MI SB1308

Requires insurers and health maintenance organizations to establish internal formal grievance procedures approved by the commissioner for policyholders and enrollees.

Mandates procedures include a designated grievance administrator, investigation method, plain English notifications, right to appear before a designated person or committee, and access to independent review under the Patient's Right to Independent Review Act.

Requires written final determination within 35 calendar days of a formal written grievance submission, with tolling for insured/enrollee delays and up to 10 business days for information requests from health care facilities.

Establishes expedited grievance process requiring determination within 72 hours when a physician certifies that standard timeframes would jeopardize the insured's life, health, or ability to regain maximum function.

Requires insurers and health maintenance organizations to annually file summary data on complaints and grievances with the commissioner and maintain copies of all complaints and responses for commissioner inspection for 2 years.