Office of Consumer Health Assistance.

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  • (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.




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