Section 405IAC10-5-2. Member appeals; insurers  


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  •    (a) A pending applicant, conditionally eligible individual, or plan member dissatisfied with the action of an insurer must first exhaust the insurer's internal appeals procedure prior to requesting a hearing with the state.

      (b) After exhausting the insurer's internal appeals procedures, a pending applicant, conditionally eligible individual, or member may request an administrative hearing with the state no later than thirty-three (33) days from the date of the insurer's resolution of appeal.

      (c) The state's hearing process shall be governed by the procedures and time limits set forth in 405 IAC 1.1. (Office of the Secretary of Family and Social Services; 405 IAC 10-5-2; filed May 18, 2015, 12:34 p.m.: 20150617-IR-405140339FRA)