Part 1 – Member Services (continued) WORDS IN ITALICS ARE EXPLAINED IN PART 2. Page 7 Delivery of Summary of Payments Forms You will receive a Summary of Health Plan Payments explanation form when you have a cost share (such as a deductible, a copayment, or a coinsurance) that applies for covered services or when Blue Cross Blue Shield HMO Blue denies coverage for all or part of a health care service or supply. This Summary of Health Plan Payments explanation form will usually be mailed to the member at the address that is on file for the subscriber. However, there are a few additional ways you may choose to receive your Summary of Health Plan Payments explanation forms. Upon submitting your request in writing to Blue Cross Blue Shield HMO Blue, you may:  Have the Summary of Health Plan Payments explanation form mailed to the member’s address that is on file with Blue Cross Blue Shield HMO Blue. (Blue Cross Blue Shield HMO Blue is not required to maintain more than one alternate address for a member.)  Access the Summary of Health Plan Payments explanations by using the online Blue Cross Blue Shield HMO Blue member self service option. To check online, log on to the Blue Cross Blue Shield HMO Blue Web site at www.bluecrossma.org. Just follow the steps to sign-up for paperless statements. When a member selects an alternate method of receipt as described above, this selection will remain in effect until the member submits a request in writing for a different method. Your request for a different method will be completed by Blue Cross Blue Shield HMO Blue within three working days of receiving the request. If you enroll in another Blue Cross Blue Shield HMO Blue health plan or a health plan offered by Blue Cross and Blue Shield of Massachusetts, Inc., you should call the Blue Cross Blue Shield HMO Blue customer service office as this may affect the delivery of your Summary of Health Plan Payments explanation forms. There may be certain times when you may request not to receive a Summary of Health Plan Payments explanation form for a certain health care service or supply. This request must be made by phone or in writing to Blue Cross Blue Shield HMO Blue. The Office of Patient Protection You can obtain information about Massachusetts health plans from the Massachusetts Office of Patient Protection. Some of the information that you can obtain from them is:  A health plan report card. It contains data that can help you evaluate and compare health plans.  Data about physicians who are disenrolled by a health plan. This data is from the prior calendar year.  A chart that compares the premium revenue that has been used for health care. This chart has data for the most recent year for which the data is available.  A report with data for health plan grievances and appeals for the prior calendar year. The Office of Patient Protection is also available to assist Massachusetts consumers. To ask for this information or to seek their assistance, you must contact the Office of Patient Protection. You can call them toll free at 1-800-436-7757. Or, you can send a fax to 1-617-624-5046. Or, you can go online and log on to the Web site at www.mass.gov/hpc/opp.