Grievance Reporting Forms

​​​​​​​Last Updated: October 2, 2024​

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) to 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. 

Instructions for completing and submitting the grievance form are here: 

Additional guidance for completing and submitting the grievance form was provided to companies in September 2024 and is available here:​

​​​​Annual Grievance Report Guidance Document​

​​Grievance Report Standardized Log (26-007S)

​Beginning with grievances received in 2023, companies must use a standardized log, which is available here: 

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

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