RD154 - State Corporation Commission on the Activities of the Office of the Managed Care Ombudsman


Executive Summary:
This annual report on the activities of the Office of the Managed Care Ombudsman (the" Office") covers the period from November 1, 2003 through October 31, 2004. During this time, the Office assisted approximately 900 consumers enrolled in Managed Care Health Insurance Plans (an "MCHIP"). The Office provided general information, responded to specific questions from consumers and other individuals, and assisted individuals that wanted to appeal an adverse decision their MCHIP issued denying a service or a claim. The Office continued its outreach and educational efforts to help consumers understand the benefits available from their MCHIPs and provided tools to assist consumers in resolving problems. When applicable, consumers were referred to other regulatory agencies for assistance. We conclude that the Office continues to provide a valuable service to consumers enrolled in Managed Care Health Insurance Plans.