Notwithstanding other sections in this Article, when a subscriber, enrolled dependent or dependent subscriber is dissatisfied with any action, or inaction, of the program's participating health plan in which he/she is enrolled, the subscriber, enrolled dependent or dependent subscriber shall first attempt to resolve the dispute with the participating health plan according to its established policies and procedures.

Note: Authority cited: Sections 12711, 12712 and 12712.5, Insurance Code. Reference: Sections 12711 and 12732, Insurance Code.

History

1. New section filed 12-20-90 as an emergency; operative 12-20-90 (Register 91, No. 11). A Certificate of Compliance must be transmitted to OAL by 4-19-91 or emergency language will be repealed by operation of law on the following day.

2. Certificate of Compliance as to 12-20-90 order transmitted to OAL on 4-18-91 and filed 5-17-91 (Register 91, No. 27).

3. Amendment filed 8-4-2003 as an emergency; operative 8-4-2003 (Register 2003, No. 32). Amendments to remain in effect for 180 days pursuant to section 21, chapter 794, Statutes of 2002 (AB 1401). A Certificate of Compliance must be transmitted to OAL by 2-2-2004 or emergency language will be repealed by operation of law on the following day.

4. Certificate of Compliance as to 8-4-2003 order transmitted to OAL 1-23-2004 and filed 3-1-2004 (Register 2004, No. 10).