reglab/housing_qa huggingface dataset:
MI Comp L § 500.3544 (2021)
2021 Michigan Compiled Laws|Chapter 500 - Insurance Code of 1956|Act 218 of 1956 - The Insurance Code of 1956 (500.100 - 500.8302)|218-1956-35 - Chapter 35 Health Maintenance Organizations (500.3501...500.3580)|Section 500.3544 - Noninsured Benefit Plan; Processing and Payment of Claims.

500.3544 Noninsured benefit plan; processing and payment of claims.Sec. 3544.  (1) A health maintenance organization may process and pay claims on behalf of a noninsured benefit plan only after the health maintenance organization has received adequate money from the noninsured benefit plan sponsor to fully cover the claim payments.  (2) As used in this section, "noninsured benefit plan" means that term as defined in section 5208. History: Add. 2016, Act 276, Imd. Eff. July 1, 2016 Popular Name: Act 218
MI Comp L § 500.3545 (2021)
2021 Michigan Compiled Laws|Chapter 500 - Insurance Code of 1956|Act 218 of 1956 - The Insurance Code of 1956 (500.100 - 500.8302)|218-1956-35 - Chapter 35 Health Maintenance Organizations (500.3501...500.3580)|Section 500.3545 - Acquisition of Obligations From Another Managed Care Entity.

500.3545 Acquisition of obligations from another managed care entity.Sec. 3545.  With the director's prior approval, a health maintenance organization may acquire obligations from another managed care entity. The director shall not grant prior approval unless the director determines that the transaction will not jeopardize the health maintenance organization's financial security. History: Add. 2000, Act 252, Imd. Eff. June 29, 2000 ;-- Am. 2016, Act 276, Imd. Eff. July 1, 2016 Popular Name: Act 218Popular Name: HMO
MI Comp L § 500.3547 (2021)
2021 Michigan Compiled Laws|Chapter 500 - Insurance Code of 1956|Act 218 of 1956 - The Insurance Code of 1956 (500.100 - 500.8302)|218-1956-35 - Chapter 35 Health Maintenance Organizations (500.3501...500.3580)|Section 500.3547 - Health Care Service Operations; Visitation or Examination by Director; Consultation With Enrollees; Authority; Access to Information Relating to Delivery of Services; Submission of Information Regarding Proposed Contract.

500.3547 Health care service operations; visitation or examination by director; consultation with enrollees; authority; access to information relating to delivery of services; submission of information regarding proposed contract.Sec. 3547.  (1) The director at any time may visit or examine the health care service operations of a health maintenance organization and consult with enrollees to the extent necessary to carry out the intent of this act.  (2) The director has the authority granted under chapter 2 with regard to a health maintenance organization under this chapter.  (3) A health maintenance organization shall give the director access to all information of the health maintenance organization relating to the delivery of health services, including, but not limited to books, papers, computer databases, and documents, in a manner that preserves the confidentiality of the health records of individual enrollees.  (4) At the request of the director, a health maintenance organization shall submit information regarding a proposed contract between the health maintenance organization and an affiliated provider that the director considers necessary to ensure that the contract is in compliance with this act. History: Add. 2000, Act 252, Imd. Eff. June 29, 2000 ;-- Am. 2016, Act 276, Imd. Eff. July 1, 2016 Popular Name: Act 218Popular Name: HMO
MI Comp L § 500.3548 (2021)
2021 Michigan Compiled Laws|Chapter 500 - Insurance Code of 1956|Act 218 of 1956 - The Insurance Code of 1956 (500.100 - 500.8302)|218-1956-35 - Chapter 35 Health Maintenance Organizations (500.3501...500.3580)|Section 500.3548 - Maintenance of Books, Records, Files, and Financial Records; Funds and Assets.

500.3548 Maintenance of books, records, files, and financial records; funds and assets.Sec. 3548.  (1) A health maintenance organization shall keep all of its books, records, and files at or under the control of its principal place of doing business in this state, and shall keep a record of all of its securities, notes, mortgages, or other evidences of indebtedness, representing investment of funds at its principal place of doing business in this state in the same manner as provided for in section 5256.  (2) A health maintenance organization shall maintain financial records for its health maintenance activities separate from the financial records of any other operation or activity.   (3) A health maintenance organization shall hold and maintain legal title to all assets, including cash and investments. A health maintenance organization shall not commingle funds or assets in pooling or cash management type arrangements with affiliates or other persons. A health maintenance organization shall hold all of its assets separate from all other activities of other members in a holding company system. History: Add. 2000, Act 252, Imd. Eff. June 29, 2000 ;-- Am. 2016, Act 276, Imd. Eff. July 1, 2016 Popular Name: Act 218Popular Name: HMO
MI Comp L § 500.3549 (2021)
2021 Michigan Compiled Laws|Chapter 500 - Insurance Code of 1956|Act 218 of 1956 - The Insurance Code of 1956 (500.100 - 500.8302)|218-1956-35 - Chapter 35 Health Maintenance Organizations (500.3501...500.3580)|Section 500.3549 - Repealed. 2016, Act 276, Imd. Eff. July 1, 2016.

500.3549 Repealed. 2016, Act 276, Imd. Eff. July 1, 2016. Compiler's Notes: The repealed section pertained to notice to appropriate board by health maintenance organization as to disciplinary action.Popular Name: Act 218Popular Name: HMO
MI Comp L § 500.3551 (2021)
2021 Michigan Compiled Laws|Chapter 500 - Insurance Code of 1956|Act 218 of 1956 - The Insurance Code of 1956 (500.100 - 500.8302)|218-1956-35 - Chapter 35 Health Maintenance Organizations (500.3501...500.3580)|Section 500.3551 - Health Maintenance Organization; Net Worth.

500.3551 Health maintenance organization; net worth.Sec. 3551.  (1) A health maintenance organization shall determine its minimum net worth using accounting procedures approved by the director. The accounting procedures must ensure that a health maintenance organization is financially and actuarially sound.  (2) To obtain or maintain a certificate of authority in this state, a health maintenance organization shall possess and maintain unimpaired net worth in an amount determined adequate by the director to continue to comply with section 403 but not in an amount less than the following, as applicable:  (a) For a health maintenance organization that contracts with or employs providers in numbers sufficient to provide 90% of the health maintenance organization's benefit payout, minimum net worth is the greatest of the following:  (i) $1,500,000.00.  (ii) Four percent of the health maintenance organization's subscription revenue.  (iii) Three months' uncovered expenditures.  (b) For a health maintenance organization that does not contract with or employ providers in numbers sufficient to provide 90% of the health maintenance organization's benefit payout, minimum net worth is the greatest of the following:  (i) $3,000,000.00.  (ii) Ten percent of the health maintenance organization's subscription revenue.  (iii) Three months' uncovered expenditures.  (3) The director shall take into account the risk-based capital requirements as developed by the National Association of Insurance Commissioners in order to determine adequate compliance with section 403 under this section. History: Add. 2000, Act 252, Imd. Eff. June 29, 2000 ;-- Am. 2016, Act 276, Imd. Eff. July 1, 2016 Popular Name: Act 218Popular Name: HMO
MI Comp L § 500.3553 (2021)
2021 Michigan Compiled Laws|Chapter 500 - Insurance Code of 1956|Act 218 of 1956 - The Insurance Code of 1956 (500.100 - 500.8302)|218-1956-35 - Chapter 35 Health Maintenance Organizations (500.3501...500.3580)|Section 500.3553 - Certificate of Authority; Deposit Requirements.

500.3553 Certificate of authority; deposit requirements.Sec. 3553.  (1) To obtain or maintain a certificate of authority in this state, a health maintenance organization shall possess and maintain a deposit in an amount determined adequate by the director to continue to comply with section 403 but not less than $100,000.00 plus 5% of annual subscription revenue up to a $1,000,000.00 maximum deposit.  (2) A health maintenance organization shall make the deposit required under subsection (1) with the state treasurer or with a federal or state chartered financial institution under a trust indenture acceptable to the director for the sole benefit of the subscribers and enrollees in case of insolvency. History: Add. 2000, Act 252, Imd. Eff. June 29, 2000 ;-- Am. 2016, Act 276, Imd. Eff. July 1, 2016 Popular Name: Act 218Popular Name: HMO
MI Comp L § 500.3555 (2021)
2021 Michigan Compiled Laws|Chapter 500 - Insurance Code of 1956|Act 218 of 1956 - The Insurance Code of 1956 (500.100 - 500.8302)|218-1956-35 - Chapter 35 Health Maintenance Organizations (500.3501...500.3580)|Section 500.3555 - Financial Plan.

500.3555 Financial plan.Sec. 3555.  A health maintenance organization shall maintain a financial plan evaluating, at a minimum, cash flow needs and adequacy of working capital. The plan under this subsection must do all of the following:  (a) Demonstrate compliance with all health maintenance organization financial requirements provided for in this act.  (b) Provide for adequate working capital, which must not be negative at any time. The director may establish a minimum working capital requirement for a health maintenance organization to ensure the prompt payment of liabilities.  (c) Identify the means of achieving and maintaining a positive cash flow, including provisions for retirement of existing or proposed indebtedness. History: Add. 2000, Act 252, Imd. Eff. June 29, 2000 ;-- Am. 2016, Act 276, Imd. Eff. July 1, 2016 Popular Name: Act 218Popular Name: HMO
MI Comp L § 500.3557 (2021)
2021 Michigan Compiled Laws|Chapter 500 - Insurance Code of 1956|Act 218 of 1956 - The Insurance Code of 1956 (500.100 - 500.8302)|218-1956-35 - Chapter 35 Health Maintenance Organizations (500.3501...500.3580)|Section 500.3557 - Notice of Changes in Operations.

500.3557 Notice of changes in operations.Sec. 3557.  A health maintenance organization shall file notice with the director of any substantive changes in operations within 30 days after the substantive change in operations occurs. A substantive change in operations includes, but is not limited to, any of the following:  (a) A change in the health maintenance organization's officers or directors. In addition to the notification, the health maintenance organization shall file a disclosure statement on a form prescribed by the director for each newly appointed or elected officer or director.  (b) A change in the location of corporate offices.  (c) A change in the organization's articles of incorporation or bylaws. A health maintenance organization shall include a copy of the revised articles of incorporation or bylaws with the notice.  (d) A change in contractual arrangements under which the health maintenance organization is managed.  (e) Any other significant change in operations. History: Add. 2000, Act 252, Imd. Eff. June 29, 2000 ;-- Am. 2016, Act 276, Imd. Eff. July 1, 2016 Popular Name: Act 218Popular Name: HMO
MI Comp L § 500.3559 (2021)
2021 Michigan Compiled Laws|Chapter 500 - Insurance Code of 1956|Act 218 of 1956 - The Insurance Code of 1956 (500.100 - 500.8302)|218-1956-35 - Chapter 35 Health Maintenance Organizations (500.3501...500.3580)|Section 500.3559 - Reinsurance Contract or Plan of Self-Insurance; Purpose; Filing; Approval; Coverage.

500.3559 Reinsurance contract or plan of self-insurance; purpose; filing; approval; coverage.Sec. 3559.  (1) Subject to subsection (2), a health maintenance organization shall obtain a reinsurance contract or establish a plan of self-insurance as necessary to ensure solvency or to protect subscribers in the event of insolvency. A reinsurance contract must be with an insurer that is authorized or eligible to transact insurance in this state.  (2) A health maintenance organization shall file a reinsurance contract or plan under subsection (1) for approval with the director within 30 days after the finalization of the contract or plan. A reinsurance contract or plan must clearly state all services to be received by the health maintenance organization. A reinsurance contract or plan is considered approved 30 days after it is filed with the director unless disapproved in writing by the director before the expiration of the 30 days.  (3) A health maintenance organization shall maintain insurance coverage to protect the health maintenance organization that includes, at a minimum, fire, theft, fidelity, general liability, errors and omissions, director's and officer's liability coverage, and malpractice insurance. A health maintenance organization shall obtain the director's prior approval before self-insuring for these coverages. History: Add. 2000, Act 252, Imd. Eff. June 29, 2000 ;-- Am. 2016, Act 276, Imd. Eff. July 1, 2016 Compiler's Notes: Enacting section 3 of Act 276 of 2016 provides:"Enacting section 3. On the effective date of this amendatory act, an insurer may submit to the director of the department of insurance and financial services for approval any modification to policies and certificates that were approved before or on the effective date of this amendatory act, to conform with amendments made to the insurance code of 1956, 1956 PA 218, MCL 500.100 to 500.8302, by this amendatory act. This enacting section does not apply to rates and rating methodologies."Popular Name: Act 218Popular Name: HMO
MI Comp L § 500.3561 (2021)
2021 Michigan Compiled Laws|Chapter 500 - Insurance Code of 1956|Act 218 of 1956 - The Insurance Code of 1956 (500.100 - 500.8302)|218-1956-35 - Chapter 35 Health Maintenance Organizations (500.3501...500.3580)|Section 500.3561 - Insolvency; Continuation of Benefits.

500.3561 Insolvency; continuation of benefits.Sec. 3561.  A health maintenance organization shall have a plan for handling insolvency that allows for continuation of benefits for the duration of the health maintenance contract period for which premiums have been paid and continuation of benefits to any enrollee who is confined on the date of insolvency in an inpatient facility until his or her discharge from the facility. Continuation of benefits in the event of insolvency is satisfied if the health maintenance organization has at least 1 of the following, as approved by the director:  (a) A financial guarantee contract insured by a surety bond issued by an independent insurer with a secure rating from a rating agency that meets the requirements of section 436a(1)(p).  (b) A reinsurance contract issued by an authorized or eligible insurer to cover the expenses to be paid for continued benefits after an insolvency.  (c) A contract between the health maintenance organization and its affiliated providers that provides for the continuation of provider services in the event of the health maintenance organization's insolvency. A health maintenance organization shall include in a contract under this subdivision a mechanism for appropriate sharing by the health maintenance organization of the continuation of provider services as approved by the director and shall not include a provision that continuation of provider services is solely the responsibility of the affiliated providers.  (d) An irrevocable letter of credit.  (e) An insolvency reserve account established with a federal or state chartered financial institution under a trust indenture acceptable to the director for the sole benefit of subscribers and enrollees, equal to 3 months' premium income. History: Add. 2000, Act 252, Imd. Eff. June 29, 2000 ;-- Am. 2016, Act 276, Imd. Eff. July 1, 2016 Popular Name: Act 218Popular Name: HMO
MI Comp L § 500.3565 (2021)
2021 Michigan Compiled Laws|Chapter 500 - Insurance Code of 1956|Act 218 of 1956 - The Insurance Code of 1956 (500.100 - 500.8302)|218-1956-35 - Chapter 35 Health Maintenance Organizations (500.3501...500.3580)|Section 500.3565 - Repealed. 2016, Act 276, Imd. Eff. July 1, 2016.

500.3565 Repealed. 2016, Act 276, Imd. Eff. July 1, 2016. Compiler's Notes: The repealed section pertained to cancellation of contract with nongroup member enrollee by nongroup subscriber.Popular Name: Act 218Popular Name: HMO
MI Comp L § 500.3567 (2021)
2021 Michigan Compiled Laws|Chapter 500 - Insurance Code of 1956|Act 218 of 1956 - The Insurance Code of 1956 (500.100 - 500.8302)|218-1956-35 - Chapter 35 Health Maintenance Organizations (500.3501...500.3580)|Section 500.3567 - Repealed. 2016, Act 276, Imd. Eff. July 1, 2016.

500.3567 Repealed. 2016, Act 276, Imd. Eff. July 1, 2016. Compiler's Notes: The repealed section pertained to cancellation of contract with nongroup member enrollee by health maintenance organization.Popular Name: Act 218Popular Name: HMO
MI Comp L § 500.3569 (2021)
2021 Michigan Compiled Laws|Chapter 500 - Insurance Code of 1956|Act 218 of 1956 - The Insurance Code of 1956 (500.100 - 500.8302)|218-1956-35 - Chapter 35 Health Maintenance Organizations (500.3501...500.3580)|Section 500.3569 - Assumption of Financial Risk.

500.3569 Assumption of financial risk.Sec. 3569.  (1) Except as provided in section 3515(2), a health maintenance organization shall assume full financial risk on a prospective basis for the provision of health services under a health maintenance organization contract. A health maintenance organization may do any of the following:  (a) Require an affiliated provider to assume financial risk under the terms of its contract.  (b) Obtain insurance.  (c) Make other arrangements for the cost of providing to an enrollee health services the aggregate value of which is more than $5,000.00 in a year for that enrollee.  (2) If the health maintenance organization requires an affiliated provider to assume financial risk under the terms of its contract, the contract must require both of the following:  (a) The health maintenance organization to pay the affiliated provider, including a subcontracted provider, directly or through a licensed third party administrator for health services provided to its enrollees.  (b) The health maintenance organization to keep all pooled funds and withhold amounts and account for them on its financial books and records and reconcile them at year end pursuant to the contract.  (3) For purposes of this section, a health maintenance organization requires an affiliated provider to assume financial risk if it shares with the affiliated provider, in return for consideration, a portion of the chance of loss, including expenses incurred, related to the delivery of health services to enrollees. The type of transactions under which a health maintenance organization may require an affiliated provider to assume financial risk under this section include, but are not limited to, full or partial capitation agreements, withholds, risk corridors, and indemnity agreements. History: Add. 2000, Act 252, Imd. Eff. June 29, 2000 ;-- Am. 2016, Act 276, Imd. Eff. July 1, 2016 Popular Name: Act 218Popular Name: HMO
MI Comp L § 500.3571 (2021)
2021 Michigan Compiled Laws|Chapter 500 - Insurance Code of 1956|Act 218 of 1956 - The Insurance Code of 1956 (500.100 - 500.8302)|218-1956-35 - Chapter 35 Health Maintenance Organizations (500.3501...500.3580)|Section 500.3571 - State or Federal Health Programs.

500.3571 State or federal health programs.Sec. 3571.  A health maintenance organization that participates in a state or federal health program shall meet the solvency and financial requirements of this act, unless the health maintenance organization is in receivership or under supervision. Notwithstanding any provision of this act to the contrary, a health maintenance organization that participates in a state or federal health program is not required to offer benefits or services that exceed the requirements of the applicable program. This section does not apply to state employee or federal employee health programs. History: Add. 2000, Act 252, Imd. Eff. June 29, 2000 ;-- Am. 2005, Act 306, Imd. Eff. Dec. 21, 2005 ;-- Am. 2016, Act 276, Imd. Eff. July 1, 2016 Popular Name: Act 218Popular Name: HMO
MI Comp L § 500.3573 (2021)
2021 Michigan Compiled Laws|Chapter 500 - Insurance Code of 1956|Act 218 of 1956 - The Insurance Code of 1956 (500.100 - 500.8302)|218-1956-35 - Chapter 35 Health Maintenance Organizations (500.3501...500.3580)|Section 500.3573 - Operation of Health Care Delivery System Not Meeting Requirements of Act; Permitted Conduct; Limitations.

500.3573 Operation of health care delivery system not meeting requirements of act; permitted conduct; limitations.Sec. 3573.  (1) A person that proposes to operate a system of health care delivery and financing to be offered to individuals, whether or not as members of groups, in exchange for a fixed payment and to be organized so that providers and the organization are in some part at risk for the cost of services in a manner similar to a health maintenance organization, but that fails to meet the requirements of this act for a health maintenance organization, may operate the system of health care delivery and financing if the director finds that the proposed operation will benefit persons who will be served by it. The director shall authorize and regulate the operation of the system in the same manner as a health maintenance organization under this act, including the filing of periodic reports, except to the extent that the director finds that the regulation is inappropriate to the system of health care delivery and financing.  (2) A person operating a system of health care delivery and financing under this section shall not advertise or solicit or in any way identify itself in a manner implying to the public that it is a health maintenance organization authorized under this act. History: Add. 2000, Act 252, Imd. Eff. June 29, 2000 ;-- Am. 2016, Act 276, Imd. Eff. July 1, 2016 Popular Name: Act 218Popular Name: HMO
MI Comp L § 500.3580 (2021)
2021 Michigan Compiled Laws|Chapter 500 - Insurance Code of 1956|Act 218 of 1956 - The Insurance Code of 1956 (500.100 - 500.8302)|218-1956-35 - Chapter 35 Health Maintenance Organizations (500.3501...500.3580)|Section 500.3580 - Repealed. 2016, Act 276, Imd. Eff. July 1, 2016.

500.3580 Repealed. 2016, Act 276, Imd. Eff. July 1, 2016. Compiler's Notes: The repealed section pertained to consumer guide to health maintenance organization.Popular Name: Act 218Popular Name: HMO
MI Comp L § 500.3600 (2021)
2021 Michigan Compiled Laws|Chapter 500 - Insurance Code of 1956|Act 218 of 1956 - The Insurance Code of 1956 (500.100 - 500.8302)|218-1956-36 - Chapter 36 Group and Blanket Disability Insurance (500.3600...500.3650)|Section 500.3600 - Repealed. 2016, Act 276, Imd. Eff. July 1, 2016.

500.3600 Repealed. 2016, Act 276, Imd. Eff. July 1, 2016. Compiler's Notes: The repealed section pertained to scope of chapter.Popular Name: Act 218
MI Comp L § 500.3601 (2021)
2021 Michigan Compiled Laws|Chapter 500 - Insurance Code of 1956|Act 218 of 1956 - The Insurance Code of 1956 (500.100 - 500.8302)|218-1956-36 - Chapter 36 Group and Blanket Disability Insurance (500.3600...500.3650)|Section 500.3601 - Repealed. 2016, Act 276, Imd. Eff. July 1, 2016.

500.3601 Repealed. 2016, Act 276, Imd. Eff. July 1, 2016. Compiler's Notes: The repealed section pertained to "group disability insurance" definition.Popular Name: Act 218
MI Comp L § 500.3601a (2021)
2021 Michigan Compiled Laws|Chapter 500 - Insurance Code of 1956|Act 218 of 1956 - The Insurance Code of 1956 (500.100 - 500.8302)|218-1956-36 - Chapter 36 Group and Blanket Disability Insurance (500.3600...500.3650)|Section 500.3601a - Repealed. 2016, Act 276, Imd. Eff. July 1, 2016.

500.3601a Repealed. 2016, Act 276, Imd. Eff. July 1, 2016. Compiler's Notes: The repealed section pertained to issuance of group disability policy to trust or trustees.Popular Name: Act 218