Educational Resources

Healthcare Reform Government Releases

Uniform Health Carrier External Review Model Act promulgated by the National Association of Insurance Commissioners (NAIC Model Act) on July 23, 2010

HHS will not take any enforcement action against an issuer that complies with the interim compliance method that will be detailed by HHS on the OCIIO website

Model notices that can be used to satisfy the disclosure requirements of the interim final regulations are posted on the DOL’s website. These include the following:
(1) A notice of adverse benefit determination (;
(2) A notice of final internal adverse benefit determination (; and
(3) A notice of final external review decision (

DOL published Technical Release 2010-01

How to Appeal a Health Claim Denial

Fighting Denied Claims

IRO and Transparency

Consumer Options

State External Review Programs

New Regulations to Help Consumers Appeal Decisions by Their Health Plans

Memorandum – Health Reform Implementation

The latest in a series of AHIP surveys shows that the market for individually purchased coverage is more affordable and accessible than may be widely known

NAIRO White Paper on How to Interpret the New Internal and External Appeals Regulations