Arizona Department of Insurance Erin H. Klug February 20, 2019

Arizona’s new Mini-COBRA law – ARS § 20-2330 A fully-insured, small group health insurance policy issued or renewed after December 31, 2018, must allow a health plan enrollee, including any qualified dependent, to continue coverage after a qualifying event. Small employer must notify enrollees in writing -- after one of 10 qualifying events -- of the right to continue coverage under the employer's health benefits plan. Small employer = average of at least 1 but fewer than 20 employees.

Arizona’s new Mini-COBRA law – ARS § 20-2330 ADOI’s Sample Notice of Coverage Continuation is available here: https://insurance.az.gov/arizona-sample- notice-continuation-coverage-mini-cobra A small employer that properly completes and timely issues the Department's form is presumed to satisfy notification requirements.

Surprise Out-of-Network Billing Notice to Enrollee Arizona’s NEW Surprise Out of Network (SOON) Billing Dispute Resolution Insurers and providers must notify patients of dispute resolution rights: Surprise Out-of-Network Billing Notice to Enrollee If you receive a bill for $1,000 or more from an out-of-network (non-contracted) provider for services provided at an in-network (contracted) facility, Arizona law may give you the right to a dispute resolution process through the Arizona Department of Insurance. The process begins with you filing a request with the Department. If the bill qualifies for dispute resolution, you or someone you designate to represent you will need to participate in the process. FOR MORE INFORMATION: Visit the Surprise Out-of-Network Bill Dispute Resolution web page at insurance.az.gov/soonbdr. Health care insurers and health care providers must give the following notice to enrollees pursuant to ARS § 20-3117: - Health insurers must include the notice in each explanation of benefits or other similar claim adjudication notice that is issued to enrollees and that involves covered services provided by a non-contracted health care provider. - A health care provider, a provider’s representative or a billing company who is contacted by an enrollee regarding a dispute involving a surprise out-of-network bill must provide the notice to the enrollee.

Arizona’s NEW Surprise Out of Network (SOON) Billing Dispute Resolution Initiated by the patient who must participate in settlement teleconference Visit https://insurance.az.gov/soonbdr to learn: Which “surprise bills” qualify for dispute resolution (many will not) How to protect yourself from surprise bills How to use the dispute resolution process Detailed explanation of the process and rules Forms for submitting request for dispute resolution