Plan will: $250 for each Complaint Self Reported acknowledge late Resolution Time and State receipt of the acknowledge- correspondence written complaint ment letter, and logs to the and Member within $250 for each two business days late written of receipt of the complaint complaint letter; response. and provide a written complaint response to the State and Member within 21 business days of receipt of the initial complaint letter $500 per day for Provision of Draft Plan Document Receipt date as the first three Plan Documents (Certificate/Evidence documented by calendar days of Coverage or vendor and that the draft of Coverage Summary Plan confirmed by document is not of Self-Insured Description as State received. plans and appropriate by plan) Summary Plan including all required $1,000 per Description for updates is provided calendar day for the fully-insured to the State at least each day the plans three months prior to draft document the first day of the is not received plan year. For for the fourth example, if the plan calendar day year effective date is and beyond. January 1st, the vendor must provide the State the draft by October 1st of the prior year. Provision of Final Final Plan Document Receipt date as $500 per day for each calendar Plan Documents (Certificate/Evidence documented by day the draft of Coverage or vendor and plan document Summary Plan confirmed by is not received Description as State for the first 3 appropriate by plan) calendar days. including all of the required edits and in
Complaint Resolution Time Plan will: acknowledge receipt of the written complaint to the and Member within two business days of receipt of the complaint letter; and provide a written complaint response to the State and Member within 21 business days of receipt of the initial complaint letter Self Reported and State correspondence logs $250 for each late acknowledge- ment letter, and $250 for each late written complaint response. Provision of Plan Documents of Coverage of Self-Insured plans and Summary Plan Description for the fully-insured plans Draft Plan Document (Certificate/Evidence of Coverage or Summary Plan Description as appropriate by plan) including all required updates is provided to the State at least three months prior to the first day of the plan year. For example, if the plan year effective date is January 1st, the vendor must provide the State the draft by October 1st of the prior year. Receipt date as documented by vendor and confirmed by State $500 per day for the first three calendar days that the draft document is not received. $1,000 per calendar day for each day the draft document is not received for the fourth calendar day and beyond. Provision of Final Plan Documents Final Plan Document (Certificate/Evidence of Coverage or Summary Plan Description as appropriate by plan) including all of the required edits and in Receipt date as documented by vendor and confirmed by State $500 per day for each calendar day the draft plan document is not received for the first 3 calendar days.
REVISED-State-of-MD-Group-Life-and-ADD-Technical-Prop-Appendix-2.1.docx