Coverage of important benefits

• Insurers must cover: mental health parity that goes beyond federal requirements, substance abuse treatment, alcoholism treatment, mammography screening, minimum mastectomy stay, and well-child care.

NoNE

Appropriate access to care

• Insurers must cover: emergency services that a "prudent layperson" thought necessary, transitional care from a provider who leaves a network, some non-formulary prescription drugs, direct access to OB/GYNs, and cancer clinical trials.
  
  
• Insurers must offer a point-of-service option.
  
  
• Law prevents insurers from "gagging" doctor-patient communications.

NoNE

Promotion of access to healthcare for the uninsured

• Small business employees have continued access to healthcare when they leave their job.
  
  
• Insurers must contribute funds to the state.

NoNE

Patient right to appeal denied claims

Fair healthcare premiums

• Limits on how much insurers can increase premiums when you get sick.
  
  

NoNE

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