Texas Insurance Code 843.205 – Member’s Handbook; Information About Complaints and Appeals
Current as of: 2024 | Check for updates
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(a) In this section, “major population” means a group constituting 10 percent or more of the enrolled population of the health maintenance organization.
(b) A health maintenance organization shall establish procedures to:
(1) provide to an enrollee a member handbook and materials relating to the complaint and appeals process in the languages of the major populations of the enrolled population; and
(2) provide access to a member handbook and the complaint and appeals process to an enrollee who has a disability that affects the enrollee’s ability to communicate or read.
Terms Used In Texas Insurance Code 843.205
- Complaint: A written statement by the plaintiff stating the wrongs allegedly committed by the defendant.
- Population: means the population shown by the most recent federal decennial census. See Texas Government Code 311.005