Code of Massachusetts Regulations
211 CMR - DIVISION OF INSURANCE
Title 211 CMR 152.00 - Health Benefit Plans Using Limited, Regional Or Tiered Provider Networks
Section 152.07 - Evidences of Coverage for Limited, Regional and Tiered Provider Network Plans
Current through Register 1531, September 27, 2024
(1) In addition to containing the information required under 211 CMR 52.13, the first or cover page of the Evidence of Coverage for a Health Benefit Plan that uses a Limited Provider Network, a Regional Provider Network of a Tiered Provider Network shall disclose prominently and in a clear and conspicuous manner language substantially similar to the following:
(2) The member identification card shall prominently display the name of the Provider Network that applies to the Health Benefit Plan. If the Provider Network is a Limited Provider Network, Regional Provider Network or Tiered Provider Network, the term abbreviation "Limited", "Regional;" or "Tiered", respectively, should be prominently displayed on the top right hand side of the card.
(3) A Carrier may use evidences of coverage issued prior to July 1, 2011 in compliance with 211 CMR 152.07. Evidences of Coverage for plans issued or renewed on or after July 1, 2011 shall comply with all of the requirements of 211 CMR 152.07. Carriers shall issue, upon renewal, to at least one subscriber in each household whose coverage renews between July 1, 2011, and June 30, 2012, an Evidence of Coverage that complies with 211 CMR 152.07.
(4) A Carrier shall include in all Evidences of Coverage for a Limited Provider Network, a Regional Provider Network or a Tiered Provider Network a statement detailing the translator and interpretation services that are available to assist Insureds, including a statement that the Carrier will provide, upon request, interpreter and translation services related to the Carrier's application and administrative procedures. The statement regarding available translator and interpretation services shall appear in the Evidence of Coverage in at least the following languages: Arabic, Cambodian, Chinese, English, French, Greek, Haitian-Creole, Italian, Lao, Portuguese, Russian and Spanish.