EXHIBIT 4.

Percent of survey respondents who complained about a problem related to their insurer’s mental health network, among participants who used the insurer’s mental health provider directory

		Reported directory inaccuracy
	Full sample (N = 333)	Yes (n = 192)	No (n = 141)
Made any complaint	17%	28%	4%
Made a complaint (by method)
Made a complaint to a government agency	2	3	2
Sent a complaint form to insurer	5	9	0
Spoke to an insurance company employee	9	16	1
Other or refused to answer	1	0	1
Made no complaint	83	72	96

source Authors’ analysis of survey data from 2018. notes The sample included privately insured English-speaking people in health plans with a provider network who had used outpatient specialty mental health care in the past twelve months and used their insurer directory in the past year. The percentages were weighted, but the sample size noted represents unweighted survey participants. Respondents were defined as having made any complaint if they answered yes to the following question: “In the past 12 months, have you complained to your insurance company or a government agency (for example, the state insurance commission) about lack of availability of in-network mental health providers, payments related to out-of-network mental health care, or other problems related to your insurer’s mental health provider network?” An unadjusted test of differences in whether participants experiencing an inaccuracy noted any complaint had a p value of <0.001. Respondents who answered yes were asked to choose one or more method of complaint from a list of four types. The method of complaint is recoded to be mutually exclusive by assigning participants to the complaint method noted most likely to be considered by regulators (that is, in the order listed in the exhibit).