reglab/statecodes huggingface dataset:
2023 Michigan Compiled Laws › Chapter 500 - Insurance Code of 1956 › Act 218 of 1956 - The Insurance Code of 1956 (500.100 - 500.8302) › 218-1956-33 - Chapter 33 Automobile Insurance Placement Facility (500.3301...500.3390) › Section 500.3310 - Board of Governors of Facility; Election and Appointment of Governors; Representation of Insurance Agents and General Public; Terms; Vacancies; Adoption of Plan of Operation by Facility Committee; Approval of Plan; Amendments and Adherence to Plan.

500.3310 Board of governors of facility; election and appointment of governors; representation of insurance agents and general public; terms; vacancies; adoption of plan of operation by facility committee; approval of plan; amendments and adherence to plan.
Sec. 3310.
(1) The board of governors of the facility shall consist of 11 governors. Seven of the governors shall be elected as provided in the plan of operation. Four governors shall be appointed by the commissioner, of which 2 shall represent insurance agents subject to section 1209(1) and 2 shall represent the general public. Each governor appointed by the commissioner pursuant to this subsection shall serve an annual term. The 7 elected members of the board of governors of the facility shall be elected to serve annual terms commencing within 45 days after the annual determination of participation ratios. Vacancies shall be filled as provided for in the plan of operation.
(2) The facility committee shall adopt a plan of operation by majority vote of the committee and shall submit it to the commissioner for his or her approval. If the commissioner finds that the plan meets the requirements of this chapter, he or she shall approve it. If the commissioner finds that the plan fails to meet the requirements of this chapter, he or she shall state in what respects the plan is deficient and shall afford the facility committee 10 days within which to correct the deficiency. If the commissioner and the facility committee fail to agree that the provisions of the plan so submitted meet the requirements of this chapter, either party to the controversy may submit the issue to the circuit court for Ingham county for a determination. If the commissioner fails to render a written decision on the plan of operation within 30 days after receipt of the plan, the plan shall be considered approved.
(3) Amendments to the plan of operation shall be subject to majority approval by the board of governors and ratified by majority of the membership vote. The membership vote shall be determined as defined in section 3303(e)(iii). Amendments to the plan of operation shall be subject to the approval of the commissioner, as provided in subsection (2).
(4) Every insurer authorized to write automobile insurance in this state shall adhere to the plan of operation.
History:
Add. 1969, Act 346, Eff. Apr. 1, 1970 ;-- Am. 1979, Act 145, Eff. Jan. 1, 1981 ;-- Am. 1980, Act 461, Imd. Eff. Jan. 15, 1981 ;-- Am. 1984, Act 367, Imd. Eff. Dec. 27, 1984 ;-- Am. 1986, Act 10, Imd. Eff. Feb. 28, 1986 ;-- Am. 2001, Act 228, Eff. Mar. 1, 2002
Popular Name:
Act 218
Popular Name:
Essential Insurance
2023 Michigan Compiled Laws › Chapter 500 - Insurance Code of 1956 › Act 218 of 1956 - The Insurance Code of 1956 (500.100 - 500.8302) › 218-1956-33 - Chapter 33 Automobile Insurance Placement Facility (500.3301...500.3390) › Section 500.3315 - Repealed. 1991, Act 191, Eff. Apr. 1, 1992.

500.3315 Repealed. 1991, Act 191, Eff. Apr. 1, 1992.
Compiler's Notes:
The repealed section pertained to a program to reduce participation ratio, definition of urban area, and the effective repeal date.
Popular Name:
Act 218
Popular Name:
Essential Insurance
2023 Michigan Compiled Laws › Chapter 500 - Insurance Code of 1956 › Act 218 of 1956 - The Insurance Code of 1956 (500.100 - 500.8302) › 218-1956-33 - Chapter 33 Automobile Insurance Placement Facility (500.3301...500.3390) › Section 500.3321 - Automobiles Not Included in MCL 500.3320; Insurance Required; Equitable Distribution of Applicants to Participating Members.

500.3321 Automobiles not included in MCL 500.3320; insurance required; equitable distribution of applicants to participating members.
Sec. 3321.
The facility shall provide, with respect to all automobiles not included in section 3320:
(a) Only the insurance required by law or required by the commissioner of insurance. The commissioner may only require insurance for which a rate has been filed by an insurance rating organization or insurer and which rate is in effect and which the commissioner finds, after a public hearing, to be reasonable, necessary, and in the public interest. The temporary provision of insurance may be required pending the public hearing if the commissioner determines it necessary to do so.
(b) The equitable distribution of applicants to participating members in accordance with the participation ratios defined in section 3303.
History:
Add. 1969, Act 346, Eff. Apr. 1, 1970 ;-- Am. 1977, Act 53, Imd. Eff. July 5, 1977
Popular Name:
Act 218
Popular Name:
Essential Insurance
2023 Michigan Compiled Laws › Chapter 500 - Insurance Code of 1956 › Act 218 of 1956 - The Insurance Code of 1956 (500.100 - 500.8302) › 218-1956-33 - Chapter 33 Automobile Insurance Placement Facility (500.3301...500.3390) › Section 500.3341 - Coverage for Certain Convictions; Premium Surcharges.

500.3341 Coverage for certain convictions; premium surcharges.
Sec. 3341.
As part of its secondary or merit rating plan, the facility shall provide for premium surcharges for any or all coverages, other than comprehensive coverage, for convictions for 1 or more of the following, when that information becomes available to the facility:
(a) A violation of section 904 of the Michigan vehicle code, 1949 PA 300, MCL 257.904.
(b) A violation of section 904a of the Michigan vehicle code, 1949 PA 300, MCL 257.904a.
(c) A violation of section 91 of the Michigan penal code, 1931 PA 328, MCL 750.91, resulting from or in connection with the operation of a motor vehicle.
(d) A violation of section 316 of the Michigan penal code, 1931 PA 328, MCL 750.316, resulting from or in connection with the operation of a motor vehicle.
(e) A violation of section 317 of the Michigan penal code, 1931 PA 328, MCL 750.317, resulting from or in connection with the operation of a motor vehicle.
(f) A violation of section 321 of the Michigan penal code, 1931 PA 328, MCL 750.321, resulting from or in connection with the operation of a motor vehicle.
(g) A violation of section 324 of the Michigan penal code, 1931 PA 328, MCL 750.324, or section 601d of the Michigan vehicle code, 1949 PA 300, MCL 257.601d.
(h) A violation of section 382 of the Michigan penal code, 1931 PA 328, MCL 750.382, resulting from or in connection with the operation of a motor vehicle.
(i) A violation of section 413 of the Michigan penal code, 1931 PA 328, MCL 750.413.
(j) A violation of section 626c of the Michigan vehicle code, 1949 PA 300, MCL 257.626c.
(k) A violation substantially similar to any of the violations listed in subdivisions (a) through (j) under the laws of another state or a local unit of government of this state or another state.
History:
Add. 2002, Act 251, Imd. Eff. May 1, 2002 ;-- Am. 2002, Act 656, Imd. Eff. Dec. 23, 2002 ;-- Am. 2008, Act 468, Eff. Oct. 31, 2010
Popular Name:
Act 218
Popular Name:
Essential Insurance
2023 Michigan Compiled Laws › Chapter 500 - Insurance Code of 1956 › Act 218 of 1956 - The Insurance Code of 1956 (500.100 - 500.8302) › 218-1956-33 - Chapter 33 Automobile Insurance Placement Facility (500.3301...500.3390) › Section 500.3350 - Additional Duties of Facility.

500.3350 Additional duties of facility.
Sec. 3350.
The facility shall provide for all of the following:
(a) One or more optional deferred premium payment plans, which shall require an advance payment at least equal to 25% of the total premium or $100.00, whichever is greater.
(b) That policies issued on facility placed business may be indorsed to exclude coverage for any named person who is operating a motor vehicle after his or her driver's license has been refused, revoked, or suspended by governmental authority other than pursuant to section 310, 310b, 310d, 315, 321a, 324, 328, 512, 515, 625, 625b, 625f, 748, 801c, or 907 of Act No. 300 of the Public Acts of 1949, as amended.
(c) For publicizing and developing public understanding of the facility.
(d) For the rendering of an annual financial statement to all participating members and the commissioner.
(e) For the reinsurance of facility placed risks including, if desired, a pool for reinsuring automobile insurance coverages with limits in excess of those required by statute, or such other underwriting arrangements as may be necessary to enable participating members to offer said limits of liability insurance.
History:
Add. 1969, Act 346, Eff. Apr. 1, 1970 ;-- Am. 1979, Act 145, Eff. Jan. 1, 1981 ;-- Am. 1980, Act 461, Imd. Eff. Jan. 15, 1981 ;-- Am. 1982, Act 502, Eff. Mar. 30, 1983
Popular Name:
Act 218
Popular Name:
Essential Insurance
2023 Michigan Compiled Laws › Chapter 500 - Insurance Code of 1956 › Act 218 of 1956 - The Insurance Code of 1956 (500.100 - 500.8302) › 218-1956-33 - Chapter 33 Automobile Insurance Placement Facility (500.3301...500.3390) › Section 500.3360 - Participating Member and Agent; Relationship.

500.3360 Participating member and agent; relationship.
Sec. 3360.
A participating member may not include the premiums and losses incurred from risks insured through the facility in determining the loss ratio of any of its agents, or otherwise use the experience from such risks as cause for altering the relationship between the participating member and its agent.
History:
Add. 1969, Act 346, Eff. Apr. 1, 1970
Popular Name:
Act 218
Popular Name:
Essential Insurance
2023 Michigan Compiled Laws › Chapter 500 - Insurance Code of 1956 › Act 218 of 1956 - The Insurance Code of 1956 (500.100 - 500.8302) › 218-1956-33 - Chapter 33 Automobile Insurance Placement Facility (500.3301...500.3390) › Section 500.3365 - Eligibility for Automobile Insurance; Requesting Assignment, Rejecting Assignment, or Requesting Reassignment; Notice of Statutory Eligibility Standards.

500.3365 Eligibility for automobile insurance; requesting assignment, rejecting assignment, or requesting reassignment; notice of statutory eligibility standards.
Sec. 3365.
(1) Any qualified applicant shall be eligible for automobile insurance as provided by this chapter through the facility.
(2) Any qualified applicant shall have the right to request assignment, reject assignment, or request reassignment to any designated participating member in accordance with procedures established by the board of governors. The procedures may limit the assignments to conform to the contractual arrangement of the recipient of assignments or servicing carrier with the facility. The opportunity to request assignment and reject assignment shall be provided on the application. The opportunity to request reassignment shall be stated on the policy at the time of issuance and shall be offered in writing to the insured at the time of renewal.
(3) At least once each year, each designated participating member shall notify all persons insured through the member on behalf of the facility, in a form approved by the commissioner, of the statutory eligibility standards for obtaining automobile insurance from insurers in the voluntary market.
History:
Add. 1969, Act 346, Eff. Apr. 1, 1970 ;-- Am. 1979, Act 145, Eff. Jan. 1, 1981
Popular Name:
Act 218
Popular Name:
Essential Insurance
2023 Michigan Compiled Laws › Chapter 500 - Insurance Code of 1956 › Act 218 of 1956 - The Insurance Code of 1956 (500.100 - 500.8302) › 218-1956-33 - Chapter 33 Automobile Insurance Placement Facility (500.3301...500.3390) › Section 500.3370 - Assistance in Applying to Facility for Placement.

500.3370 Assistance in applying to facility for placement.
Sec. 3370.
If the commissioner finds, after a hearing, held pursuant to Act No. 306 of the Public Acts of 1969, as amended, or if the board of governors, upon its own motion, finds that a large number of persons are failing to gain the benefits of the facility, the facility shall provide service to assist the public in making application to the facility for placement.
History:
Add. 1969, Act 346, Eff. Apr. 1, 1970 ;-- Am. 1979, Act 145, Eff. Jan. 1, 1981
Popular Name:
Act 218
Popular Name:
Essential Insurance
2023 Michigan Compiled Laws › Chapter 500 - Insurance Code of 1956 › Act 218 of 1956 - The Insurance Code of 1956 (500.100 - 500.8302) › 218-1956-33 - Chapter 33 Automobile Insurance Placement Facility (500.3301...500.3390) › Section 500.3380 - Hearing and Ruling by Board of Governors; Grounds; Applicability of Right to Hearing; Filing Request for Hearing; Hearing to Be Prompt and Fair; Appeal; Order.

500.3380 Hearing and ruling by board of governors; grounds; applicability of right to hearing; filing request for hearing; hearing to be prompt and fair; appeal; order.
Sec. 3380.
(1) Any participating member, applicant, or person insured under a policy placed through the facility may request a formal hearing and ruling by the board of governors of the facility on any of the following:
(a) An alleged violation of the plan of operation.
(b) Any alleged improper act or ruling of the facility directly affecting an assessment, premium, or coverage furnished.
(c) A participating member's application to be a recipient of distributed assignments or to service risks.
(2) A right to a hearing under subsection (1) shall not apply to any claim arising out of insurance provided by any designated participating member. A request for hearing must be filed within 30 days after the date of the alleged act or decision.
(3) The plan of operation shall provide for prompt and fair hearings.
(4) Any formal ruling by the board of governors may be appealed to the commissioner by filing notice of appeal with the facility and commissioner within 30 days after issuance of the ruling.
(5) The commissioner shall issue an order approving the action or decision, disapproving the action or decision, or directing the board of governors to reconsider the ruling.
History:
Add. 1969, Act 346, Eff. Apr. 1, 1970 ;-- Am. 1979, Act 145, Eff. Jan. 1, 1981
Popular Name:
Act 218
Popular Name:
Essential Insurance
2023 Michigan Compiled Laws › Chapter 500 - Insurance Code of 1956 › Act 218 of 1956 - The Insurance Code of 1956 (500.100 - 500.8302) › 218-1956-33 - Chapter 33 Automobile Insurance Placement Facility (500.3301...500.3390) › Section 500.3385 - Recoupment of Assessments; Surcharge; Rate Including Factor for Recoupment.

500.3385 Recoupment of assessments; surcharge; rate including factor for recoupment.
Sec. 3385.
Any assessments paid by participating members pursuant to section 3330(1)(c) may be recouped through a surcharge in the insurers rates for automobile insurance policies issued by the member, including policies issued on behalf of the facility. A rate shall not be considered excessive because the rate includes a factor for recoupment pursuant to this section.
History:
Add. 1979, Act 145, Eff. Jan. 1, 1981
Popular Name:
Act 218
Popular Name:
Essential Insurance
2023 Michigan Compiled Laws › Chapter 500 - Insurance Code of 1956 › Act 218 of 1956 - The Insurance Code of 1956 (500.100 - 500.8302) › 218-1956-33 - Chapter 33 Automobile Insurance Placement Facility (500.3301...500.3390) › Section 500.3390 - Determinations Made by Commissioner.

500.3390 Determinations made by commissioner.
Sec. 3390.
Determinations made by the commissioner pursuant to this chapter shall be made independent of the credits provided to insurers pursuant to the former single business tax act, 1975 PA 228, or the Michigan business tax act, 2007 PA 36, MCL 208.1101 to 208.1601.
History:
Add. 1987, Act 261, Imd. Eff. Dec. 28, 1987 ;-- Am. 2007, Act 187, Imd. Eff. Dec. 21, 2007
Popular Name:
Act 218
Popular Name:
Essential Insurance
2023 Michigan Compiled Laws › Chapter 500 - Insurance Code of 1956 › Act 218 of 1956 - The Insurance Code of 1956 (500.100 - 500.8302) › 218-1956-34 - Chapter 34 Disability Insurance Policies (500.3400...500.3480) › Section 500.3400 - Definitions; Scope of Chapter, Exemptions, Exceptions.

500.3400 Definitions; scope of chapter, exemptions, exceptions.
Sec. 3400.
(1) As used in this chapter:
(a) "Affiliated provider" means a health professional, licensed hospital, licensed pharmacy, or other person that has entered into a participating provider contract, directly or indirectly, with a health maintenance organization to render 1 or more health services to an enrollee. Affiliated provider includes a person described in this subdivision that has entered into a written arrangement with another person, including, but not limited to, a physician hospital organization or physician organization, that contracts directly with a health maintenance organization.
(b) "Disability insurance policy" includes an insurance policy or insurance contract that insures against loss resulting from sickness or from bodily injury or death by accident, or both, including also the granting of specific hospital benefits and medical, surgical, and sick-care benefits to an individual, family, or group, subject to the exclusions provided in this section.
(2) This chapter does not apply to or affect any of the following:
(a) A liability or worker's disability compensation insurance policy, regardless of whether supplementary expense coverage is included.
(b) A reinsurance policy or contract.
(c) Life insurance, endowment, or annuity contracts, or contracts supplemental to life insurance, endowment, or annuity contracts, that only contain provisions relating to disability insurance that do any of the following:
(i) Provide additional benefits in case of death or dismemberment or loss of sight by accident.
(ii) Operate to safeguard the contracts against lapse or to give a special surrender value, special benefit, or annuity in the event that the insured or annuitant becomes totally and permanently disabled, as defined by the contract or supplemental contract. A supplemental contract described in this subparagraph must be issued under the authority of section 602.
(3) An insurer may omit the provisions required under sections 3407, 3411, and 3420 from ticket policies sold only to passengers by common carriers.
(4) Section 3475 applies to group, blanket, or family expense disability insurance contracts and the remaining provisions of this chapter apply to group, blanket, or family expense disability insurance contracts only as provided in this chapter.
History:
1956, Act 218, Eff. Jan. 1, 1957 ;-- Am. 1963, Act 56, Eff. Sept. 6, 1963 ;-- Am. 2016, Act 276, Imd. Eff. July 1, 2016
Popular Name:
Act 218
2023 Michigan Compiled Laws › Chapter 500 - Insurance Code of 1956 › Act 218 of 1956 - The Insurance Code of 1956 (500.100 - 500.8302) › 218-1956-34 - Chapter 34 Disability Insurance Policies (500.3400...500.3480) › Section 500.3401 - Repealed. 2016, Act 276, Imd. Eff. July 1, 2016.

500.3401 Repealed. 2016, Act 276, Imd. Eff. July 1, 2016.
Compiler's Notes:
The repealed section pertained to purpose and short title of chapter.
Popular Name:
Act 218
2023 Michigan Compiled Laws › Chapter 500 - Insurance Code of 1956 › Act 218 of 1956 - The Insurance Code of 1956 (500.100 - 500.8302) › 218-1956-34 - Chapter 34 Disability Insurance Policies (500.3400...500.3480) › Section 500.3401a - Group Disability Insurance; Issuance; Filing and Approval of Form.

500.3401a Group disability insurance; issuance; filing and approval of form.
Sec. 3401a.
(1) An insurer authorized to write disability insurance in this state may issue group disability insurance policies.
(2) Except as otherwise provided in section 2236(8)(d), an insurer shall not deliver or issue for delivery in this state a group disability insurance policy unless a copy of the form has been filed with and approved by the director.
History:
Add. 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 218
2023 Michigan Compiled Laws › Chapter 500 - Insurance Code of 1956 › Act 218 of 1956 - The Insurance Code of 1956 (500.100 - 500.8302) › 218-1956-34 - Chapter 34 Disability Insurance Policies (500.3400...500.3480) › Section 500.3402 - Disability Insurance Policy; Provisions Required.

500.3402 Disability insurance policy; provisions required.
Sec. 3402.
An insurer shall not deliver or issue for delivery in this state a disability insurance policy for an individual or family unless all of the following requirements are met:
(a) The entire money and other considerations for the policy are expressed in the policy.
(b) The time at which the insurance takes effect and terminates is expressed in the policy.
(c) The policy purports to insure only 1 individual, except that a policy may insure, originally or by subsequent amendment, upon the application of an adult member of a family who is considered to be the policyholder, any 2 or more eligible members of that family, including husband, wife, dependent children, any children under a specified age, and any other individual dependent upon the policyholder, if coverage is made available to any dependent child at least until the child turns 26 years of age for a health insurance policy or 19 years of age for a policy of disability insurance, a policy providing pediatric dental benefits, or a policy providing pediatric vision benefits.
History:
1956, Act 218, Eff. Jan. 1, 1957 ;-- Am. 2016, Act 276, Imd. Eff. July 1, 2016
Popular Name:
Act 218
2023 Michigan Compiled Laws › Chapter 500 - Insurance Code of 1956 › Act 218 of 1956 - The Insurance Code of 1956 (500.100 - 500.8302) › 218-1956-34 - Chapter 34 Disability Insurance Policies (500.3400...500.3480) › Section 500.3402a - Group Disability Insurance Policy; Provisions Required.

500.3402a Group disability insurance policy; provisions required.
Sec. 3402a.
An insurer shall include all of the following provisions in a group disability insurance policy:
(a) That the policy, application of the employer or of an executive officer or trustee of an association, and the individual applications, if any, of the employees or members insured, constitute the entire contract between the parties. The insurer's identification of what constitutes the entire contract creates a rebuttable presumption that the identified items are the entire contract.
(b) That a statement made by the employer, the executive officer or trustee of an association, or an individual employee or member, in the absence of fraud, is a representation and not a warranty. An insurer shall not use a statement made by the employer, the executive officer or trustee of an association, or an individual employee or member as a defense to a claim under the policy, unless the statement is contained in a written application.
(c) That the insurer will issue to the employer or the executive officer or trustee of an association, for delivery to an employee or member who is insured under the policy, an individual certificate that states the insurance protection to which the employee or member is entitled and to whom benefits are payable.
(d) That new employees or members, as applicable, who are eligible and who apply will be added to the group or class originally insured.
History:
Add. 2016, Act 276, Imd. Eff. July 1, 2016
Popular Name:
Act 218
2023 Michigan Compiled Laws › Chapter 500 - Insurance Code of 1956 › Act 218 of 1956 - The Insurance Code of 1956 (500.100 - 500.8302) › 218-1956-34 - Chapter 34 Disability Insurance Policies (500.3400...500.3480) › Section 500.3402b - Group or Nongroup Disability Insurance Policy; Coordination of Benefits; Provision; Limitation; "Other Coverage" Defined; Payment by Each Insurer.

500.3402b Group or nongroup disability insurance policy; coordination of benefits; provision; limitation; "other coverage" defined; payment by each insurer.
Sec. 3402b.
(1) Subject to the coordination of benefits act, 1984 PA 64, MCL 550.251 to 550.255, an insurer may include in a group or nongroup disability insurance policy a provision for the coordination of benefits otherwise payable under the policy with benefits payable for the same loss under other group or nongroup disability insurance. An insurer that does not include in a group or nongroup disability insurance policy a provision for the coordination of benefits as described in this subsection shall coordinate benefits under the policy in the manner prescribed in the coordination of benefits act, 1984 PA 64, MCL 550.251 to 550.255.
(2) Subject to subsection (1), an insurer may include a provision in a group or nongroup disability insurance policy that benefits payable by the policy may be limited if there is other valid coverage with another insurer that provides benefits for the same loss on an expense-incurred basis. The insurer may provide that if it is not given written notice on the application for coverage that the other valid coverage exists, or if other coverage is acquired after the effective date of the coverage, the only liability under any expense-incurred coverage of the policy is the amount of the covered claim that exceeds the benefits payable by the other coverage. An insurer shall apply benefits paid or payable by the primary insurer to satisfy any deductibles, coinsurance, and copayments with the policy. An insurer shall not apply payments made by a primary insurer to reduce the policy maximum limits on the policy. As used in this subsection, "other coverage" includes a plan that provides coverage under a health insurance policy, hospital or medical service subscriber contract, medical practice or other prepayment plan, or other expense-incurred plan or program. Other coverage does not include Medicaid, hospital daily indemnity plans, specified disease only policies, or limited occurrence policies that provide only for intensive care or coronary care at a hospital, first aid outpatient medical expenses resulting from accidents, or specified accidents such as travel accidents.
(3) If there are more than 1 group or nongroup disability insurance policies that cover the same loss and contain a provision described in subsection (2), and the insurers each pay a share of the covered expenses for the claim, neither insurer is required to pay more than it would have paid had it been the primary insurer.
History:
Add. 2016, Act 276, Imd. Eff. July 1, 2016
Popular Name:
Act 218
2023 Michigan Compiled Laws › Chapter 500 - Insurance Code of 1956 › Act 218 of 1956 - The Insurance Code of 1956 (500.100 - 500.8302) › 218-1956-34 - Chapter 34 Disability Insurance Policies (500.3400...500.3480) › Section 500.3402c - Family Expense Insurance Policy.

500.3402c Family expense insurance policy.
Sec. 3402c.
(1) For purposes of this chapter, family expense insurance is accident and health insurance that is written under 1 policy issued to the head of a family who may be either spouse and that insures the head of the family and 1 or more dependents, including a nondependent spouse. Benefits under a family expense insurance policy, except as applied to the head of the family, do not include indemnification for loss of time from any cause.
(2) An insurer authorized to write accident and health insurance in this state may issue family expense insurance policies.
(3) An insurer shall not deliver or issue for delivery in this state a family expense insurance policy unless a copy of the form of the policy is filed with and approved by the director.
(4) An insurer shall include in a family expense insurance policy the applicable provisions of sections 3406 to 3466 and all of the following provisions:
(a) That the policy and the application signed by the individual acting as the head of the family for the purpose of family expense insurance constitute the entire contract between the parties. The insurer's identification of what constitutes the entire contract creates a rebuttable presumption that the identified items are the entire contract.
(b) That a statement made by the head of the family, in the absence of fraud, is a representation and not a warranty. An insurer shall not use a statement made by the head of the family as a defense to a claim under the policy, unless the statement is contained in a written application.
(c) That new members of the family who are eligible, on application of the head of the family, will be added to the family group originally insured.
(5) A family expense insurance policy is subject to sections 3474 and 3474a.
History:
Add. 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 218
2023 Michigan Compiled Laws › Chapter 500 - Insurance Code of 1956 › Act 218 of 1956 - The Insurance Code of 1956 (500.100 - 500.8302) › 218-1956-34 - Chapter 34 Disability Insurance Policies (500.3400...500.3480) › Section 500.3402d - Blanket Disability Insurance; Coverage.

500.3402d Blanket disability insurance; coverage.
Sec. 3402d.
(1) For purposes of this chapter, blanket disability insurance is disability insurance that covers special groups of individuals, as follows:
(a) A policy issued to a common carrier as the policyholder and that covers a group defined as all individuals who are passengers of the common carrier.
(b) A policy issued to an employer as the policyholder and that covers all employees or any group of employees defined by reference to exceptional hazards incidental to the employment.
(c) A policy issued to a university, college, school, or other educational institution, or to the head or principal of the university, college, school, or institution as the policyholder, that covers students or teachers.
(d) A policy issued to a volunteer fire department, first aid group, or other volunteer group as the policyholder that covers all of the members of the department or group.
(e) A policy issued to a creditor as the policyholder that insures debtors of the creditor.
(f) A policy issued to a sports team or camp as the policyholder that covers members or campers.
(2) In the discretion of the director, blanket disability insurance may be issued to any other special group of individuals that is substantially similar to a group described in subsection (1).
History:
Add. 2016, Act 276, Imd. Eff. July 1, 2016
Popular Name:
Act 218
2023 Michigan Compiled Laws › Chapter 500 - Insurance Code of 1956 › Act 218 of 1956 - The Insurance Code of 1956 (500.100 - 500.8302) › 218-1956-34 - Chapter 34 Disability Insurance Policies (500.3400...500.3480) › Section 500.3402e - Blanket Disability Insurance Policies; Issuance.

500.3402e Blanket disability insurance policies; issuance.
Sec. 3402e.
(1) An insurer authorized to write disability insurance in this state may issue blanket disability insurance policies.
(2) An insurer shall not deliver or issue for delivery in this state a blanket disability insurance policy unless a copy of the form of the policy is filed with and approved by the director.
(3) A blanket disability insurance policy is subject to sections 3474 and 3474a.
History:
Add. 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 218
2023 Michigan Compiled Laws › Chapter 500 - Insurance Code of 1956 › Act 218 of 1956 - The Insurance Code of 1956 (500.100 - 500.8302) › 218-1956-34 - Chapter 34 Disability Insurance Policies (500.3400...500.3480) › Section 500.3402f - Blanket Disability Insurance Policy; Provisions.

500.3402f Blanket disability insurance policy; provisions.
Sec. 3402f.
An insurer shall include in a blanket disability insurance policy the applicable provisions of sections 3406 to 3466 and all of the following provisions:
(a) That the policy and the application signed by the policyholder constitute the entire contract between the parties. The insurer's identification of what constitutes the entire contract creates a rebuttable presumption that the identified items are the entire contract.
(b) That a statement made by the policyholder, in the absence of fraud, is a representation and not a warranty. An insurer shall not use a statement made by the policyholder as a defense to a claim under the policy, unless the statement is contained in a written application.
(c) That individuals who are eligible for coverage, on application of the policyholder, will be added to the group or class originally insured.
History:
Add. 2016, Act 276, Imd. Eff. July 1, 2016
Popular Name:
Act 218
2023 Michigan Compiled Laws › Chapter 500 - Insurance Code of 1956 › Act 218 of 1956 - The Insurance Code of 1956 (500.100 - 500.8302) › 218-1956-34 - Chapter 34 Disability Insurance Policies (500.3400...500.3480) › Section 500.3402g - Blanket Disability Insurance Policy; Certificate; Payment of Benefits.

500.3402g Blanket disability insurance policy; certificate; payment of benefits.
Sec. 3402g.
(1) An insurer shall not require an individual application from an individual covered under a blanket disability insurance policy. The director may require the insurer to furnish a certificate to each individual insured under a blanket disability policy.
(2) Except as otherwise provided in this subsection, an insurer shall pay benefits under a blanket disability insurance policy to the insured or to the insured's designated beneficiary or estate. If the insured is a minor or developmentally disabled, an insurer may pay benefits under a blanket disability insurance policy to the insured's parent, guardian, or other person to which the insured is a dependent. An insurer may provide in a blanket disability insurance policy that, with the consent of the insured, the benefits may be paid directly to a person that legally furnishes hospital, medical, surgical, or sick-care services to the insured, within the limits under the policy and without other preference as to creditors.
History:
Add. 2016, Act 276, Imd. Eff. July 1, 2016
Popular Name:
Act 218
2023 Michigan Compiled Laws › Chapter 500 - Insurance Code of 1956 › Act 218 of 1956 - The Insurance Code of 1956 (500.100 - 500.8302) › 218-1956-34 - Chapter 34 Disability Insurance Policies (500.3400...500.3480) › Section 500.3402h - Legal Liability of Policyholder.

500.3402h Legal liability of policyholder.
Sec. 3402h.
Sections 3402d to 3402g do not affect the legal liability of a policyholder for the death of or injury to an employee, member, or other individual insured under the blanket disability insurance policy.
History:
Add. 2016, Act 276, Imd. Eff. July 1, 2016
Popular Name:
Act 218
2023 Michigan Compiled Laws › Chapter 500 - Insurance Code of 1956 › Act 218 of 1956 - The Insurance Code of 1956 (500.100 - 500.8302) › 218-1956-34 - Chapter 34 Disability Insurance Policies (500.3400...500.3480) › Section 500.3403 - Health Insurance Policy Offering Dependent Coverage; Required Provisions; Denial Prohibited; Grounds.

500.3403 Health insurance policy offering dependent coverage; required provisions; denial prohibited; grounds.
Sec. 3403.
(1) An insurer that delivers, issues for delivery, or renews in this state a health insurance policy that makes dependent coverage available under the health insurance policy shall do all of the following:
(a) Make available dependent coverage, at the option of the policyholder, until the dependent has attained 26 years of age.
(b) Provide the same health insurance benefits to a dependent child that are available to any other covered dependent.
(c) Provide health insurance benefits to a dependent child at the same rate or premium applicable to any other covered dependent.
(d) Include both of the following provisions in the health insurance policy:
(i) That the health insurance benefits applicable for children are payable with respect to a newly born child of the insured from the moment of birth.
(ii) That the coverage for newly born children consists of coverage of injury or sickness including the necessary care and treatment of medically diagnosed congenital defects and birth abnormalities.
(2) A health insurance policy that offers dependent coverage shall not deny enrollment to an insured's child on any of the following grounds:
(a) The child was born out of wedlock.
(b) The child is not claimed as a dependent on the insured's federal income tax return.
(c) The child does not reside with the insured or in the insurer's service area.
(3) This section does not require an insurer or plan to make coverage available for a child of a child receiving dependent coverage.
History:
Add. 1975, Act 20, Imd. Eff. Apr. 3, 1975 ;-- Am. 2016, Act 276, Imd. Eff. July 1, 2016 ;-- Am. 2023, Act 158, Eff. Feb. 13, 2024
Compiler's Notes:
Section 2 of Act 20 of 1975 provides: “The requirements of this act shall apply to all insurance policies delivered or issued for delivery in this state more than 120 days after the effective date of the act.”
Popular Name:
Act 218
2023 Michigan Compiled Laws › Chapter 500 - Insurance Code of 1956 › Act 218 of 1956 - The Insurance Code of 1956 (500.100 - 500.8302) › 218-1956-34 - Chapter 34 Disability Insurance Policies (500.3400...500.3480) › Section 500.3404 - Insurance Policy Issued for Delivery to Nonresident.

500.3404 Insurance policy issued for delivery to nonresident.
Sec. 3404.
The director may require that a policy issued by an insurer domiciled in this state for delivery to a person residing in another state meet the standards prescribed in sections 2212a, 3402, and 3406 to 3466 if the official that is responsible for the administration of the insurance laws of the other state advises the director that the policy is not subject to approval or disapproval by the official.
History:
1956, Act 218, Eff. Jan. 1, 1957 ;-- Am. 2016, Act 276, Imd. Eff. July 1, 2016
Popular Name:
Act 218
2023 Michigan Compiled Laws › Chapter 500 - Insurance Code of 1956 › Act 218 of 1956 - The Insurance Code of 1956 (500.100 - 500.8302) › 218-1956-34 - Chapter 34 Disability Insurance Policies (500.3400...500.3480) › Section 500.3405a - Use of Most Favored Nation Clause.

500.3405a Use of most favored nation clause.
Sec. 3405a.
(1) Notwithstanding any provision of this act to the contrary, this section applies to the use of a most favored nation clause in a provider contract on and after February 1, 2013.
(2) Subject to subsection (3), beginning February 1, 2013, an insurer or a health maintenance organization shall not use a most favored nation clause in any provider contract, including a provider contract in effect on February 1, 2013, unless the most favored nation clause has been filed with and approved by the director. Subject to subsection (3), beginning February 1, 2013, an insurer or a health maintenance organization shall not enforce a most favored nation clause in any provider contract without the prior approval of the director.
(3) Beginning January 1, 2014, an insurer or a health maintenance organization shall not use a most favored nation clause in any provider contract, including a provider contract in effect on January 1, 2014.
(4) As used in this section, "most favored nation clause" means a clause that does any of the following:
(a) Prohibits, or grants a contracting insurer or health maintenance organization an option to prohibit, a provider from contracting with another party to provide health care services at a lower rate than the payment or reimbursement rate specified in the contract with the insurer or health maintenance organization.
(b) Requires, or grants a contracting insurer or health maintenance organization an option to require, a provider to accept a lower payment or reimbursement rate if the provider agrees to provide health care services to any other party at a lower rate than the payment or reimbursement rate specified in the contract with the insurer or health maintenance organization.
(c) Requires, or grants a contracting insurer or health maintenance organization an option to require, termination or renegotiation of an existing provider contract if a provider agrees to provide health care services to any other party at a lower rate than the payment or reimbursement rate specified in the contract with the insurer or health maintenance organization.
(d) Requires a provider to disclose, to the insurer or health maintenance organization or the insurer's or health maintenance organization's designee, the provider's contractual payment or reimbursement rates with other parties.
(5) As used in this section, after December 31, 2016, "insurer" includes a nonprofit dental care corporation operating under 1963 PA 125, MCL 550.351 to 550.373.
History:
Add. 2013, Act 5, Imd. Eff. Mar. 18, 2013 ;-- Am. 2016, Act 276, Imd. Eff. July 1, 2016
Popular Name:
Act 218
2023 Michigan Compiled Laws › Chapter 500 - Insurance Code of 1956 › Act 218 of 1956 - The Insurance Code of 1956 (500.100 - 500.8302) › 218-1956-34 - Chapter 34 Disability Insurance Policies (500.3400...500.3480) › Section 500.3406 - Disability Insurance Policy; Provisions Required, Captions, Omissions, Substitutions.

500.3406 Disability insurance policy; provisions required, captions, omissions, substitutions.
Sec. 3406.
(1) Except as provided in subsection (2) of this section, each such policy delivered or issued for delivery to any person in this state shall contain the provisions specified in sections 3407 through 3424 in the words in which the same appear in such sections: Provided, however, That the insurer may, at its option, substitute for 1 or more of such provisions corresponding provisions of different wording approved by the commissioner which are in each instance not less favorable in any respect to the insured or the beneficiary. Such provisions shall be preceded individually by the caption appearing in the pertinent section or, at the option of the insurer, by such appropriate individual or group captions or subcaptions as the commissioner may approve.
(2) If any such provision is in whole or in part inapplicable to or inconsistent with the coverage provided by a particular form of policy the insurer, with the approval of the commissioner, shall omit from such policy any inapplicable provision or part of a provision, and shall modify any inconsistent provision or part of the provision in such manner as to make the provision as contained in the policy consistent with the coverage provided by the policy.
History:
1956, Act 218, Eff. Jan. 1, 1957
Popular Name:
Act 218
2023 Michigan Compiled Laws › Chapter 500 - Insurance Code of 1956 › Act 218 of 1956 - The Insurance Code of 1956 (500.100 - 500.8302) › 218-1956-34 - Chapter 34 Disability Insurance Policies (500.3400...500.3480) › Section 500.3406a - Reconstructive Surgery Following Mastectomy; Prosthetic Device.

500.3406a Reconstructive surgery following mastectomy; prosthetic device.
Sec. 3406a.
An insurer that delivers, issues for delivery, or renews in this state a health insurance policy shall offer benefits for prosthetic devices to maintain or replace the body parts of an individual who has undergone a mastectomy. This coverage must provide that reasonable charges for medical care and attendance for an individual who receives reconstructive surgery following a mastectomy or who is fitted with a prosthetic device are covered benefits after the individual's attending physician has certified the medical necessity or desirability of a proposed course of rehabilitative treatment. The cost and fitting of a prosthetic device following a mastectomy is included within the type of coverage required under this section.
History:
Add. 1982, Act 527, Eff. Mar. 30, 1983 ;-- Am. 2016, Act 276, Imd. Eff. July 1, 2016
Popular Name:
Act 218
2023 Michigan Compiled Laws › Chapter 500 - Insurance Code of 1956 › Act 218 of 1956 - The Insurance Code of 1956 (500.100 - 500.8302) › 218-1956-34 - Chapter 34 Disability Insurance Policies (500.3400...500.3480) › Section 500.3406b - Coverage for Mental Health Services by Mental Health Care Provider.

500.3406b Coverage for mental health services by mental health care provider.
Sec. 3406b.
A policy or certificate which provides coverage for mental health services shall provide coverage for mental health services provided to an individual by a mental health care provider operated by or under contract with the department of mental health or a county community mental health board in those instances when appropriate mental health services cannot be delivered otherwise, or if the provider of the mental health services is designated by an order of a court; provided that the mental health provider meets the standards set by the insurer for all other providers of the type.
History:
Add. 1984, Act 280, Imd. Eff. Dec. 20, 1984
Popular Name:
Act 218
2023 Michigan Compiled Laws › Chapter 500 - Insurance Code of 1956 › Act 218 of 1956 - The Insurance Code of 1956 (500.100 - 500.8302) › 218-1956-34 - Chapter 34 Disability Insurance Policies (500.3400...500.3480) › Section 500.3406c - Hospice Care; Definition; Description of Coverage.

500.3406c Hospice care; definition; description of coverage.
Sec. 3406c.
(1) An insurer that delivers, issues for delivery, or renews in this state a health insurance policy that provides coverage for inpatient hospital care shall offer to include coverage for hospice care. As used in this section, "hospice" means a health care program that provides a coordinated set of services rendered at home or in outpatient or institutional settings for individuals suffering from a disease or condition with a terminal prognosis.
(2) If hospice care coverage is provided, an insurer shall include a description of the hospice coverage in communications sent to the insured.
History:
Add. 1984, Act 368, Eff. Jan. 1, 1986 ;-- Am. 1994, Act 233, Imd. Eff. June. 30, 1994 ;-- Am. 2016, Act 276, Imd. Eff. July 1, 2016
Popular Name:
Act 218