Evidence of coverage: Issuance; contents; amendment.
1. A prepaid limited health service organization shall issue evidence of coverage to each subscriber. Each evidence of coverage must contain a clear and complete statement of:
(a) The limited health service which the enrollee is entitled to receive;
(b) Any limitation of that service, type of service or benefits to be provided, and exclusions, including any deductible, copayment or other charges;
(c) Where and in what manner information is available concerning the location of and manner in which the limited health service may be obtained; and
(d) The method established for the resolution of complaints submitted by enrollees concerning the provision of the limited health service.
2. A prepaid limited health service organization may provide to a subscriber any amendment to the evidence of coverage in a separate document.
Last modified: February 27, 2006