Grievance Reporting Forms

Last Updated: January 16, 2018

Procedure to Submit Required Annual Market Regulatory Reports to OCI

Grievance reporting forms are required to be filed with the Office of the Commissioner of Insurance (OCI) by March 1. Section 632.83, Wis. Stat., and s. Ins 18.06, Wis. Adm. Code, require all health benefit plans (HBPs), health maintenance organizations (HMOs), limited service health organizations (LSHOs), and preferred provider plans (PPPs) submit annual reports to the commissioner describing their internal grievance procedures and summarizing their experience for the calendar year.

For the purpose of grievance reporting, HBPs include all health insurance policies not considered HMOs, LSHOs, Med Supp, or PPPs. Dental-only and vision-only PPPs are considered HBPs for grievance reporting purposes.

OCI has an online interface for insurance companies to interact with the Wisconsin Market Regulatory Reports and Forms application.

The insurer's Wisconsin Market Regulatory Reports and Forms Security Administrator/Forms Administrator will assign the required grievance reporting form (OCI 26-007) to staff for completion. The form is completed utilizing the online Wisconsin Market Regulatory Reports and Forms application. The grievance reporting assignment reflects the product types the company is required to complete based on information gathered by OCI. If our records are not accurate, the company must notify us by e-mail.

For information regarding the Wisconsin Market Regulatory Reports and Forms application, please reference the procedures document.

For any questions, please e-mail ocimrreports@wisconsin.gov. The e-mail should include the company's legal name and NAIC company number.