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LegalText 42 U.S.C. § 300gg93 Health insurance consumer information us united_states_code code_section 42 THE PUBLIC HEALTH AND WELFARE 6A PUBLIC HEALTH SERVICE 300gg93 42 U.S.C. § 300gg93 current 119-100 2026-06-26 official https://uscode.house.gov/download/releasepoints/us/pl/119/100/xml_usc42@119-100.zip /us/usc/t42/s300gg93 data/legal/raw/us/code/title-42/usc42.xml f9db1fb06eaaadbb00aacec881b2578208e564350578f983c6d5c2c23bb1df14 644321055a08eb1f260a6a3e31ac157fa024756abf612a9fd6857e7e400cf24e ae9012860b02ed06f15f26f11291c72c9bf74670250ade79c421e81d16664403 2026-07-04 official
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42 U.S.C. § 300gg93 - Health insurance consumer information

Text

(a) In general The Secretary shall award grants to States to enable such States (or the Exchanges operating in such States) to establish, expand, or provide support for—

(1) offices of health insurance consumer assistance; or

(2) health insurance ombudsman programs.

(b) Eligibility (1) In general To be eligible to receive a grant, a State shall designate an independent office of health insurance consumer assistance, or an ombudsman, that, directly or in coordination with State health insurance regulators and consumer assistance organizations, receives and responds to inquiries and complaints concerning health insurance coverage with respect to Federal health insurance requirements and under State law.

(2) Criteria A State that receives a grant under this section shall comply with criteria established by the Secretary for carrying out activities under such grant.

(c) Duties The office of health insurance consumer assistance or health insurance ombudsman shall—

(1) assist with the filing of complaints and appeals, including filing appeals with the internal appeal or grievance process of the group health plan or health insurance issuer involved and providing information about the external appeal process;

(2) collect, track, and quantify problems and inquiries encountered by consumers;

(3) educate consumers on their rights and responsibilities with respect to group health plans and health insurance coverage;

(4) assist consumers with enrollment in a group health plan or health insurance coverage by providing information, referral, and assistance; and

(5) resolve problems with obtaining premium tax credits under section 36B of title 26.

(d) Data collection As a condition of receiving a grant under subsection (a), an office of health insurance consumer assistance or ombudsman program shall be required to collect and report data to the Secretary on the types of problems and inquiries encountered by consumers. The Secretary shall utilize such data to identify areas where more enforcement action is necessary and shall share such information with State insurance regulators, the Secretary of Labor, and the Secretary of the Treasury for use in the enforcement activities of such agencies.

(e) Funding (1) Initial funding There is hereby appropriated to the Secretary, out of any funds in the Treasury not otherwise appropriated, $30,000,000 for the first fiscal year for which this section applies to carry out this section. Such amount shall remain available without fiscal year limitation.

(2) Authorization for subsequent years There is authorized to be appropriated to the Secretary for each fiscal year following the fiscal year described in paragraph (1), such sums as may be necessary to carry out this section.

(July 1, 1944, ch. 373, title XXVII, § 2793, as added Pub. L. 111148, title I, § 1002, Mar. 23, 2010, 124 Stat. 138.)

Notes

Statutory Notes and Related Subsidiaries

Effective DateSection effective for fiscal years beginning with fiscal year 2010, see section 1004(a) of Pub. L. 111148, set out as a note under section 300gg11 of this title. Section effective Mar. 23, 2010, see section 1004(b) of Pub. L. 111148, set out as a note under section 300gg11 of this title.