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Michigan Compiled Laws - General Insurance Laws

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• Declaration of Emergency - Mich. Comp. Laws Section 550.1
  That an emergency exists in the United States of America and the state of Michigan with respect to its financial and investment institutions and...
• Insurance Company Disbursement Limitations - Mich. Comp. Laws Section 550.2
  The provisions of any law of this state to the contrary notwithstanding, during any period of public calamity resulting in abnormal financial losses to...
• Insurance Commissioner Regulatory Powers - Mich. Comp. Laws Section 550.3
  The rules and regulations made by the commissioner of insurance pursuant to this act, when filed with the secretary of the state of Michigan,...
• Foreign Insurance Companies; Other States' Regulations, Application - Mich. Comp. Laws Section 550.4
  The said commissioner is hereby authorized and empowered to put into effect, and to enforce as against any foreign insurance company doing business in...
• Purposes of Act - Mich. Comp. Laws Section 550.5
  The purposes of the provisions of this act, among other things, are to preserve as far as possible the solvency of such insurance companies...
• Suits Against Insurance Companies; Statute of Limitations, Extension - Mich. Comp. Laws Section 550.6
  During the period of any such calamity or emergency no suit at law or in equity shall be commenced or brought on for hearing,...
• Duration of Emergency; Proclamations - Mich. Comp. Laws Section 550.7
  The emergency referred to in section 1 hereof shall be deemed to continue until March 30, 1935, unless the legislature of this state, if...
• Violation of Act; Misdemeanor; License Revocation, Grounds - Mich. Comp. Laws Section 550.8
  Any person or corporation violating any of the provisions hereof, or any regulation or proclamation made pursuant hereto, shall be deemed guilty of a...
• Repealed - Interstate Insurance Receivership Compact (550.11 - 550.13) - Mich. Comp. Laws
• Short Title - Mich. Comp. Laws Section 550.51
  This act shall be known and may be cited as the "prudent purchaser act".
• Definitions - Mich. Comp. Laws Section 550.52
  As used in this act: (a) "Commissioner" means the commissioner of insurance. (b) "Dental care corporation" means a dental care corporation incorporated under Act...
• Prudent Purchaser Agreement; Number; Location of Health Care Provider; Membership on Provider Panel; Written Standards; Notice Procedures; Provider Application Period; Providing Standards on Request; Notice of Acceptance or Rejection; Reasons for Termination; Professional Review Program; Evaluation; 2 or More Classes of Health Care Providers Providing Same Health Care Service; Removal From Provider Panel; Membership in More Than 1 Provider Panel; Provider Panel Including Health Care Providers and Facilities Outside Michigan; Required Information; Emergency Episode of Illness or Injury; Limiting Number of Prudent Purchaser Agreements; Benefits for Services Within Scope of Practice of Optometry or Chiropractic - Mich. Comp. Laws Section 550.53
  (1) An organization may enter into a prudent purchaser agreement with 1 or more health care providers of a specific service to control health...
• Disclosure of Financial Relationships Between Organization and Participating Health Care Providers, Health Care Facilities, or Other Entities - Mich. Comp. Laws Section 550.53a
  An organization that establishes a prudent purchaser agreement shall disclose in writing to all purchasers of its coverage and to all covered members of...
• Prudent Purchaser Agreement Services; Providing Requested Information to Insurer - Mich. Comp. Laws Section 550.53b
  An organization that is providing prudent purchaser agreement services to an insurer shall provide the insurer on a timely basis with information requested by...
• Discrimination Prohibited; Complaint of Violation; Hearing; Penalty - Mich. Comp. Laws Section 550.54
  An organization shall not refuse to enter into a prudent purchaser agreement with a health care provider on the basis of religion, race, color,...
• Notice of Membership in Provider Panels; Display - Mich. Comp. Laws Section 550.55
  A health care provider which is a member of a provider panel shall display a notice in a conspicuous place at the entrance of...
• Reporting Certain Information on Standard Forms Required; Availability of Information to Appropriate State Agencies; Confidentiality - Mich. Comp. Laws Section 550.56
  (1) An organization which enters into prudent purchaser agreements with health care providers under this act shall report with its annual statement, or on...
• Agreements Between Health Care Providers and Purchasers of Health Care Services - Mich. Comp. Laws Section 550.57
  Nothing in this act shall preclude 1 or more health care providers from entering into agreements with purchasers of health care services for the...
• Organization Subject to Enabling Act; Financial Records - Mich. Comp. Laws Section 550.58
  (1) An organization which provides or administers health care benefits or coverage under a prudent purchaser agreement shall remain subject to all of the...
• Report on Competition in Retail Pharmacy Industry - Mich. Comp. Laws Section 550.59
  The department of management and budget shall contract with an independent third party for a report which shall determine the extent of competition in...
• Repealed. 2005, Act 203, Imd. Eff. Nov. 10, 2005. - Mich. Comp. Laws
• Repealed. 1988, Act 282, Imd. Eff. July 27, 1988. - Mich. Comp. Laws
• Provisions Inapplicable to Certain Contracts and Renewal Thereof - Mich. Comp. Laws Section 550.62
  Nothing in this act shall apply to any contract which is in existence before the effective date of this act, or the renewal of...
• Conditional Effective Date - Mich. Comp. Laws Section 550.63
  This act shall not take effect unless all of the following bills of the 82nd Legislature are enacted into law: (a) Senate Bill No....
• Repealed - Surety Companies (550.101 - 550.111) - Mich. Comp. Laws
• Repealed - Mutual Insurance Companies; Approval Fee (550.151 - 550.152) - Mich. Comp. Laws
• Repealed - Uniform Insurers Liquidation Act (550.201 - 550.213) - Mich. Comp. Laws
• Office Agent of Insurance Company Taken Over by Insurance Commissioner or Receiver; Off - Set for Damages - Mich. Comp. Laws Section 550.231
  Any insurance agent, who has been the office agent of an insurance company taken over by the commissioner of insurance or an insurance company...
• Applicability of Act - Mich. Comp. Laws Section 550.232
  The provisions of this act shall apply to any balances unpaid and owing any such insurance companies at the time this act shall take...
• Construction of Act - Mich. Comp. Laws Section 550.233
  This act shall be construed as supplemental to the existing laws of this state governing insurance companies and insurance agents, and insofar as inconsistent...
• Short Title - Mich. Comp. Laws Section 550.251
  This act shall be known and may be cited as "the coordination of benefits act".
• Definitions - Mich. Comp. Laws Section 550.252
  As used in this act: (a) "Certificate" means any of the following: (i) A certificate issued by a health care corporation in connection with...
• Policy or Certificate Containing Coordination of Benefits Provision; Payment of Benefits; Reduction or Limitation of Benefits Prohibited; Health Maintenance Organization - Mich. Comp. Laws Section 550.253
  (1) Any policy or certificate delivered or issued for delivery in this state in connection with a group disability benefit plan may contain provisions...
• Rules - Mich. Comp. Laws Section 550.254
  The commissioner of insurance may promulgate rules to implement and supervise this act pursuant to the administrative procedures act of 1969, Act No. 306...
• Conditional Effective Date - Mich. Comp. Laws Section 550.255
  This act shall not take effect unless all of the following bills of the 82nd Legislature are enacted into law: (a) Senate Bill No....
• Definitions - Mich. Comp. Laws Section 550.281
  As used in this act: (a) "Department" means the department of community health. (b) "Entity" means a health insurer; a health maintenance organization; a...
• Determination That Health Coverage Recipient Is Also Medical Assistance Recipient; Information to Be Provided by Health Insurer - Mich. Comp. Laws Section 550.283
  (1) An entity shall provide on a monthly basis to the department, in a format determined by the department, information necessary to enable the...
• Determination That Health Coverage Recipient Is Also Medical Assistance Recipient; Actions by Department - Mich. Comp. Laws Section 550.285
  If the department determines that a health coverage recipient is also a medical assistance recipient: (a) The department may use information received under section...
• Violation of Act; Administrative Fine; Notice; Right to Hearing - Mich. Comp. Laws Section 550.287
  An entity that violates this act is subject to an administrative fine of not more than $500.00 for each day the entity does not...
• Rules - Mich. Comp. Laws Section 550.289
  The department may promulgate rules pursuant to the administrative procedures act of 1969, 1969 PA 306, MCL 24.201 to 24.328, necessary to implement this...
• Repealed - Nonprofit Medical Care Corporations (550.301 - 550.316) - Mich. Comp. Laws
• Nonprofit Dental Care Corporation; Formation; Purpose; Types of Dental Care Plans; Services in Other States; Corporation Subject to Nonprofit Corporation Act - Mich. Comp. Laws Section 550.351
  (1) Three or more residents of this state may form a nonprofit corporation under the provisions of this act for the purpose of establishing,...
• Subscriber Contract Payment Regulations; Prohibited Provisions - Mich. Comp. Laws Section 550.352
  No contract shall provide for the payment of any cash or other material benefits to a subscriber or to his estate on account of...
• Supervision by Insurance Commissioner; Incorporation Procedures - Mich. Comp. Laws Section 550.353
  A nonprofit dental care corporation is subject to regulation and supervision by the commissioner of insurance as hereinafter provided. Any law of this state...
• Articles of Incorporation; Contents - Mich. Comp. Laws Section 550.354
  Any persons associating as a nonprofit dental care corporation shall qualify under this act by subscribing to and filing articles of incorporation as provided...
• Articles of Incorporation; Execution, Filing, Fee, Approval, Amendment - Mich. Comp. Laws Section 550.355
  The articles shall be acknowledged before a notary public of this state by at least 1 of the persons signing them. The articles shall...
• Contracts; Statement to Insurance Commissioner; Contents, Examination - Mich. Comp. Laws Section 550.356
  Before a corporation shall enter into or solicit contracts to provide dental services at the expense of such corporation to persons who shall become...
• Certificate of Authority to Commence Business and Issue Contracts; Requirements - Mich. Comp. Laws Section 550.357
  If the commissioner is satisfied that: (a) The solicitation of subscriptions would not work a fraud upon the persons so solicited, (b) The rates...
• Certificate of Authority; Revocation; Liquidation - Mich. Comp. Laws Section 550.358
  The commissioner of insurance, after reasonable notice and hearing, may revoke a certificate, order or consent, made by him and forbid applications for membership,...
• Corporation Examination by Insurance Commissioner; Expenses - Mich. Comp. Laws Section 550.359
  The commissioner of insurance, or any deputy, examiner, or other person whom the commissioner appoints, may visit and examine into the affairs of a...
• Nonprofit Dental Care Corporation Subject to Mcl 500.224 and 500.225; Costs and Expenses - Mich. Comp. Laws Section 550.359a
  A nonprofit dental care corporation is subject to sections 224(4) through (13) and 225 of the insurance code of 1956, Act No. 218 of...
• Annual Statement; Filing - Mich. Comp. Laws Section 550.360
  A corporation, annually on or before March 1 of each year, shall file in the office of the commissioner of insurance a sworn statement...
• Providing Dental Services Outside State - Mich. Comp. Laws Section 550.361
  A dental care corporation may provide dental services to persons outside the state who are eligible under contracts entered into under section 19. History:...
• Dental Care Service Contracts; Preliminary Requirements; Payments - Mich. Comp. Laws Section 550.362
  A dental care corporation before entering into a contract with an applicant or group of applicants for dental services may require: (a) A physical...
• Dental Care Corporation; Board of Directors; Membership, Qualifications - Mich. Comp. Laws Section 550.363
  The board of directors of a dental care corporation shall consist of not more than 25 members and shall have representation from the general...
• Contract Limitations; Service Classes; County Residents - Mich. Comp. Laws Section 550.364
  A dental care corporation, by its articles of incorporation or bylaws, may limit the care that it will furnish, and may divide such care...
• Dentists; Eligibility; Agreements With Corporation - Mich. Comp. Laws Section 550.365
  A licensed dentist is eligible to render professional services to subscribers upon compliance with uniform requirements prescribed by the dental care corporation. At least...
• Subscriber - Dentist Relationship; Choice of Dentist; Refusal to Place Name of Dentist on Register; Removal of Name From Register - Mich. Comp. Laws Section 550.366
  The relation between a subscriber or any of his or her dependents and a dentist shall be identical with the relation that ordinarily exists...
• Prudent Purchaser Agreements; Rates; Provisions Inapplicable to Certain Contracts and Renewal Thereof - Mich. Comp. Laws Section 550.366a
  (1) A dental care corporation may enter into prudent purchaser agreements with dentists pursuant to the prudent purchaser act. (2) The rates charged by...
• Reserve Funds; Maintenance; Investment - Mich. Comp. Laws Section 550.367
  A dental care corporation, before beginning business and at all times while engaged in business, shall maintain reserves in such form and amount as...
• Dental Care to Be in Accordance With Accepted Dental Practice - Mich. Comp. Laws Section 550.368
  Dental care rendered by a dental care corporation shall at all times be in accordance with the accepted dental practice in the community in...
• Dental Care for Needy and Other Persons; Payments; Contracts - Mich. Comp. Laws Section 550.369
  A dental care corporation may receive from governmental or private agencies, corporations, associations, groups, or individuals, within or outside the state, payments covering all...
• Coordination of Benefits - Mich. Comp. Laws Section 550.369a
  If a group contract issued by a corporation contains a coordination of benefits provision, the benefits shall be payable pursuant to the coordination of...
• Dentist - Patient Relationship; Civil Actions - Mich. Comp. Laws Section 550.370
  A civil action based upon or arising out of the dentist-patient relationship shall not be maintained against a dental care corporation.
• Previously Existing Corporations Merger; Agreement, Approval - Mich. Comp. Laws Section 550.371
  A nonprofit corporation heretofore incorporated under Act No. 327 of the Public Acts of 1931, as amended, engaged in operations prior to the effective...
• Dental Care Corporations; Tax Exemption - Mich. Comp. Laws Section 550.372
  A corporation subject to the provisions of this act is declared to be a charitable and benevolent institution, and its funds and property shall...
• False Statement; Penalty - Mich. Comp. Laws Section 550.373
  Any person, or any agent or officer of a corporation, who violates any of the provisions of this act or who makes a false...
• Repealed - Nonprofit Hospital Service Corporations (550.501 - 550.517) - Mich. Comp. Laws
• Definitions - Mich. Comp. Laws Section 550.521
  As used in this act: (a) "Commissioner" means the commissioner of insurance. (b) "Life insurance" means that term as defined in section 602 of...
• Records; Production; Maintenance; Availability for Inspection; Payment of Expenses - Mich. Comp. Laws Section 550.522
  (1) The commissioner may order a provider to produce records, books, files, or other information that is necessary to determine the qualifications of the...
• Disclosure of Information - Mich. Comp. Laws Section 550.523
  A provider shall disclose all of the following information to the viator no later than the date the contract is signed by the viator:...
• Documents to Be Obtained by Provider; Right to Avoid or Rescind Contract - Mich. Comp. Laws Section 550.524
  (1) A provider entering into a contract with a viator shall obtain both of the following: (a) A written statement from a physician that...
• Agreement to Commit Suicide; Payment Prohibited - Mich. Comp. Laws Section 550.524a
  A provider shall not offer to provide or provide any payment to a viator that is conditioned on the viator's agreement to commit suicide.
• Disposition of Contract Consideration - Mich. Comp. Laws Section 550.525
  (1) Upon receipt from the viator of the documents to effect the transfer of the policy, the provider shall deposit the contract consideration in...
• Double or Additional Indemnity - Mich. Comp. Laws Section 550.526
  If a policy provides for double or additional indemnity in case of accidental death and accidental death occurs, the provider shall be entitled only...
• Offer to Purchase Policy or Certificate; Notice to Insurer - Mich. Comp. Laws Section 550.527
  An offer to purchase a life insurance policy or certificate from the viator shall be transmitted to the insurer providing the life insurance policy,...
• Order Prohibiting Provider From Entering Viatical Settlement Contract; Additional Orders - Mich. Comp. Laws Section 550.528
  (1) The commissioner may issue an order prohibiting the provider from entering into a viatical settlement contract in this state if the commissioner finds...
• Credit Insurance Act; Short Title - Mich. Comp. Laws Section 550.601
  This act shall be known and may be cited as "credit insurance act".
• Scope of Act - Mich. Comp. Laws Section 550.602
  All life insurance and all accident and health insurance sold in connection with loans or other credit transactions shall be subject to the provisions...
• Credit Insurance Act; Definitions - Mich. Comp. Laws Section 550.603
  As used in this act: (1) "Credit life insurance" means insurance on the life of a debtor pursuant to or in connection with a...
• Credit Life Insurance, Credit Accident and Health Insurance; Forms - Mich. Comp. Laws Section 550.604
  Credit life insurance and credit accident and health insurance shall be issued only in the following forms: (a) Individual policies of life insurance issued...
• Credit Life Insurance; Amount - Mich. Comp. Laws Section 550.605
  The amount of credit life insurance shall not exceed the indebtedness. Where indebtedness repayable in substantially equal installments is secured by an individual policy...
• Periodic Indemnity Payable - Mich. Comp. Laws Section 550.606
  The amount of periodic indemnity payable by credit accident and health insurance in the event of disability, as defined in the policy, shall not...
• Term; Refund on Termination Prior to Expiration - Mich. Comp. Laws Section 550.607
  The term of any credit life insurance or credit accident and health insurance shall commence, subject to acceptance by the insurer, on the date...
• Evidence of Insurance; Policy or Certificate Delivery - Mich. Comp. Laws Section 550.608
  All credit life insurance and credit accident and health insurance sold shall be evidenced by an individual policy, or in the case of group...
• Policy or Certificate; Contents - Mich. Comp. Laws Section 550.609
  Each individual policy or group certificate of credit life insurance, and credit accident and health insurance in addition to other requirements of law, shall...
• Policy or Certificate; Delivery to Debtor - Mich. Comp. Laws Section 550.610
  The individual policy or group certificate of insurance shall be delivered to the insured debtor at the time the indebtedness is incurred except as...
• Policy or Certificate; Application, Contents - Mich. Comp. Laws Section 550.611
  If the individual policy or group certificate of insurance is not delivered to the debtor at the time the indebtedness is incurred, a copy...
• Papers Filed With Commissioner of Issuing State - Mich. Comp. Laws Section 550.612
  All policies, certificates of insurance, notices of proposed insurance, applications for insurance, binder, endorsements and riders shall be filed with the commissioner of the...
• Papers Filed With Commissioner of Issuing State; Disapproval - Mich. Comp. Laws Section 550.613
  The commissioner within 30 days after the filing of all policies, certificates of insurance, notices of proposed insurance, applications for insurance, binders, endorsements and...
• Papers Filed With Commissioner of Issuing State; Use, Hearing, Prior Written Approval - Mich. Comp. Laws Section 550.614
  If the commissioner notifies the insurer that the form does not comply with this subsection, it is unlawful thereafter for such insurer to issue...
• Papers Filed With Commissioner of Issuing State; Withdrawal of Approval - Mich. Comp. Laws Section 550.615
  The commissioner, at any time after a hearing, of not less than 20 days written notice to the insurer, may withdraw his approval of...
• Papers Filed With Commissioner of Issuing State; Use After Withdrawal of Approval - Mich. Comp. Laws Section 550.616
  It is not lawful for the insurer to issue such forms or use them after the effective date of such withdrawal of approval.
• Papers Filed With Commissioner of Issuing State; Judicial Review - Mich. Comp. Laws Section 550.617
  Any order or final determination of the commissioner under the provisions of this section shall be subject to judicial review.
• Schedule of Premium Rates; Refunds; Nonissuance Credit - Mich. Comp. Laws Section 550.618
  Each insurer issuing credit life insurance or credit accident and health insurance shall file with the commissioner its schedules of premium rates for use...
• Policies Issuable Only by Authorized Insurers - Mich. Comp. Laws Section 550.619
  All policies of credit life insurance and credit accident and health insurance shall be delivered or issued for delivery in this state only by...
• Payment of Claims; Claim Files; Group Insurance Claims - Mich. Comp. Laws Section 550.620
  All claims shall be promptly reported to the insurer or its designated claim representative, and the insurer shall maintain adequate claim files. All claims...
• Procurement of Insurance by Debtor - Mich. Comp. Laws Section 550.621
  When credit life insurance or credit accident and health insurance is required as additional security for any indebtedness, the debtor, upon request to the...
• Rules; Violation, Notice of Hearing, Finding, Order - Mich. Comp. Laws Section 550.622
  The commissioner, after notice and hearing, may issue such rules and regulations in accordance with Act No. 88 of the Public Acts of 1943,...
• Violation; Penalty; License or Authority, Suspension or Revocation - Mich. Comp. Laws Section 550.623
  In addition to any other penalty provided by law, any person who violates an order of the commissioner after it has become final, and...
• Effect of Act; Scope of Act - Mich. Comp. Laws Section 550.624
  This act shall not alter or amend any provision of Act No. 21 of the Public Acts of 1939, as amended, being sections 493.1...
• Insurance of State Property; Determination; Approval; Bids; Purchase of Deductible or Catastrophe Insurance; Payment of Premiums - Mich. Comp. Laws Section 550.701
  (1) An officer or agent of this state or a person or persons having charge of a state owned and state used building or...
• Repealed. 1965, Act 365, Imd. Eff. July 23, 1965. - Mich. Comp. Laws
• Loss in Case of Damage; Fixing Amount - Mich. Comp. Laws Section 550.704
  In case any buildings or property of the state other than those insured under the provisions of section 1 shall be damaged by fire,...
• Loss in Case of Damage; Payment, Release of Additional Amounts Necessary to Rebuild or Restore - Mich. Comp. Laws Section 550.705
  When the amount of loss has been fixed and determined to be $50,000.00 or less by the controller, the amount so determined is appropriated...
• Repealed. 1993, Act 199, Eff. Dec. 28, 1994. - Mich. Comp. Laws
• Repealed. 1965, Act 365, Imd. Eff. July 23, 1965. - Mich. Comp. Laws
• Self - Liquidation Projects Exempted; Applicability of Act - Mich. Comp. Laws Section 550.709
  The provisions of this act shall not have application to any structure, building, or the contents thereof, acquired, purchased or erected as self-liquidating projects...
• Election of Coverage - Mich. Comp. Laws Section 550.710
  An institution, agency, authority or instrumentality of the state which, under the constitution or laws of the state, has control and direction of the...
• State Insurance Fund Abolished; Reversion of Funds - Mich. Comp. Laws Section 550.711
  The state insurance fund is abolished on June 30, 1965, and any unencumbered balance in the fund at that time shall revert to the...
• Repealed - Repair of Destroyed State Property (550.801 - 550.805) - Mich. Comp. Laws
• Short Title - Mich. Comp. Laws Section 550.901
  This act shall be known and may be cited as the "third party administrator act".
• Definitions - Mich. Comp. Laws Section 550.902
  As used in this act: (a) "Administrative services manager" or "manager" means an individual responsible for conducting the daily operations of a third party...
• Third Party Administrator; Certificate Required; Requirements; Instances in Which Tpa Subject to Act; Name - Mich. Comp. Laws Section 550.910
  (1) A person shall not operate as a third party administrator without obtaining and maintaining a certificate of authority pursuant to this act. (2)...
• Application for Certificate of Authority; Form, Verification, and Contents; Filing Notice of Modification - Mich. Comp. Laws Section 550.912
  (1) An application for a certificate of authority to operate as a TPA shall be in a form prescribed by the commissioner, shall be...
• Certificate of Authority; Issuance; Notice of Disapproval; Continued Compliance With Subsection (1) - Mich. Comp. Laws Section 550.914
  (1) The commissioner shall issue a certificate of authority to operate as a TPA if the commissioner is satisfied that the TPA has adequate...
• Repealed. 2002, Act 74, Imd. Eff. Mar. 15, 2002. - Mich. Comp. Laws
• Fees; Payment; Collection; and Designation - Mich. Comp. Laws Section 550.918
  (1) The commissioner shall collect, and the persons affected shall pay to the commissioner, the following fees: (a) Filing fee to accompany application for...
• Tpa Advisory Board; Creation; Appointment, Qualifications, and Terms of Members; Expenses; Duty of Board; Report - Mich. Comp. Laws Section 550.919
  (1) A TPA advisory board is created. The board shall consist of 7 members appointed by the commissioner, at least 4 of whom shall...
• Authority of Commissioner - Mich. Comp. Laws Section 550.920
  The commissioner shall have the same authority with respect to a TPA or manager as he or she does with respect to an insurance...
• Hearings - Mich. Comp. Laws Section 550.922
  The commissioner may designate 1 or more persons to conduct hearings provided for under this act, hearings required by the administrative procedures act of...
• Destruction or Disposal of Records, Books, Papers, and Other Data - Mich. Comp. Laws Section 550.924
  The commissioner is authorized to destroy or otherwise dispose of all records, books, papers, and other data on file with the department which in...
• Provision of Administrative Services Pursuant to Written Service Contract; Maintenance of Books and Records; Tpa and Manager as Fiduciary - Mich. Comp. Laws Section 550.930
  (1) A TPA may only provide administrative services pursuant to a written service contract. For the duration of the service contract, a TPA shall...
• Benefit Plan; Notice; Plan Covering Less Than 500 Individuals; Service Contract Between Tpa and Governmental Entity Not Subject to Erisa; Construction of Act - Mich. Comp. Laws Section 550.932
  (1) A TPA, in connection with a benefit plan, shall provide in its service contract a provision that the person contracting for the services...
• Confidentiality - Mich. Comp. Laws Section 550.934
  (1) A TPA shall provide for the confidentiality of personal data identifying an individual covered by a plan. A TPA shall not disclose records...
• Annual Statement; Report - Mich. Comp. Laws Section 550.936
  (1) Each TPA acting within this state shall annually, on or before March 1, prepare under oath and deposit with the commissioner a statement...
• Prohibited Conduct Generally - Mich. Comp. Laws Section 550.940
  A TPA or manager, in processing claims, shall not do any of the following: (a) Misrepresent pertinent facts relating to coverage. (b) Fail to...
• Additional Prohibited Conduct - Mich. Comp. Laws Section 550.942
  A manager or TPA, in order to induce a person to contract or to continue to contract with the TPA; to induce a person...
• Additional Prohibited Conduct - Mich. Comp. Laws Section 550.944
  (1) A TPA shall not refuse to enter into a service contract or provide administrative services other than processing claims because of race, color,...
• Violation; Probable Cause; Notice; Conference; Disposition of Matter Upon Agreement of Parties; Action for Damages; Hearing; Findings and Decision; Cease and Desist Order; Additional Order - Mich. Comp. Laws Section 550.950
  (1) When the commissioner has probable cause to believe that a TPA or manager is violating, or has violated section 40, indicating a persistent...
• Civil Fine; Suspension or Revocation of Certificate or License - Mich. Comp. Laws Section 550.952
  If a TPA or manager violates a cease and desist order under this act and has been given notice and an opportunity for a...
• Alteration, Modification, or Setting Aside of Order - Mich. Comp. Laws Section 550.954
  The commissioner may at any time, by order, after notice and opportunity for hearing, reopen and alter, modify, or set aside, in whole or...
• Judicial Review; Petition for Review; Transcript of Record and Copy of Order or Decision; Hearing Cause as Civil Case in Equity; Evidence; Duty of Court; Incomplete Record; Stay of Order or Decision; Jurisdiction - Mich. Comp. Laws Section 550.956
  (1) Any final order or decision made, issued, or executed by the commissioner under this act shall be subject to review, after hearing had...
• Self - Incrimination; False Oath or Affirmation - Mich. Comp. Laws Section 550.958
  (1) A person shall not be excused from attending and testifying, or producing any books, papers, or other documents before any court or magistrate,...
• Rules - Mich. Comp. Laws Section 550.960
  (1) The commissioner, after notice and hearing, may promulgate rules pursuant to the administrative procedures act of 1969, Act No. 306 of the Public...
• Repealed. 2002, Act 74, Imd. Eff. Mar. 15, 2002. - Mich. Comp. Laws
• Transfer of Third Party Administrator Advisory Board to Department of Energy, Labor, and Economic Growth by Type III Transfer; Abolishment of Third Party Administrator Advisory Board - Mich. Comp. Laws Section 550.971
  550.971 Transfer of third party administrator advisory board to department of energy, labor, and economic growth by type III transfer; abolishment of third party...
• Repealed - Medical Care Savings Account Act (550.981 - 550.988) - Mich. Comp. Laws
• Short Title - Mich. Comp. Laws Section 550.1001
  This act shall be known and may be cited as "the health benefit agent act".
• Definitions - Mich. Comp. Laws Section 550.1002
  As used in this act: (a) "Affiliate" means that term as defined in section 1301 of the insurance code of 1956, Act No. 218...
• Persons Authorized to Sell Health Benefits; Packaging Health Benefits With Insurance; Annual Appointment Fee - Mich. Comp. Laws Section 550.1003
  (1) Health benefits shall only be sold on behalf of a health benefit corporation by either of the following: (a) A health benefit agent....
• Influencing Agent Prohibited - Mich. Comp. Laws Section 550.1004
  A health benefit corporation shall not attempt in any way to influence an agent in the packaging of health benefits.
• Applicability of Certain Statutory Provisions - Mich. Comp. Laws Section 550.1004a
  (1) The provisions of sections 1, 2, 3, 4(1), (2), (3), (4), (6), 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15,...
• Compensation of Health Benefit Agents - Mich. Comp. Laws Section 550.1005
  Health benefit corporations shall compensate health benefit agents primarily on a reasonable commission basis. Health benefit corporations may provide reasonable bonuses or other reasonable...
• Authorized Agents; Requirements, Duties, and Restrictions; Powers of Commissioner - Mich. Comp. Laws Section 550.1006
  (1) Agents licensed under chapter 12 of the insurance code of 1956, Act No. 218 of the Public Acts of 1956, to sell accident...
• Contracts or Other Arrangements for Packaging of Health Benefits With Insurance; Policy Supplementing Health Benefits of Health Maintenance Organization - Mich. Comp. Laws Section 550.1008
  (1) Except as otherwise provided in this act, a health care corporation organized under Act No. 350 of the Public Acts of 1980, being...
• Licensing Affiliate of Health Benefit Corporation as Insurance Agent Prohibited; Certain Employees or Affiliates of Health Benefit Corporation Prohibited From Transacting Insurance - Mich. Comp. Laws Section 550.1009
  (1) An affiliate of a health benefit corporation shall not be licensed as an insurance agent under chapter 12 of the insurance code of...
• Health Benefit Agent as Fiduciary; Evidence of Violation of Fiduciary Responsibility; Use of Reasonable Accounting Methods; Records Required; Examination of Records; Prohibited Conduct - Mich. Comp. Laws Section 550.1010
  (1) A health benefit agent shall be a fiduciary for all money received or held by him or her in his or her capacity...
• Notice of Termination of Agent's Authority; Liability; Duration of Agent's Responsibility; Cancellation or Refusal to Renew Certificate of Subscriber; Certain Referrals or Communications Prohibited; Records, Names of Subscribers, and Expiration Dates of Certificates and Contracts as Property of Agent; Copies of Written Communications Between Health Benefit Corporations and Subscribers; Grounds for Cancellation of Agent's Contract or Termination of Agent's Authority; Authorizing Licensed Accident and Health Insurance Agent to Sell Health Benefits - Mich. Comp. Laws Section 550.1012
  (1) A health benefit corporation shall give to the commissioner and the agent immediate written notice of the termination of an agent's authority to...
• Suspension, Revocation, Refusal to Grant, or Refusal to Renew Accident and Health Insurance License; Grounds; Notice; Hearing; Summary Suspension; Subpoenas - Mich. Comp. Laws Section 550.1014
  (1) The commissioner, after notice and opportunity for a hearing, may suspend or revoke the accident and health insurance license of an agent who...
• Violation of Act; Orders; Penalties for Violation of Cease and Desist Order; Injunction - Mich. Comp. Laws Section 550.1016
  (1) If the commissioner finds that a person has violated this act, after an opportunity for a hearing pursuant to the administrative procedures act...
• Construction of Act - Mich. Comp. Laws Section 550.1018
  This act shall not be construed as authorizing a health benefit corporation or affiliate of a health benefit corporation to market or transact, as...
• Conditional Effective Date - Mich. Comp. Laws Section 550.1020
  This act shall not take effect unless House Bill No. 5527 of the 83rd Legislature is enacted into law.
• Short Title - Mich. Comp. Laws Section 550.1101
  This act shall be known and may be cited as "the nonprofit health care corporation reform act".
• Legislative Intent and Policy - Mich. Comp. Laws Section 550.1102
  (1) It is the purpose of and intent of this act, and the policy of the legislature, to promote an appropriate distribution of health...
• Meanings of Words and Phrases - Mich. Comp. Laws Section 550.1103
  For the purposes of this act, the words and phrases defined in sections 104 to 108 shall have the meanings ascribed to them in...
• Definitions; a to C - Mich. Comp. Laws Section 550.1104
  (1) "Administrative procedures act" means the administrative procedures act of 1969, Act No. 306 of the Public Acts of 1969, as amended, being sections...
• Definitions; H - Mich. Comp. Laws Section 550.1105
  (1) "Health care benefit" means the right under a certificate to have payment made by a health care corporation for a specified health care...
• Definitions; L to O - Mich. Comp. Laws Section 550.1106
  (1) "Large subscriber group" means a group of 10,000 or more subscribers. (2) "Medium subscriber group" means a group of 150 or more subscribers,...
• Definitions; P - Mich. Comp. Laws Section 550.1107
  (1) "Participating provider" means a provider that has entered into a participating contract with a health care corporation and that meets the standards set...
• Definitions; R, S - Mich. Comp. Laws Section 550.1108
  (1) "Reimbursement arrangement" means policies, practices, and methods by which a health care corporation makes payments to a provider to implement the provider class...
• Health Care Corporation; Incorporation; Number of Persons; Payment of Cash or Other Material Benefit to Subscriber; Applicable Laws; Charitable and Benevolent Institution; Exemption From Taxation; Certificate of Authority; Health Care Benefits and Certificates - Mich. Comp. Laws Section 550.1201
  (1) A health care corporation shall not be incorporated in this state except under this act. (2) Not less than 7 persons, all of...
• Articles of Incorporation; Contents; Number; Forms; Examination and Certification by Attorney General; Fees - Mich. Comp. Laws Section 550.1202
  (1) Persons associating to form a health care corporation under this act shall subscribe to articles of incorporation that shall contain all of the...
• Amendment or Restatement of Articles; Review; Approval - Mich. Comp. Laws Section 550.1203
  By action of its board of directors, a health care corporation may integrate into a single instrument the provisions of its articles of incorporation...
• Filing of Statements and Documents; Examination; Investigation; Additional Information; Conditions; Duties of Commissioner - Mich. Comp. Laws Section 550.1204
  (1) Before entering into contracts or securing applications of subscribers, the persons incorporating a health care corporation shall file all of the following in...
• Unimpaired Surplus - Mich. Comp. Laws Section 550.1204a
  (1) A health care corporation shall possess and maintain unimpaired surplus in an amount determined adequate by the commissioner to comply with section 403...
• Repealed. 2003, Act 59, Eff. July 23, 2003. - Mich. Comp. Laws
• Actuarial Practices and Accounting Principles; Financial Report - Mich. Comp. Laws Section 550.1205a
  A health care corporation shall report financial information in conformity with sound actuarial practices and statutory accounting principles in the same manner as designated...
• Funds, Property, and Business of Health Care Corporation; Investments; Insurance; Prepaid Health Care Benefits - Mich. Comp. Laws Section 550.1206
  (1) The funds and property of a health care corporation shall be acquired, held, and disposed of only for the lawful purposes of the...
• Powers of Health Care Corporation; Interests of Senior Citizens; Validity of Corporate Acts - Mich. Comp. Laws Section 550.1207
  (1) A health care corporation, subject to any limitation provided in this act, in any other statute of this state, or in its articles...
• Action by Member; Complaint - Mich. Comp. Laws Section 550.1208
  (1) An action may be brought in the right of a health care corporation to procure a judgment in its favor, by a member...
• Action by Member; Discontinuance, Compromise, or Settlement; Notice; Expense - Mich. Comp. Laws Section 550.1209
  An action authorized by section 208 shall not be discontinued, compromised, or settled without approval by the court having jurisdiction of the action. If...
• Action by Member; Reasonable Expenses; Attorney's Fees - Mich. Comp. Laws Section 550.1210
  (1) If an action brought in the right of the corporation is successful, in whole or in part, or if anything is received by...
• Administrative Services Only and Cost - Plus Arrangements; Service Contracts; Fees; Administrative Costs; Marketing Policy; Notice; Coverage, Rights, and Obligations Under Collective Bargaining Agreement; Liability of Individual; Report; "noninsured Benefit Plan" Defined - Mich. Comp. Laws Section 550.1211
  (1) Pursuant to section 207(1)(g), a health care corporation may enter into service contracts containing an administrative services only or cost-plus arrangement. Except as...
• Definitions; Prohibited Acts by Corporation; Processing Claims for Benefits on Timely Basis; Claim Form; Notice to Covered Individuals; Notice to Corporation of Complaint and Proceedings Contemplated; Hearing; Findings; Order; Violation of Order; Penalty; Action and Award of Actual Monetary Damages; Review; Stay of Enforcement - Mich. Comp. Laws Section 550.1211a
  (1) As used in this section: (a) "Noninsured benefit plan" means a health benefit plan without coverage by a health care corporation, health maintenance...
• Action Without Notice or Lapse of Time Periods; Waiver; Attorney - in - Fact - Mich. Comp. Laws Section 550.1212
  When, under this act or the articles of incorporation or bylaws of a health care corporation or by the terms of an agreement or...
• Indemnification - Mich. Comp. Laws Section 550.1213
  (1) A health care corporation may indemnify any person who was or is a party to, or is threatened to be made a party...
• Rate of Interest - Mich. Comp. Laws Section 550.1214
  A health care corporation may by agreement in writing, and not otherwise, agree to pay a rate of interest in excess of the legal...
• Health Care Corporation as Shareholder in Other Nonprofit Corporation; Rights, Powers, Privileges, and Liabilities - Mich. Comp. Laws Section 550.1215
  When a health care corporation, consistent with the purposes of the corporation prescribed in this act, is a shareholder in any other nonprofit corporation,...
• Repealed. 2002, Act 559, Imd. Eff. Sept. 27, 2002. - Mich. Comp. Laws
• Health Care Corporation; Prohibited Actions - Mich. Comp. Laws Section 550.1218
  A health care corporation shall not do any of the following: (a) Take any action to change its nonprofit status. (b) Dissolve, merge, consolidate,...
• Provisions Superseded - Mich. Comp. Laws Section 550.1219
  A nonprofit health care corporation is subject to chapter 37 of the insurance code of 1956, 1956 PA 218, MCL 500.3701 to 500.3723. To...
• Board of Directors; Powers and Duties Generally; Appointment, Qualifications, and Terms of Members; Vacancy; Officer or Employee as Voting or Nonvoting Director; Method of Selection; Definitions; Prohibition - Mich. Comp. Laws Section 550.1301
  (1) The property and lawful business of a health care corporation existing and authorized to do business under this act shall be held and...
• Bylaws Generally - Mich. Comp. Laws Section 550.1302
  (1) The board of directors shall adopt initial bylaws and may amend or repeal those bylaws or adopt new bylaws, subject to the prior...
• Meetings; Required Provisions in Bylaws; Notice; Waiver; Participation by Conference Telephone or Similar Communications Equipment; Quorum; Action by Board; Actions Requiring Majority Vote; Record Roll Call Vote; Recording Vote in Minutes - Mich. Comp. Laws Section 550.1303
  (1) Regular or special meetings of the board or a committee of the board shall be held within this state. With respect to regular...
• Books, Records, and Minutes; Copy of Minutes; Disclosure, Publication, and Dissemination of Minutes; Compelling Production of Books or Records - Mich. Comp. Laws Section 550.1304
  (1) A health care corporation shall keep accurate books and records of account and minutes of the proceedings of the board of directors of...
• Establishment and Composition of Corporate Body; Service of Members on Committees; Membership on Board of Directors - Mich. Comp. Laws Section 550.1305
  (1) A health care corporation may establish a corporate body. The corporate body shall consist of individuals selected in the same manner as individuals...
• Effect of Common Directorship, Officership, or Interest on Validity of Contract or Other Transaction; Burden of Establishing Validity of Contract; Exclusion of Common or Interested Directors in Determination of Quorum; Compensation of Directors; Bylaws Regarding Conflict of Interest - Mich. Comp. Laws Section 550.1306
  (1) A contract or other transaction between a health care corporation and 1 or more of its directors or officers, or between a health...
• Advisory Councils; Committees of Board of Directors; Bylaws Regarding Membership and Emergency Meetings and Actions - Mich. Comp. Laws Section 550.1307
  The board of directors may establish those advisory councils and, unless otherwise provided in the articles of incorporation or bylaws, those committees it considers...
• Committees of Board of Directors; Powers and Authority; Prohibited Activities; Emergency Actions - Mich. Comp. Laws Section 550.1308
  (1) To the extent provided by resolution of the board or in the bylaws or articles, a committee established pursuant to section 307 may...
• Officers and Assistants; Selection; Restriction; Authority and Duties; Removal; Contractual Rights; Bond; Vacancies; Compensation; Pension - Mich. Comp. Laws Section 550.1309
  (1) The board of directors shall select the officers of the health care corporation and a chairperson, vice-chairperson, and other board officers and assistants...
• Fiduciary Duties; Scope and Manner of Discharge; Removal of Director for Breach of Fiduciary Duty; Notice and Hearing - Mich. Comp. Laws Section 550.1310
  (1) With respect to management of the affairs and property of the health care corporations, and in the selection, supervision, and control of committees...
• Liability for Misapplication or Misuse of Corporate Money or Property - Mich. Comp. Laws Section 550.1311
  Each director or officer of a health care corporation shall be individually liable for the misapplication or misuse of corporate money or property caused...
• Action for Failure to Perform Duties; Commencement - Mich. Comp. Laws Section 550.1312
  An action against a director or officer for failure to perform the duties imposed by this act shall be commenced within 3 years after...
• False Statement as Misdemeanor; Liability for False Statement or Report; Commencement of Action for Civil Liability - Mich. Comp. Laws Section 550.1313
  (1) Except with respect to statements which are subject to prosecution for perjury, as defined in section 423 of Act No. 328 of the...
• Offering of Health Care Benefits; Limiting Benefits; Division of Benefits Into Classes or Kinds; Prohibited Conduct; Grounds for Denial of Coverage; Coordination of Benefits, Subrogation, and Nonduplication of Benefits; Health Care Corporation as Party in Interest; Limiting or Denying Coverage or Participation Status; Requirements for Participation and Reimbursement; Determination by Commissioner; Definitions - Mich. Comp. Laws Section 550.1401
  (1) A health care corporation established, maintained, or operating in this state shall offer health care benefits to all residents of this state, and...
• Health Care Service Rendered by Dentist; Benefits or Reimbursement; "dentist" Defined; Certificates to Which Section Applicable - Mich. Comp. Laws Section 550.1401a
  (1) If a group or nongroup certificate of a health care corporation provides for health care benefits for a health care service, those benefits...
• Certificate Providing Benefits for Mental Health Services; Requirements - Mich. Comp. Laws Section 550.1401b
  A certificate issued by a corporation which provides benefits for mental health services shall provide benefits for mental health services provided to an individual...
• Replacement Group Certificate With Preexisting Condition Limitation; Elimination, Reduction, or Limitation of Benefits; "disability Coverage" Defined - Mich. Comp. Laws Section 550.1401c
  (1) If existing group disability coverage is replaced by a group certificate with a preexisting condition limitation and insuring 10 or more members, coverage...
• Services Performed by Physician's Assistant; Reimbursement; Conditions; Applicability of Section; Supervision by Physician; Definitions - Mich. Comp. Laws Section 550.1401d
  (1) Subject to subsections (2) and (3), if a health care corporation group or nongroup certificate provides for health care benefits for services performed...
• Group Certificate Issued by Health Care Corporation; Renewal or Continuation; Guaranteed Renewal - Mich. Comp. Laws Section 550.1401e
  (1) Except as provided in this section, a health care corporation that has issued a nongroup certificate shall renew or continue in force the...
• Health Care Corporation; Access to Obstetrician - Gynecologist - Mich. Comp. Laws Section 550.1401f
  (1) A health care corporation certificate that requires a member to designate a participating primary care provider and provides for annual well-woman examinations and...
• Health Care Corporation; Access to Pediatric Care Services - Mich. Comp. Laws Section 550.1401g
  (1) A health care corporation certificate that requires a member to designate a participating primary care provider and provides for dependent care coverage shall...
• Health Care Corporation Providing Prescription Drug Coverage; Formulary Restrictions - Mich. Comp. Laws Section 550.1401h
  A health care corporation that provides coverage for prescription drugs and limits those benefits to drugs included in a formulary shall do all of...
• Prescription Drug Coverage; Pilot Project; Provisions; Interim Report; Determination; Evaluation - Mich. Comp. Laws Section 550.1401i
  (1) Beginning January 1, 2004, a health care corporation shall establish and offer to provide or include prescription drug coverage in at least 1...
• Prescription Drug Coverage; Rate Differentials; Filing - Mich. Comp. Laws Section 550.1401j
  The rates charged to nongroup and group conversion subscribers for a certificate that includes prescription drug coverage pursuant to section 401i may include rate...
• Telemedicine Services; Provisions; Definition; Applicability - Mich. Comp. Laws Section 550.1401k
  (1) A group or nongroup health care corporation certificate shall not require face-to-face contact between a health care professional and a patient for services...
• Health Care Corporation; Prohibited Conduct; Commission or Compensation; New Preexisting Condition Limitation Waiting Period; Readjusting Rates; Participation in Trade Practice Conference for Disability Insurers; Provider Class Plan Not Altered or Superseded; Probable Cause to Believe Provisions Violated; Notice; Disposition of Matter by Agreement of Parties; Action for Damages; Hearing; Issuance of Cease and Desist Order; Violation of Cease and Desist Order; Civil Fine; Action for Actual Monetary Damage; Attorneys' Fees - Mich. Comp. Laws Section 550.1402
  (1) A health care corporation shall not do any of the following: (a) Misrepresent pertinent facts or certificate provisions relating to coverage. (b) Fail...
• Terms and Conditions of Certificate; Form; Description; Requested Information; Written Request; "board Certified" Defined - Mich. Comp. Laws Section 550.1402a
  (1) A health care corporation shall provide a written form in plain English to subscribers upon enrollment that describes the terms and conditions of...
• Preexisting Condition Limitation or Exclusion; Prohibition; Exception; "group" Defined - Mich. Comp. Laws Section 550.1402b
  (1) For an individual covered under a nongroup certificate or under a certificate not covered under subsection (2), a health care corporation may exclude...
• Termination of Participation Between Primary Care Physician and Health Care Corporation; Notice to Member; Effect of Termination; Definitions - Mich. Comp. Laws Section 550.1402c
  (1) If participation between a primary care physician and a health care corporation terminates, the physician may provide written notice of this termination within...
• Payment of Benefits; Interest; Claim Form; Exception - Mich. Comp. Laws Section 550.1403
  (1) A health care corporation, on a timely basis, shall pay to a member benefits as are entitled and provided under the applicable certificate....
• Benefits Paid by Check or Written Instrument; Escheat - Mich. Comp. Laws Section 550.1403a
  Benefits paid by a health care corporation to a subscriber or provider by way of a check or other similar written instrument for the...
• Advertising Material Prohibited - Mich. Comp. Laws Section 550.1403b
  A health care corporation shall not include in any bill for services or products any advertising material for any other service or product sold...
• Violation of Mcl 550.1402 or Mcl 550.1403; Private Informal Managerial - Level Conference; Review by Commissioner; Internal Procedures; Determination by Commissioner; Expedited Grievance Procedure; Procedural Rules; Hearing Matter as Contested Case; Authorization to Act on Behalf of Member - Mich. Comp. Laws Section 550.1404
  (1) A person who has reason to believe that a health care corporation has violated section 402 or 403, if the violation was with...
• Single Billing Form; Development; Explanation of Total Bill for Services - Mich. Comp. Laws Section 550.1405
  (1) A health care corporation, in consultation with the department of social services, shall develop a single billing form to be used for the...
• Confidentiality of Records; Disclosures; Consent; Policy Regarding Protection of Privacy and Confidentiality of Personal Data; Violation as Misdemeanor; Penalty; Civil Action for Damages; Effect of Section on Governmental Agencies; Compliance With Federal Law and Regulations; "Health Care Operations" Defined - Mich. Comp. Laws Section 550.1406
  (1) A health care corporation shall, in order to ensure the confidentiality of records containing personal data that may be associated with identifiable members,...
• Complaint System; Procedures; Response to Complaint; Access to Complaints and Responses; Record of Complaints; Annual Report; Other Legal Remedies - Mich. Comp. Laws Section 550.1407
  (1) A health care corporation shall establish and maintain a complaint system which affords adequate and reasonable procedures for the expeditious resolution of written...
• False, Dishonest, or Fraudulent Claim for Payment as Misdemeanor; Penalty; Civil Action; Prosecution - Mich. Comp. Laws Section 550.1408
  Any provider, member, or other person who knowingly makes, presents, or causes to be presented to a health care corporation any false, dishonest, or...
• Civil Action for Negligence - Mich. Comp. Laws Section 550.1409
  A civil action for negligence based upon, or arising out of, the health care provider-patient relationship shall not be maintained against a health care
• Coverage for Children Who Are Full - Time or Part - Time Students; Continuing Coverage if Dependent Student Takes Leave of Absence Due to Illness or Injury; Eligibility; Requirements - Mich. Comp. Laws Section 550.1409a
  (1) Any certificate delivered, issued for delivery, or renewed in this state that provides for coverage for dependent children who are full-time or part-time...
• Certificate Providing Coverage of Dependent Terminating At Specified Age; Exception - Mich. Comp. Laws Section 550.1410
  Any certificate issued by a health care corporation which provides that coverage of a dependent of the subscriber terminates at a specified age shall...
• Provisions of Group Certificate; Electing Coverage Under Group Conversion Certificate; Notice of Conversion Privilege; Requirements of Group Conversion Certificate; Premium; Issuance; Compliance - Mich. Comp. Laws Section 550.1410a
  (1) A group certificate that is issued or renewed in this state after December 31, 1990 shall include provisions consistent with this section. (2)...
• Repealed. 1994, Act 40, Imd. Eff. Mar. 14, 1994. - Mich. Comp. Laws
• Expired. 1980, Act 430, Eff. Jan. 1, 1982 - Mich. Comp. Laws Section 550.1414
  550.1414 Expired. 1980, Act 430, Eff. Jan. 1, 1982. Compiler's Notes: The expired section pertained to treatment of alcoholism and drug abuse. Popular Name:...
• Treatment of Substance Abuse; Contracts; Qualifications of Provider; Coverage for Intermediate and Outpatient Care for Substance Abuse Required; Demonstration Projects; Substance Abuse Advisory Committee; Report; Contracts Based on Final Report; Reimbursement; Group and Nongroup Certificates; Exceptions; Option to Decline Coverage; Charges, Terms, and Conditions; Reduction of Coverage; Deductibles and Copayment Provision; Minimum Coverage; Adjustment; Definitions; Effective Date of Section - Mich. Comp. Laws Section 550.1414a
  (1) A health care corporation shall offer benefits for the inpatient treatment of substance abuse by a licensed allopathic physician or a licensed osteopathic...
• Offer of Wellness Coverage by Health Care Corporation - Mich. Comp. Laws Section 550.1414b
  (1) A health care corporation may offer group wellness coverage. Wellness coverage may provide for an appropriate rebate or reduction in premiums or for...
• Benefits for Prosthetic Devices - Mich. Comp. Laws Section 550.1415
  (1) Not later than 12 months after the effective date of this act, a health care corporation shall offer or include coverage, in all...
• Coverage for Breast Cancer Diagnostic Services, Breast Cancer Outpatient Services, and Breast Cancer Rehabilitative Services; Coverage for Breast Cancer Screening Mammography; Definitions; Effective Date of Section - Mich. Comp. Laws Section 550.1416
  (1) Subject to dollar limits, deductibles, and coinsurance provisions that are not less favorable than those for physical illness generally, a health care corporation...
• Coverage for Drug Used in Antineoplastic Therapy and Cost of Its Administration; Conditions - Mich. Comp. Laws Section 550.1416a
  A health care corporation shall provide coverage in each group and nongroup certificate for a federal food and drug administration approved drug used in...
• Establishment of Program to Prevent Onset of Clinical Diabetes Required; Report; Coverages; "diabetes" Defined - Mich. Comp. Laws Section 550.1416b
  (1) A health care corporation shall establish and provide to members and participating providers a program to prevent the onset of clinical diabetes. This...
• Off - Label Use of Approved Drug; Coverage; Conditions; Compliance; Use of Copayment, Deductible, Sanction, or Utilization Control; Limitation; Definitions - Mich. Comp. Laws Section 550.1416c
  (1) A health care corporation group or nongroup certificate that provides pharmaceutical coverage shall provide coverage for an off-label use of a federal food...
• Coverage for Obstetrical and Gynecological Services by Physician or Nurse Midwife - Mich. Comp. Laws Section 550.1416d
  (1) As used in this section, "nurse midwife" means an individual licensed as a registered professional nurse under article 15 of the public health...
• Diagnosis and Treatment of Autism Spectrum Disorders; Coverage; Prohibition; Availability of Other Benefits; Conditions; Qualified Health Plan Offered Through American Health Benefit Exchange Pursuant to Federal Law; Prescription Drug Plan; Coordinated Benefits; Definitions - Mich. Comp. Laws Section 550.1416e
  (1) Except as otherwise provided in this section, a health care corporation group or nongroup certificate shall provide coverage for the diagnosis of autism...
• Hospice Care; Contracts With Health Care Corporation; Description of Benefit - Mich. Comp. Laws Section 550.1417
  (1) A health care corporation shall offer to include benefits for hospice care in each certificate that provides benefits for inpatient hospital care. (2)...
• Emergency Health Services; Medical Coverage Required; "stabilization" Defined - Mich. Comp. Laws Section 550.1418
  (1) A health care corporation certificate that provides coverage for emergency health services shall provide coverage for medically necessary services provided to a member...
• Certificate Offering Dependent Coverage to Child; Denial of Enrollment on Certain Grounds Prohibited - Mich. Comp. Laws Section 550.1419
  A health care corporation certificate that offers dependent coverage shall not deny enrollment to a subscriber's child on any of the following grounds: (a)...
• Eligibility of Parent for Dependent Coverage; Health Coverage of Child Through Noncustodial Parent; Court or Administrative Order and Notice Required - Mich. Comp. Laws Section 550.1419a
  (1) If a parent is eligible for dependent coverage through a health care corporation, the health care corporation shall: (a) Permit the parent to...
• Individual Eligible Under Title XIX of Social Security Act; Assignment of Rights of Subscriber to Department of Social Services - Mich. Comp. Laws Section 550.1419b
  (1) A health care corporation shall not consider whether an individual is eligible for or has available medical assistance under title XIX of the...
• Repealed. 2006, Act 441, Imd. Eff. Oct. 19, 2006. - Mich. Comp. Laws
• "program" Defined - Mich. Comp. Laws Section 550.1435
  As used in sections 436 to 439, "program" means the Michigan caring program created in section 436.
• Michigan Caring Programs for Children; Creation; Contribution Requirements; Rating Methodologies; Supersedure of Inconsistent Provisions - Mich. Comp. Laws Section 550.1436
  There may be created within each health care corporation a Michigan caring program for children. The program shall provide primary health care coverage for...
• Eligibility of Child for Enrollment in Program - Mich. Comp. Laws Section 550.1437
  A child is eligible for enrollment in the program if the child meets all of the following: (a) Is less than 19 years of...
• Limitation of Benefits; Provision of Other Health Care Benefits - Mich. Comp. Laws Section 550.1438
  (1) Notwithstanding any other provision of this act, a health care corporation may limit the benefits it will furnish to an eligible child enrolled...
• Fees Prohibited; Exception; Funding; Enrollment of Children - Mich. Comp. Laws Section 550.1439
  The program shall not charge any fee to an enrolled eligible child or the child's parents or legal guardians except that if prescription drug...
• Repealed. 2002, Act 559, Imd. Eff. Sept. 27, 2002;--2006, Act 462, Imd. Eff. Dec. 20, 2006. - Mich. Comp. Laws
• Contracts With Health Care Facilities - Mich. Comp. Laws Section 550.1501
  (1) A health care corporation subject to this act may enter into contracts with health care facilities in Michigan or health facilities in any...
• Special Participating Contracts With Health Care Providers for Provision of Primary Health Care Benefits to Children Enrolled in Michigan Caring Program - Mich. Comp. Laws Section 550.1501a
  A health care corporation may enter into special participating contracts with health care providers for the provision of primary health care benefits to children...
• Conduct on Behalf of or Information Provided to Subscriber by Health Care Provider; Prohibition or Discouragement by Health Care Corporation - Mich. Comp. Laws Section 550.1501b
  A health care corporation shall not prohibit or discourage a health care provider from advocating on behalf of a subscriber for appropriate medical treatment...
• Contracts for Reimbursement With Professional Health Care Providers; Private Provider - Patient Relationship; Methods of Diagnosis or Treatment Not to Be Restricted; Refusal to Reimburse for Overutilized Services; Choice of Providers; List of Providers; Recommendation of Provider as Misdemeanor; Symbol of Participation; Health Maintenance Organization Not Impeded; Contracts Subject to Mcl 550.1504 to 550.1518; Participation of Freestanding Surgical Outpatient Facility; Optometric Services; Status of License or Registration - Mich. Comp. Laws Section 550.1502
  (1) A health care corporation may enter into participating contracts for reimbursement with professional health care providers practicing legally in this state for health...
• Prudent Purchaser Agreements; Group Contracts; Options; Group Contracts Under Which Financial or Other Advantage Realized; Additional Option; Applicability of Subsection (5); Individual Contracts; Rates; Contracts Subject to Mcl 550.1504 to 550.1518; Discrimination Against Class of Health Care Providers; Provisions Inapplicable to Certain Contracts or Renewals; Optometric and Chiropractic Services; Status of License or Registration - Mich. Comp. Laws Section 550.1502a
  (1) For the purpose of doing business as an organization under the prudent purchaser act, 1984 PA 233, MCL 550.51 to 550.63, a health...
• Uniform Reporting by Health Care Providers - Mich. Comp. Laws Section 550.1503
  In the course of developing and establishing provider class plans under this part, a health care corporation shall address the issue of uniform reporting...
• Reimbursement Arrangements; Goals; Definitions; Supplemental Efforts - Mich. Comp. Laws Section 550.1504
  (1) A health care corporation shall, with respect to providers, contract with or enter into a reimbursement arrangement to assure subscribers reasonable access to,...
• Provider Class Plan; Development, Modification, Implementation, or Review; Procedures to Obtain Advice and Consultation - Mich. Comp. Laws Section 550.1505
  (1) A health care corporation shall establish and implement procedures to obtain advice and consultation from a provider class, either through individual providers of...
• Provider Class Plan; Transmitting to Commissioner; Examination; Determination; Notice; Placing Plan Into Effect; Retention of Plan for Commissioner's Records - Mich. Comp. Laws Section 550.1506
  (1) A health care corporation shall transmit a copy of each provider class plan to the commissioner 45 days before the earliest effective date...
• Provider Class Plan; Inclusion and Transmittal of Items Omitted - Mich. Comp. Laws Section 550.1507
  Within 15 days after receipt of the notification as provided in section 506(3), the health care corporation shall include the items omitted from the...
• Provider Class Plan; Modifications - Mich. Comp. Laws Section 550.1508
  (1) Except during the 6-month period provided in section 509(2), a provider class plan retained by the commissioner as provided in section 506(4) may...
• Achievement of Goals and Objectives; Determinations by Commissioner - Mich. Comp. Laws Section 550.1509
  (1) The commissioner may determine if the health care corporation has substantially achieved the goals of a corporation as provided in section 504 and...
• Additional Determinations by Commissioner - Mich. Comp. Laws Section 550.1510
  (1) After considering the information and factors described in section 509(4), the goals of a health care corporation as provided in section 504, and...
• Provider Class Plan; Transmittal to Commissioner; Preparation by Commissioner - Mich. Comp. Laws Section 550.1511
  (1) Upon receipt of notice under section 510(2), the health care corporation, within 6 months or a period determined by the commissioner pursuant to...
• Extension of 6 - Month Period Provided in Mcl 550.511(1); Determination - Mich. Comp. Laws Section 550.1512
  The commissioner may extend the 6-month period provided in section 511(1) once, for not more than 90 days, if the commissioner determines that a...
• Provider Class Plan; Examination; Automatic Retention; Placing Plan Into Effect; Preparation of Plan by Commissioner; Notice - Mich. Comp. Laws Section 550.1513
  (1) Upon receipt of a provider class plan under section 511(1), the commissioner, after considering the information and factors described in section 509(4), within...
• Appeal; Selection and Qualifications of Hearing Officer; Consolidation; Annual Report - Mich. Comp. Laws Section 550.1514
  (1) All appeals under this part shall be held before an independent hearing officer. The state court administrator shall compile and maintain a list...
• Appeal; Parties; Request; Time; Relief; Transmittal of Provider Class Plan to Hearing Officer; Determinations - Mich. Comp. Laws Section 550.1515
  (1) An appeal may be brought from any action or determination of the commissioner under section 509(1), 510(1), or 513(1) or (2), by a...
• Provider Class Plan; Standards - Mich. Comp. Laws Section 550.1516
  (1) All provider class plans retained by the commissioner under section 513 or approved by the hearing officer shall maintain the following standards for...
• Annual Report - Mich. Comp. Laws Section 550.1517
  A health care corporation shall transmit an annual report for each provider class to the commissioner regarding the level of achievement of the goals...
• Considerations and Standards; Applicability; Appeal - Mich. Comp. Laws Section 550.1518
  The considerations set forth in section 509(4) and the standards set forth in section 516 shall only apply for purposes of this act and...
• Regulation and Supervision of Health Care Corporation; Delegation of Authority - Mich. Comp. Laws Section 550.1601
  (1) A health care corporation shall be subject to regulation and supervision by the commissioner as provided in this act. (2) A designee of...
• Statement of Condition; Statistical, Financial, and Other Reports - Mich. Comp. Laws Section 550.1602
  (1) Not later than March 1 each year, subject to a 30-day extension that may be granted by the commissioner, a health care corporation...
• Visitation and Examination; Access to Books, Papers, and Documents; Witnesses; Expenses; Disclosure of Information; Reporting Violation; Action by Attorney General; Ex Parte Order Directing Compliance - Mich. Comp. Laws Section 550.1603
  (1) The commissioner may visit and examine the affairs of a health care corporation. The corporation shall in every way facilitate an examination or...
• Health Care Corporation Subject to Mcl 500.224 and 500.225; Costs and Expenses - Mich. Comp. Laws Section 550.1603a
  A health care corporation is subject to sections 224(4) through (13) and 225 of the insurance code of 1956, Act No. 218 of the...
• Confidentiality; Violation as Misdemeanor; Penalty - Mich. Comp. Laws Section 550.1604
  (1) The commissioner shall ensure that confidentiality of records containing personal data which may be associated with identifiable individuals. Except as is necessary to...
• Certificate of Authority; Suspension or Limitation; Circumstances; Order; Hearing; Notice - Mich. Comp. Laws Section 550.1605
  (1) Upon due notice and an opportunity for an evidentiary hearing pursuant to the administrative procedures act, the commissioner may suspend or limit the...
• Authority of Commissioner Regarding Officers and Directors; Authority as to Dissolution, Taking Over, or Liquidation of Corporations; Insolvency Defined - Mich. Comp. Laws Section 550.1606
  (1) The commissioner shall have the same authority regarding the officers and directors of a health care corporation as the commissioner has with respect...
• Submission of New or Revised Certificate and Applicable Proposed Rates; Approval or Disapproval; Exemption; Circumstances and Conditions; Notice; Implementation of Certificates and Rates - Mich. Comp. Laws Section 550.1607
  (1) A health care corporation shall submit a copy of any new or revised certificate to the commissioner along with applicable proposed rates and...
• Rates Charged to Nongroup Subscribers for Certificate; Methodology and Definitions of Rating System, Formula, Component, and Factor Used to Calculate Rates for Group Subscribers for Certificate; Filing; Approval, Disapproval, or Modification; Standard; Burden of Proof; Effective Date of Proposed Rate; Rate Adjustments; Implementation Prior to Approval; Examination of Financial Arrangement; Formulae, and Factors - Mich. Comp. Laws Section 550.1608
  (1) The rates charged to nongroup subscribers for each certificate shall be filed in accordance with section 610 and shall be subject to the...
• Excessive Rate; Administrative Expense Budget; Equitable Rate; Adequate Rate; Line of Business to Be Self - Sustaining; Cost Transfers for Benefit of Senior Citizens and Group Conversion Subscribers - Mich. Comp. Laws Section 550.1609
  (1) A rate is not excessive if the rate is not unreasonably high relative to the following elements, individually or collectively; provision for anticipated...
• Filing of Information and Materials Relative to Proposed Rate; Notice; Approval, Approval With Modifications, or Disapproval; Additional Information and Materials; Determination; Notice; Visitation and Examination; Expenses; Order; Effect of Inability to Approve 1 or More Rating Classes of Business Within Line of Business; Information in Support of Nongroup Rate Filing; Public Inspection of Information; Forms and Instructions for Filing Proposed Rates - Mich. Comp. Laws Section 550.1610
  (1) Except as provided under section 608(4) or (5), a filing of information and materials relative to a proposed rate shall be made not...
• Legislative Intent - Mich. Comp. Laws Section 550.1611
  It is the intent of the legislature to promote uniformity of rates among subscribers to the greatest extent practicable.
• Notice of Rate Filing; Contents of Request for Hearing; Advertisements; Limitation on Fee for Copy of Rate Filing; Waiver or Reduction of Fee; Calculation of Costs - Mich. Comp. Laws Section 550.1612
  (1) Upon receipt of a rate filing under section 610, the commissioner immediately shall notify each person who has requested in writing notice of...
• Request for Hearing; Standing of Person; Access to Filing; Confidentiality; Penalty; Appointment and Qualifications of Independent Hearing Officer; Commencement of Hearing; Discovery; Conducting Hearing; Burden of Proving Compliance; Factors in Rendering Proposal for Decision; Order Rendering Decision; Withdrawal of Order - Mich. Comp. Laws Section 550.1613
  (1) If the request for a hearing under this section is with regard to a rate filing not yet acted upon under section 610(2)(a),...
• Interim Rates; Petition; Determination; Granting Interim Rate; Final Rate Determination; Refunds or Adjustments; Limitation on Order Establishing Interim Rate Adjustment; Rates to Which Section Applicable - Mich. Comp. Laws Section 550.1614
  (1) Not less than 75 days after a filing is received, as provided in section 610, the health care corporation may petition the commissioner,...
• Review of Final Order or Decision - Mich. Comp. Laws Section 550.1615
  Any final order or decision made, issued, or executed by the commissioner under this act after a hearing held before the commissioner or a...
• Endorsing, Filing, and Indexing Documents; Notice of Refusal to File; Judicial Review; Certificate of Correction; Persons Adversely Affected by Correction; Documents to Which Section Inapplicable - Mich. Comp. Laws Section 550.1616
  (1) If a document required or permitted to be filed with the commissioner under this act substantially conforms to the requirements of this act,...
• Rules - Mich. Comp. Laws Section 550.1617
  The commissioner may promulgate rules which the commissioner considers necessary to carry out the purposes of, and to execute and enforce this act. The...
• Compliance With New Procedures, Benefits, or Contracts - Mich. Comp. Laws Section 550.1618
  Whenever any section of this act requires a health care corporation to implement any new procedure, provide any new benefit, or enter into any...
• Injunction; Declaratory and Equitable Relief; Enforcement of Act or Rules - Mich. Comp. Laws Section 550.1619
  (1) The attorney general may bring an action, or apply to the circuit court for a court order, to enjoin a health care corporation...
• Formal Reorganization Not Required; Duties of Health Care Corporation; Amendments to Articles and Bylaws; Description of Board Restructuring; Review; Certification; Statement of Reasons for Disapproval; Judicial Remedies; Effect of Noncompliance; Extension of Corporate Existence; Powers Undiminished - Mich. Comp. Laws Section 550.1701
  (1) Each health care corporation on the effective date of this act shall be subject to this act without formal reorganization under this act,...
• Discontinuation of Certain Rules; Continuation of Certain Orders and Approvals - Mich. Comp. Laws Section 550.1702
  Rules which were promulgated under former Act No. 108 or 109 of the Public Acts of 1939, shall not continue in effect under this...
• Repeal of Mcl 550.301 to 550.316 and 550.501 to 550.517 - Mich. Comp. Laws Section 550.1703
  The following acts and parts of acts are repealed: (a) Act No. 108 of the Public Acts of 1939, as amended, being sections 550.301...
• Effective Date - Mich. Comp. Laws Section 550.1704
  This act shall take effect April 3, 1981.
• Short Title - Mich. Comp. Laws Section 550.1731
  This act shall be known and may be cited as the "health insurance claims assessment act".
• Definitions - Mich. Comp. Laws Section 550.1732
  As used in this act: (a) "Carrier" means any of the following: (i) An insurer or health maintenance organization regulated under the insurance code...
• Assessment; Levy; Limitation; Adjustment; Credit; Notice; Carrying Forward Unused Credit; Refund - Mich. Comp. Laws Section 550.1733
  (1) For dates of service beginning on or after January 1, 2012, subject to subsections (2), (3), and (4), there is levied upon and...
• Carrier Required to File Rates; Methodology - Mich. Comp. Laws Section 550.1733a
  (1) A carrier that is required to file rates or file for approval rates with the commissioner is not required to file rates in...
• Filing Return; Dates; Form; Contents; Payment Method - Mich. Comp. Laws Section 550.1734
  (1) Every carrier and third party administrator with paid claims subject to the assessment under this act shall file with the department on April...
• Records; Failure to File Return or Keep Proper Records; Right of Department to Impose Assessment - Mich. Comp. Laws Section 550.1735
  (1) A carrier or third party administrator liable for an assessment under this act shall keep accurate and complete records and pertinent documents as...
• Administration of Assessment; Conflicting Provisions of Law; Rules; Annual Report - Mich. Comp. Laws Section 550.1736
  (1) The department shall administer the assessment imposed under this act under 1941 PA 122, MCL 205.1 to 205.31, and this act. If 1941...
• Health Insurance Claims Assessment Fund; Establishment; Creation; Deposit; Money Remaining in Fund; Transfer of Money - Mich. Comp. Laws Section 550.1737
  (1) All money received and collected under this act shall be deposited by the department in the health insurance claims assessment fund established in...
• Appropriation - Mich. Comp. Laws Section 550.1738
  There is appropriated to the department for the 2010-2011 state fiscal year $1,000,000.00 to begin implementing the requirements of this act. Any portion of...
• Amount Received From Health Insurance Claims Assessment Fund; Limitation; Report - Mich. Comp. Laws Section 550.1739
  (1) For administration and compliance requirements created by this act, in the 2011-2012 state fiscal year and each fiscal year thereafter, the department shall...
• Failure to Pay Assessment, Interest, or Penalty; Final Determination; Written Notice to Commissioner; Suspension or Revocation of Certificate of Authority to Transact Insurance - Mich. Comp. Laws Section 550.1740
  The department shall provide the commissioner with written notice of any final determination that a carrier or a third party administrator has failed to...
• Development and Implementation of Dashboard - Mich. Comp. Laws Section 550.1741
  The department shall develop and implement a dashboard to provide information to the citizens of this state, which dashboard shall include, but is not...
• Short Title - Mich. Comp. Laws Section 550.1801
  This act shall be known and may be cited as the "group health plan act".
• "plan" Defined - Mich. Comp. Laws Section 550.1803
  As used in this act, "plan" means a group health plan as defined in section 607 of part 6 of subtitle B of title...
• Plan Offering Dependent Coverage to Child; Denial of Enrollment on Certain Grounds Prohibited - Mich. Comp. Laws Section 550.1805
  A plan that offers dependent coverage shall not deny enrollment to a covered individual's child on any of the following grounds: (a) The child...
• Eligibility of Parent for Dependent Coverage; Health Coverage of Child Through Noncustodial Parent; Duties of Plan Administrator; Court or Administrative Order and Notice Required - Mich. Comp. Laws Section 550.1807
  (1) If a parent is eligible for dependent coverage through a plan, the plan administrator shall: (a) Permit the parent to enroll, under the...
• Individual Eligible Under Title XIX of Social Security Act; Assignment of Rights of Insured to Department of Social Services - Mich. Comp. Laws Section 550.1809
  (1) A plan shall not consider whether an individual is eligible for or has available medical assistance under title XIX of the social security...
• Violation; Fine - Mich. Comp. Laws Section 550.1811
  A violation of this act is subject to a civil fine of not more than $500.00 for each violation.
• Short Title - Mich. Comp. Laws Section 550.1831
  This act shall be known and may be cited as the "autism coverage reimbursement act".
• Definitions - Mich. Comp. Laws Section 550.1833
  As used in this act: (a) "Autism coverage reimbursement program" or "program" means the autism coverage reimbursement program created under section 5. (b) "Autism...
• Autism Coverage Reimbursement Program; Creation; Operation; Development of Application, Approval, and Compliance Process; Forms; Approval or Denial of Application; Limitation on Amount of Coverage; Receipt of Funding by Third Party Administrator; Increase in Rates by Carrier - Mich. Comp. Laws Section 550.1835
  (1) No later than 120 days after the effective date of this act, the department shall create and operate an autism coverage reimbursement program...
• Autism Coverage Fund; Creation Within State Treasury; Investment; Credit of Interest and Earnings; Administration of Fund by Department for Auditing Purposes; Expenditures; Reimbursement; Effect of Insufficient Money in Fund; Notice of Insufficient Funds; Money in Fund At Close of Fiscal Year - Mich. Comp. Laws Section 550.1837
  (1) The autism coverage fund is created within the state treasury. (2) The state treasurer may receive money or other assets from any source...
• Annual Report - Mich. Comp. Laws Section 550.1839
  The department shall submit an annual report to the state budget director and the senate and house of representatives standing committees on appropriations not...
• Implementation of Program - Mich. Comp. Laws Section 550.1841
  (1) The department shall not implement the program under this act until the legislature has appropriated sufficient funds to cover the same. (2) Not...
• Short Title - Mich. Comp. Laws Section 550.1861
  This act shall be known and may be cited as the "health care sharing ministries freedom to share act".
• Definitions - Mich. Comp. Laws Section 550.1863
  As used in this act: (a) "Eligible entity" means a faith-based, nonprofit entity that maintains tax-exempt status under section 501(c) of the internal revenue...
• Health Care Sharing Ministry; Establishment; Operation; Business of Insurance Prohibited - Mich. Comp. Laws Section 550.1865
  An eligible entity may establish and operate a health care sharing ministry under this act. An eligible entity that establishes and operates a health...
• Health Care Sharing Ministry; Requirements - Mich. Comp. Laws Section 550.1867
  To be considered a health care sharing ministry under this act, the ministry shall meet all of the following requirements: (a) Limit participation in...
• Effective Date - Mich. Comp. Laws Section 550.1869
  This act takes effect January 1, 2013.
• Short Title - Mich. Comp. Laws Section 550.1901
  This act shall be known and may be cited as the "patient's right to independent review act".
• Definitions - Mich. Comp. Laws Section 550.1903
  As used in this act: (a) "Adverse determination" means a determination by a health carrier or its designee utilization review organization that an admission,...
• Scope - Mich. Comp. Laws Section 550.1905
  (1) Except as otherwise provided in subsection (2), this act applies to all health carriers that provide or perform utilization review. (2) This act...
• Right to Request External Review for Adverse Determination; Written Notice - Mich. Comp. Laws Section 550.1907
  (1) A health carrier shall provide written notice to a covered person in plain English of the internal grievance and external review processes at...
• Written Request to Commissioner - Mich. Comp. Laws Section 550.1909
  Except for a request for an expedited external review under section 13, all requests for external review shall be made in writing to the
• Request for External Review; Commencement; Preliminary Review; Notice of Acceptance; Duties of Commissioner; Incomplete Request; Nonacceptance; Assignment of Independent Review Organization; Duty of Health Carrier to Provide Documents; Reconsideration by Health Carrier of Its Adverse Determination; Recommendation; Considerations; Review by Commissioner; Notice of Decision - Mich. Comp. Laws Section 550.1911
  (1) Not later than 60 days after the date of receipt of a notice of an adverse determination or final adverse determination under section...
• Expedited External Review - Mich. Comp. Laws Section 550.1913
  (1) Except as provided in subsection (11), a covered person or the covered person's authorized representative may make a request for an expedited external...
• Decision as Final Administrative Remedy; Other Remedies - Mich. Comp. Laws Section 550.1915
  (1) An external review decision and an expedited external review decision are the final administrative remedies available under this act. A person aggrieved by...
• Approved Independent Review Organizations; Application; Form; Fee; Expiration; Termination; Updated List - Mich. Comp. Laws Section 550.1917
  (1) The commissioner shall approve independent review organizations eligible to be assigned to conduct external reviews under this act to ensure that an independent...
• Approved Independent Review Organizations; Requirements - Mich. Comp. Laws Section 550.1919
  (1) To be approved under section 17 to conduct external reviews, an independent review organization shall do both of the following: (a) Have and...
• Independent Review Organization; Liability for Damages - Mich. Comp. Laws Section 550.1921
  An independent review organization or clinical peer reviewer working on behalf of an independent review organization is not liable in damages to any person...
• Maintenance of Records; Report to Commissioner - Mich. Comp. Laws Section 550.1923
  (1) An independent review organization assigned to conduct an external review under section 11 or 13 shall maintain for 3 years written records in...
• Description of Internal Grievance and External Review Procedures; Inclusion With Materials Provided to Covered Persons - Mich. Comp. Laws Section 550.1925
  (1) Each health carrier shall include a description of the internal grievance and external review procedures in or attached to the policy, certificate, membership...
• Rules - Mich. Comp. Laws Section 550.1927
  The commissioner may promulgate rules pursuant to the administrative procedures act of 1969, 1969 PA 306, MCL 24.201 to 24.328, necessary to carry out...
• Cease and Desist Order; Additional Orders; Fines; Hearing; Injunction; Creation of Cancer Clinical Trials; Disposition of Funds - Mich. Comp. Laws Section 550.1929
  (1) If the commissioner finds that a violation of this act has occurred, the commissioner shall reduce the findings and decision to writing and...
• "Local Unit of Government" Defined - Mich. Comp. Laws Section 550.1951
  As used in this act, "local unit of government" means any political subdivision of this state, including, but not limited to, school districts, community...
• Entities Contracting With State or Local Government for Costs of Health Care Services Under Self - Funded Plan; Duties - Mich. Comp. Laws Section 550.1952
  (1) An entity that contracts with a state or local unit of government to provide, deliver, arrange for, pay for, or reimburse any of...
• Exceptions - Mich. Comp. Laws Section 550.1953
  This act does not apply to a self-funded plan that provides coverage only for dental, vision care, or any other limited supplemental benefit.
• Short Title; Intent; Establishment - Mich. Comp. Laws Section 550.2001
  (1) This act shall be known and may be cited as the "elder prescription insurance coverage act". (2) It is the intent of the...
• Definitions - Mich. Comp. Laws Section 550.2002
  As used in this act: (a) "Department" means the department of community health. (b) "EPIC program" means the elder prescription insurance coverage program created...
• Epic Program; Provisions; Eligibility Requirements; Enrollment; Assessment for Medicaid; "institution" Explained; Business With Not More Than 1 Employee and Less Than $200,000.00 in Assets - Mich. Comp. Laws Section 550.2003
  (1) The EPIC program shall provide prescription drug coverage, including related supplies as determined by the department in consultation with the advisory committee established...
• Expedited Enrollment Process; Temporary Eligibility Card or Voucher; Eligibility Requirements - Mich. Comp. Laws Section 550.2004
  (1) The department shall establish an expedited enrollment process or provide an emergency voucher if an otherwise eligible EPIC applicant immediately needs to obtain...
• Brand Name Drug; Copayment - Mich. Comp. Laws Section 550.2005
  Except as otherwise specified in this section, if an enrollee chooses to have a prescription filled with a brand name drug when a recognized...
• Program Benefits; Duties of Department - Mich. Comp. Laws Section 550.2006
  In providing program benefits, the department may do all of the following: (a) Enter into a contract with a private individual, corporation, or agency...
• Other Senior Focused Entities; Utilization and Assistance; Establishment of Advisory Committee - Mich. Comp. Laws Section 550.2007
  (1) To assist in implementing this act, the department may utilize the office of services to the aging, area agencies on aging, senior citizens...
• Reports - Mich. Comp. Laws Section 550.2008
  The department shall provide quarterly reports to the senate and house appropriations committees, and the senate and house fiscal agencies, that include quantified data...
• Program Not as Entitlement; Limitation on Benefits; Epic as Payer of Last Resort; Use of Automated System; Pharmacy Dispensing Fee - Mich. Comp. Laws Section 550.2009
  (1) The program created by this act is not an entitlement. Benefits are limited to the level supported by the money explicitly appropriated in...

Last modified: March 17, 2013