Chapter Ins 18

HEALTH BENEFIT PLAN GRIEVANCES AND INDEPENDENT REVIEW ORGANIZATIONS CERTIFICATION AND REVIEW PROCEDURES

Subchapter I — Definitions

Ins 18.01   Definitions.

Subchapter II — Grievance Procedures

Ins 18.02   Definitions.

Ins 18.03   Grievances.

Ins 18.04   Right of the commissioner to request OCI complaints be handled as grievances.

Ins 18.05   Expedited grievance procedure.

Ins 18.06   Reporting requirements.

Subchapter III — Independent Review Procedures

Ins 18.10   Definitions.

Ins 18.105   Annual CPI adjustment for independent review eligibility.

Ins 18.11   Independent review.

Ins 18.12   Independent review organization procedures.

Ins 18.13   Standards of independent review.

Ins 18.14   Approval of independent review organizations.

Ins 18.16   Independent review organization reporting requirements.

Ins 18.18   Independent review organization fees.

subch. I of ch. Ins 18 Subchapter I — Definitions

Ins 18.01 Ins 18.01 Definitions. In this chapter: