reglab/housing_qa huggingface dataset:
MI Comp L § 500.3861 (2021)
2021 Michigan Compiled Laws|Chapter 500 - Insurance Code of 1956|Act 218 of 1956 - The Insurance Code of 1956 (500.100 - 500.8302)|218-1956-38 - Chapter 38 Medicare Supplement Policies and Certificates (500.3801...500.3861)|Section 500.3861 - Probable Cause of Violation; Notice of Hearing; Opportunity to Confer and Discuss; Hearing; Applicability of MCL 500.2038 to 500.2040; Violation; Penalty.

500.3861 Probable cause of violation; notice of hearing; opportunity to confer and discuss; hearing; applicability of MCL 500.2038 to 500.2040; violation; penalty. Sec. 3861.  (1) If the commissioner has probable cause to believe that an insurer or agent has violated or is violating this chapter and that a hearing by the commissioner would be in the public interest, the commissioner shall give notice in writing to the person involved pursuant to the administrative procedures act of 1969, Act No. 306 of the Public Acts of 1969, being sections 24.201 to 24.328 of the Michigan Compiled Laws, setting forth the general nature of the complaint against him or her, and the proceedings contemplated. Before the issuance of a notice of hearing, the commissioner shall give the person an opportunity to confer and discuss the possible complaint and proceedings in person with the commissioner or his or her representative, and the matter may be disposed of summarily upon agreement of the parties.  (2) The provisions of section 2030 shall apply with respect to a hearing held pursuant to subsection (1), except that the use of an independent hearing officer shall not be allowed.  (3) If, after opportunity for a hearing held pursuant to Act No. 306 of the Public Acts of 1969, the commissioner determines that the insurer or agent has violated this chapter, the provisions of sections 2038 to 2040 shall apply. Each medicare supplement policy issued or delivered in violation of any of the provisions contained in this chapter shall constitute a separate violation for purposes of assessing a civil fine.  (4) In addition to any other applicable penalties for violations of this act, the commissioner may require insurers violating this chapter to cease marketing any medicare supplement policy or certificate in this state that is related directly or indirectly to a violation or may require the insurer to take such actions as are necessary to comply with this chapter. History: Add. 1992, Act 84, Imd. Eff. June 2, 1992 Popular Name: Act 218
MI Comp L § 500.3902 (2021)
2021 Michigan Compiled Laws|Chapter 500 - Insurance Code of 1956|Act 218 of 1956 - The Insurance Code of 1956 (500.100 - 500.8302)|218-1956-39 - Chapter 39 Long-Term Care Insurance (500.3901...500.3955)|Section 500.3902 - Offer of Long-Term Care Coverage by Subsidiary of Health Care Corporation.

500.3902 Offer of long-term care coverage by subsidiary of health care corporation.Sec. 3902.  A nonprofit health care corporation shall only offer long-term care coverage through a subsidiary of the health care corporation and as provided in this chapter. If a health care corporation subsidiary offers long-term care coverage in this state, the sale of that coverage is not exempt from taxation by this state or any political subdivision of this state. History: Add. 2006, Act 441, Imd. Eff. Oct. 19, 2006 Popular Name: Act 218
MI Comp L § 500.3903 (2021)
2021 Michigan Compiled Laws|Chapter 500 - Insurance Code of 1956|Act 218 of 1956 - The Insurance Code of 1956 (500.100 - 500.8302)|218-1956-39 - Chapter 39 Long-Term Care Insurance (500.3901...500.3955)|Section 500.3903 - Group Long-Term Care Insurance; Coverage Offered to Groups Described in MCL 500.3901(c)(iv) and 500.3901(c)(iii).

500.3903 Group long-term care insurance; coverage offered to groups described in MCL 500.3901(c)(iv) and 500.3901(c)(iii). Sec. 3903.  (1) Group long-term care insurance coverage shall not be offered to a resident of this state under a group certificate issued in another state to a group described in section 3901(c)(iv), unless this state or another state which the commissioner determines has and enforces statutory and regulatory long-term care insurance requirements substantially similar to those adopted in this state has made a determination that those requirements have been met.  (2) Before advertising, marketing, or offering a group long-term care insurance certificate within this state to a group described in section 3901(c)(iii), the group or the insurer shall file evidence with the commissioner that the group meets all of the following requirements:  (a) Consists of at least 100 members.  (b) Has been in active existence for at least 1 year.  (c) Holds regular meetings at least annually.  (d) Except for credit unions, the group collects dues or solicits contributions from members.   (e) The members have voting privileges and representation on the governing board and committees.   (f) Has been organized and maintained in good faith for purposes other than obtaining insurance unless the commissioner waives this requirement.  (3) Thirty days after making the filing under this section, the group described in section 3901(c)(iii) shall be considered to satisfy subsection (2) organizational requirements, unless the commissioner makes a finding that the group does not satisfy those organizational requirements. History: Add. 1992, Act 84, Imd. Eff. June 2, 1992 Popular Name: Act 218
MI Comp L § 500.3905 (2021)
2021 Michigan Compiled Laws|Chapter 500 - Insurance Code of 1956|Act 218 of 1956 - The Insurance Code of 1956 (500.100 - 500.8302)|218-1956-39 - Chapter 39 Long-Term Care Insurance (500.3901...500.3955)|Section 500.3905 - Long-Term Care Coverage; Requirements; Certain Coverages Requiring Care Recommendations.

500.3905 Long-term care coverage; requirements; certain coverages requiring care recommendations. Sec. 3905.  (1) Long-term care coverage shall meet all of the following requirements:  (a) Shall include coverage for intermediate/basic care, which shall not be significantly less than the coverage provided for skilled nursing care.  (b) Shall not limit or exclude coverage by type of illness, type of provider, territorial limitations, treatment, medical condition, or accident other than a motor vehicle accident, except as follows:  (i) Preexisting conditions.  (ii) Mental or nervous disorders; however, this shall not be defined to include more than neurosis, psychoneurosis, psychopathy, psychosis, or mental or emotional disease or disorder and shall not permit exclusion or limitation of benefits on the basis of Alzheimer's disease or related disorders.   (iii) Alcoholism or drug addiction.  (iv) Illness, treatment, or medical condition arising out of any of the following:  (A) War or act of war, whether declared or undeclared.  (B) Participation in a felony, riot, or insurrection.  (C) Service in the armed forces or units auxiliary to the armed forces.  (D) Suicide, whether or not the individual was sane or insane at the time of the suicide, attempted suicide, or intentionally self-inflicted injury.  (2) Long-term care coverage other than home care coverage may provide that before certain coverages in the policy take effect, care must first be recommended by a person or persons as provided in the policy and approved by the commissioner or prescribed by a licensed treating physician. Long-term care coverage for home care may provide that before coverage for home care in the policy takes effect, care must first be prescribed or recommended by a person or persons as provided in the policy and approved by the commissioner.  History: Add. 1992, Act 84, Imd. Eff. June 2, 1992 Popular Name: Act 218
MI Comp L § 500.3907 (2021)
2021 Michigan Compiled Laws|Chapter 500 - Insurance Code of 1956|Act 218 of 1956 - The Insurance Code of 1956 (500.100 - 500.8302)|218-1956-39 - Chapter 39 Long-Term Care Insurance (500.3901...500.3955)|Section 500.3907 - Individual Long-Term Care Policy; Guaranteed Renewable Provision; Conversion; New Limitation Period; Intermediate Care Facility or Skilled Nursing Facility; Home Care Services.

500.3907 Individual long-term care policy; guaranteed renewable provision; conversion; new limitation period; intermediate care facility or skilled nursing facility; home care services.  Sec. 3907.  (1) Each individual long-term care policy shall contain a guaranteed renewable provision. An insurer shall not cancel or otherwise terminate a long-term care insurance policy on the grounds of the age or the deterioration of the mental or physical health of the insured.  (2) Each group long-term care certificate shall contain a conversion provision permitting an individual entitled to benefits under the group certificate to elect to convert from the group certificate to an individual long-term care policy with the option of receiving benefits substantially similar to the prior coverage. An individual shall be entitled to convert to the individual policy at all times except under the following circumstances:  (a) Termination of the individual's group coverage resulted from the individual's failure to make any required payment of premium when due.  (b) The terminating coverage is replaced by other group coverage effective on the day following the termination of the other group coverage.  (3) If existing coverage is converted to or replaced by a long-term care insurance policy with the same insurer, the long-term care insurance policy shall not contain a provision establishing a new limitation period except with respect to an increase in benefits voluntarily selected by the insured. The premium for the converted policy shall be calculated on the basis of the insured's age at inception of coverage under the group certificate.  (4) A long-term care insurance policy that provides coverage for care in an intermediate care facility or a skilled nursing facility shall also provide coverage for home care services that is a dollar amount equivalent to at least 1/2 of 1 year's coverage available for nursing home benefits under the policy at the time covered home health services are being received. History: Add. 1992, Act 84, Imd. Eff. June 2, 1992 Popular Name: Act 218
MI Comp L § 500.3908 (2021)
2021 Michigan Compiled Laws|Chapter 500 - Insurance Code of 1956|Act 218 of 1956 - The Insurance Code of 1956 (500.100 - 500.8302)|218-1956-39 - Chapter 39 Long-Term Care Insurance (500.3901...500.3955)|Section 500.3908 - Long-Term Care Partnership Program Policy; Conversion or Replacement.

500.3908 Long-term care partnership program policy; conversion or replacement.Sec. 3908.  (1) Subject to subsection (2), long-term care insurance that is delivered or issued for delivery in this state after December 31, 2007, and before long-term care partnership program policies are approved for sale in this state, may be converted to or replaced with a long-term care partnership program policy.  (2) Before converting the long-term care insurance to, or replacing the long-term care insurance with, a long-term care partnership program policy under this section, the insured and the insurer shall both agree to the conversion or the replacement.  (3) As used in this section, "long-term care partnership program policy" means that term as defined in section 3957. History: Add. 2015, Act 198, Eff. Feb. 22, 2016 Popular Name: Act 218
MI Comp L § 500.3909 (2021)
2021 Michigan Compiled Laws|Chapter 500 - Insurance Code of 1956|Act 218 of 1956 - The Insurance Code of 1956 (500.100 - 500.8302)|218-1956-39 - Chapter 39 Long-Term Care Insurance (500.3901...500.3955)|Section 500.3909 - Option to Purchase Inflation Protection; Summary of Coverage; Applicability of Section.

500.3909 Option to purchase inflation protection; summary of coverage; applicability of section. Sec. 3909.  (1) An insurer shall not offer a long-term care insurance policy unless the insurer also offers to the policyholder, in addition to any other inflation protection, the option to purchase a policy that provides for benefit levels to increase with benefit maximums or reasonable durations that are meaningful to account for reasonably anticipated increases in the costs of long-term care services covered by the policy. Insurers shall offer to each policyholder, at the time of purchase, the option to purchase a policy with an inflation protection feature no less favorable than 1 of the following:   (a) Increases benefit levels annually in a manner so that the increases are compounded annually at a rate not less than 5%.  (b) Guarantees the insured individual the right to periodically increase benefit levels without providing evidence of insurability or health status so long as the option for the previous period has not been declined. The amount of the additional benefit shall be not less than the difference between the existing policy benefit and that benefit compounded annually at a rate of at least 5% for the period beginning with the purchase of the existing benefit and extending until the year in which the offer is made.  (c) Covers a specified percentage of actual or reasonable charges and does not include a maximum specified indemnity amount or limit.  (2) If the policy is issued to a group, the required offer in subsection (1) shall be made to the group policyholder. However, if the policy is issued to a group defined in section 3901(c)(iv) other than to a continuing care retirement community, the offering shall be made to each proposed certificate holder.  (3) Insurers shall include all of the following information in or with the summary of coverage:   (a) A graphic comparison of the benefit levels of a policy that increases benefits over the policy period with a policy that does not increase benefits. The graphic comparison shall show benefit levels over at least a 20-year period.  (b) Any expected premium increases or additional premiums to pay for automatic or optional benefit increases. If premium increases or additional premiums will be based on the attained age of the applicant at the time of the increase, the insurer shall also disclose the magnitude of the potential premiums the applicant would need to pay at ages 75 and 85 for benefit increases. An insurer may use a reasonable hypothetical, or a graphic demonstration, for the purposes of this disclosure.  (4) This section does not apply to life insurance products that accelerate the death benefit to provide long-term care benefits. History: Add. 1992, Act 84, Imd. Eff. June 2, 1992 Popular Name: Act 218
MI Comp L § 500.3910 (2021)
2021 Michigan Compiled Laws|Chapter 500 - Insurance Code of 1956|Act 218 of 1956 - The Insurance Code of 1956 (500.100 - 500.8302)|218-1956-39 - Chapter 39 Long-Term Care Insurance (500.3901...500.3955)|Section 500.3910 - Option of Purchasing Policy or Certificate Including Nonforfeiture Benefits; Offer.

500.3910 Option of purchasing policy or certificate including nonforfeiture benefits; offer.Sec. 3910.  (1) This section does not apply to life insurance policies or riders containing accelerated benefits for long-term care.  (2) Except as provided in subsection (3), a long-term care insurance policy shall not be delivered or issued for delivery in this state unless the policyholder or certificateholder has been offered the option of purchasing a policy or certificate including a nonforfeiture benefit. An offer shall be in writing if the nonforfeiture benefit is not otherwise described in the outline of coverage or other materials given to the prospective policyholder or certificateholder. The offer of a nonforfeiture benefit may be in the form of a rider that is attached to the policy. If the policyholder or certificateholder declines the nonforfeiture benefit, the insurer shall provide a contingent benefit upon lapse that shall be available for a specified period of time following a substantial increase in premium rates.  (3) When a group long-term care insurance policy is issued, the offer required in subsection (2) shall be made to the group policyholder. However, if the policy is issued as group long-term care insurance as defined in section 3901(c)(iv), other than to a continuing care retirement community or other similar entity, the offering shall be made to each proposed certificateholder. History: Add. 2006, Act 442, Imd. Eff. Oct. 19, 2006 Popular Name: Act 218
MI Comp L § 500.3910b (2021)
2021 Michigan Compiled Laws|Chapter 500 - Insurance Code of 1956|Act 218 of 1956 - The Insurance Code of 1956 (500.100 - 500.8302)|218-1956-39 - Chapter 39 Long-Term Care Insurance (500.3901...500.3955)|Section 500.3910b - Reduction Options; Applicability of Section to Long-Term Care Policies and Certificates Issued on or After June 1, 2007.

 ***** 500.3910b SEE SUBSECTION (7) FOR APPLICABILITY ***** 500.3910b Reduction options; applicability of section to long-term care policies and certificates issued on or after June 1, 2007.Sec. 3910b.  (1) A long-term care insurance policy or certificate shall provide that a policyholder or certificateholder who wishes to reduce coverage and lower the policy or certificate premium may choose at least 1 of the following options:  (a) Reducing the lifetime maximum benefit.  (b) Reducing the daily, weekly, or monthly benefit amount.  (2) In addition to the reduction options listed in subsection (1), a long-term care insurer may offer additional reduction options that are consistent with the policy or certificate design or the insurer's administrative processes.  (3) A long-term care insurer shall include in the long-term care insurance policy or certificate a description of the ways in which coverage may be reduced and the process for requesting and implementing a reduction in coverage.  (4) The age to determine the premium for reduced coverage shall be based on the age used to determine the premiums for the coverage currently in force.  (5) A long-term care insurer may limit any reduction in coverage to plans available for that policy form and to those for which benefits will be available after consideration of claims paid or payable.  (6) If a long-term care insurance policy or certificate is about to lapse, the insurer shall provide written notice to the insured of the options in subsection (1) to lower the premium by reducing coverage and of the premiums applicable to the reduced coverage options. The insurer may include in the notice additional options to those required in subsection (1). The notice shall provide the insured at least 30 days in which to elect to reduce coverage, and the policy or certificate shall be reinstated without underwriting if the insured elects the reduced coverage.  (7) This section applies to long-term care policies and certificates issued on or after June 1, 2007. History: Add. 2006, Act 442, Imd. Eff. Oct. 19, 2006 Popular Name: Act 218
MI Comp L § 500.3911 (2021)
2021 Michigan Compiled Laws|Chapter 500 - Insurance Code of 1956|Act 218 of 1956 - The Insurance Code of 1956 (500.100 - 500.8302)|218-1956-39 - Chapter 39 Long-Term Care Insurance (500.3901...500.3955)|Section 500.3911 - Preexisting Condition; Limitation Period; Definition.

500.3911 Preexisting condition; limitation period; definition. Sec. 3911.  (1) A preexisting condition limitation period in a long-term care insurance policy, other than a group long-term care certificate described in section 3901(c)(i), shall not exceed 1 of the following:  (a) Six months after the effective date of coverage.  (b) A period of time set by the commissioner if the commissioner has found that a longer limitation period than provided for in subdivision (a) is justified because the group is specially limited by age, group categories, or other specific policy provisions and that the longer limitation period will be in the best interest of the public.  (2) A long-term care insurance policy, other than a group long-term care certificate described in section 3901(c)(i) , shall not use a definition of preexisting condition that is more restrictive than the definition in section 3901.   (3) The definition of preexisting condition does not prohibit an insurer from using an application form designed to elicit the complete health history of an applicant and, on the basis of the answers on that application, underwrite in accordance with that insurer's established underwriting standards.  (4) Unless otherwise provided in the policy, a preexisting condition, regardless of whether it is disclosed on the application, need not be covered until after the limitation period. A long-term care insurance policy shall not exclude or use waivers or riders of any kind to exclude, limit, or reduce coverage or benefits for specifically named or described preexisting conditions beyond the limitation period. History: Add. 1992, Act 84, Imd. Eff. June 2, 1992 Popular Name: Act 218
MI Comp L § 500.3913 (2021)
2021 Michigan Compiled Laws|Chapter 500 - Insurance Code of 1956|Act 218 of 1956 - The Insurance Code of 1956 (500.100 - 500.8302)|218-1956-39 - Chapter 39 Long-Term Care Insurance (500.3901...500.3955)|Section 500.3913 - Home Health Care Benefits.

500.3913 Home health care benefits. Sec. 3913.  (1) A long-term care insurance policy shall not limit or exclude services for home health care benefits in any of the following ways:  (a) By requiring that the insured would need skilled care in a skilled nursing facility if home health care services were not provided.  (b) By requiring that the insured first or simultaneously receive nursing or therapeutic services in a home or community setting before home health care services are covered.  (c) By limiting eligible services to services provided by registered nurses or licensed practical nurses.  (d) By requiring that a nurse or therapist provide services covered by the policy that can be provided by a home health aide or other licensed or certified home care worker acting within the scope of his or her licensure or certification.  (e) By requiring that the insured have an acute condition before home health care services are covered.  (f) By limiting benefits to services provided by medicare-certified agencies or providers.  (2) Home health care coverage may be applied to the nonhome health care benefits provided in the policy when determining maximum coverage under the terms of the policy.  (3) A long-term care insurance policy that provides coverage for home care services or assisted living services shall define and provide a detailed explanation in plain English of what home care services or assisted living services are covered. A long-term care insurance policy that provides coverage for assisted living facility stays shall define in plain English what assisted living facilities are covered. History: Add. 1992, Act 84, Imd. Eff. June 2, 1992 ;-- Am. 2001, Act 4, Imd. Eff. Mar. 30, 2001 Popular Name: Act 218
MI Comp L § 500.3915 (2021)
2021 Michigan Compiled Laws|Chapter 500 - Insurance Code of 1956|Act 218 of 1956 - The Insurance Code of 1956 (500.100 - 500.8302)|218-1956-39 - Chapter 39 Long-Term Care Insurance (500.3901...500.3955)|Section 500.3915 - Certain Conditions Prohibited.

500.3915 Certain conditions prohibited.Sec. 3915.  A long-term care insurance policy sold before, on, or after June 2, 1992 shall not condition benefits on any of the following:  (a) The prior institutionalization of the insured.  (b) Prior receipt of a higher level of institutional care. History: Add. 1992, Act 84, Imd. Eff. June 2, 1992 ;-- Am. 2006, Act 442, Imd. Eff. Oct. 19, 2006 Popular Name: Act 218
MI Comp L § 500.3917 (2021)
2021 Michigan Compiled Laws|Chapter 500 - Insurance Code of 1956|Act 218 of 1956 - The Insurance Code of 1956 (500.100 - 500.8302)|218-1956-39 - Chapter 39 Long-Term Care Insurance (500.3901...500.3955)|Section 500.3917 - Replacement Policy; Waiver of Time Periods Applicable to Preexisting Conditions and Probationary Periods.

500.3917 Replacement policy; waiver of time periods applicable to preexisting conditions and probationary periods. Sec. 3917.  If a long-term care insurance policy or certificate replaces another long-term care policy or certificate, the replacing insurer shall waive any time periods applicable to preexisting conditions and probationary periods for similar benefits in the new long-term care policy to the extent that similar exclusions have been satisfied under the original policy. History: Add. 1992, Act 84, Imd. Eff. June 2, 1992 Popular Name: Act 218