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Indemnity Health Plans: Key Features of Consumer Complaint and Appeal Systems

HEHS-98-189 Published: Jun 30, 1998. Publicly Released: Jul 31, 1998.
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Highlights

Pursuant to a congressional request, GAO reviewed the key features that are important to indemnity plans' complaint and appeal systems, focusing on: (1) the elements that are considered important to a system for processing indemnity plan member complaints and appeals; (2) the extent to which indemnity plan complaint and appeal systems contain these elements; and (3) how indemnity plans compare with health maintenance organizations (HMO) in the extent to which their complaint and appeal systems incorporate recommended elements.

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Comparative analysisConsumer protectionDispute settlementsHealth care planningHealth care programsHealth insuranceHealth maintenance organizationsInformation disclosureWritten communicationIndemnity