Coverage of important benefits

• Insurers must cover: substance abuse treatment, alcoholism treatment, and mammography screening.

NoNE

Appropriate access to care

• Insurers must cover: medically necessary emergency services without prior authorization, transitional care from a provider who leaves a network, some non-formulary prescription drugs, direct access to OB/GYNs, and cancer clinical trials.
  
  
• Law prevents insurers from "gagging" doctor-patient communications.

NoNE

Patient right to appeal denied claims

Ensured payment of claims

• Insurers must have financial reserves to cover claims.
  
  
• State will take corrective action and seize assets to pay claims.

NoNE

Truth in marketing

• Marketing materials must follow detailed guidelines.

NoNE

Prompt payment rules

• Insurers must pay providers within reasonable required timeframe.

NoNE

Proper oversight of insurers

• Management of complaints from you and your healthcare provider.
  
  
• Investigation, oversight, and enforcement of plan rules (including financial penalties).

NoNE