Nebraska Statutes 44-32,135. Information to subscribers and enrollees
Each health maintenance organization shall provide a list of providers to its subscribers upon enrollment and reenrollment. Each health maintenance organization shall provide notice within thirty days of any material change in the operation of the health maintenance organization to its subscribers if the change affects the subscribers directly. An enrollee shall be notified in writing by the health maintenance organization of the termination of the primary care provider who provided health care services to that enrollee. The health maintenance organization shall provide assistance to the enrollee in transferring to another participating provider. Each health maintenance organization shall provide to subscribers information on how services may be obtained and where additional information on access to services can be obtained and a toll-free telephone number for calls within the service area.
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Terms Used In Nebraska Statutes 44-32,135
- Enrollee: shall mean an individual who is covered by a health maintenance organization and shall include both subscribers and dependents of subscribers. See Nebraska Statutes 44-3299
- Health maintenance organization: shall mean any person who undertakes to provide or arrange for the delivery of basic health care services to enrollees on a prepaid basis except for enrollee responsibility for copayments or deductibles. See Nebraska Statutes 44-32,105
- Participating provider: shall mean a provider who, under an express or implied contract with the health maintenance organization or with its contractor or subcontractor, has agreed to provide health care services to enrollees with an expectation of receiving payment, other than copayment or deductible, directly or indirectly from the health maintenance organization. See Nebraska Statutes 44-32,110
- Provider: shall mean any physician, hospital, or other person licensed or otherwise authorized to furnish health care services. See Nebraska Statutes 44-32,111