

• 98-6 Annual Reporting of Grievances under SB21
• 99-2 Annual Reporting on Quality Assessment as Enacted under SB 21 (1997)
• 99-3 Annual Reporting on Utilization Review as Enacted under SB 21 (1997)
• 99-4 Annual Reporting on Scope of Network as Enacted under SB 21 (1997) Available at: http://www.cbs.state.or.us/external/ins/docs/

Attachments - Texas

1. Texas Department of Insurance, HMO Quality Assurance Section Audit Tools, Downloaded on 29 February 2000, http://www.tdi.state.tx.us/company/hmoqual/examhome.html
2. Texas Department of Insurance, Internet Complaint Information System, Sample reports, Downloaded on 31 January 2000, http://www.tdi.state.tx.us/consumer/icis/ciindex.html
3. Office of Public Insurance Counsel Comparing Texas HMOs 1999: Health Plan Quality from the Consumer's Point of View, 1999, Available at: http://www.opic.state.tx.us/counties.html
4. Texas Department of Insurance HMO Information and Sample HMO Profile - Aetna, Downloaded on 29 February 2000, Available at: http://www.tdi.state.tx.us/company/hmo/geninfo.html
5. Texas Department of Insurance Sample Company Information - Humana Health Plan of Texas. Inc, Downloaded on 14 April 2000, Available at: http://onyxpub.tdi.state.tx.us:8881/pcci/pcci.search
6. Texas Department of Insurance, Types of Coverage and Reasons for Complaint, ICIS, Downloaded on 27 August 1999, Available at: http://www.tdi.state.tx.us/consumer/icis/ciindex.html
7. Texas Department of Insurance, Aggregate Number of HMO complaints for FY 1999, including Access and CIS Complaint Codes, Facsimile received 14 February 2000
8. Texas Department of Insurance, HMO Complaints for Calendar Year 1999, Downloaded 26 April 2000, Available at http://www.tdi.state.tx.us/company/cihmo99.html

Attachments - Vermont

1. Vermont Department of Banking, Insurance, Securities and Health Care Administration, Division of Health Care Administration,Insurance Complaint Form
2. Vermont Department of Banking, Insurance, Securities and Health Care Administration, Division of Health Care Administration,Grievance Process Tables
3. Vermont Department of Banking, Insurance, Securities and Health Care Administration, Division of Health Care Administration,Vermont Managed Health Care Plans, A Guide for Consumers, 1999 Available at: http://www.state.vt.us/bis/hca/consumer/pubs/MCguide99.pdf
4. Vermont Department of Banking, Insurance, Securities and Health Care Administration, Division of Health Care Administration,Telephone Call Intake Form
5. Vermont Office of Health Care Ombudsman, Data Collection Form, 13 January 1999
6. Vermont Office of Health Care Ombudsman, Client Satisfaction Questionnaire