reglab/statecodes huggingface dataset:
2023 Michigan Compiled Laws › Chapter 550 - General Insurance Laws › Act 350 of 1980 - The Nonprofit Health Care Corporation Reform Act (550.1101 - 550.1704) › 350-1980-6 - Part 6 (550.1601...550.1620) › Section 550.1614 - Interim Rates; Petition; Determination; Granting Interim Rate; Final Rate Determination; Refunds or Adjustments; Limitation on Order Establishing Interim Rate Adjustment; Rates to Which Section Applicable.

550.1614 Interim rates; petition; determination; granting interim rate; final rate determination; refunds or adjustments; limitation on order establishing interim rate adjustment; rates to which section applicable.
Sec. 614.
(1) Not less than 75 days after a filing is received, as provided in section 610, the health care corporation may petition the commissioner, who shall make a determination with respect to interim rates and shall order interim rates in the amount prescribed in subsection (2). Interim rates shall not be implemented if the commissioner finds that the health care corporation has substantially contributed to the delay or that the health care corporation has not provided information requested by the commissioner relative to a determination under this section. The interim rate determination shall not be a contested case under chapter 4 of the administrative procedures act.
(2) The commissioner shall grant an interim rate, in an amount as determined by the commissioner, if the commissioner makes a finding that the corporation has made a convincing showing that there is probable cause to believe that the failure to grant the interim rate will result in an underwriting loss for that line of business for the period for which rates are being requested. As used in this subsection, "underwriting loss" means the difference between income from current rates plus investment income, and projected claims plus projected administrative expenses.
(3) If the final rate determination results in approval of a lower rate, appropriate refunds or adjustments, as determined by the commissioner, shall be made to reflect payments made in excess of the approved rate.
(4) The order establishing an interim rate adjustment made pursuant to this section shall be limited to adjusting rates for certificates then in effect, and shall not be used to alter certificates or implement new certificates.
(5) This section shall apply only to rates subject to section 608(1) for which a hearing has been requested.
History:
1980, Act 350, Eff. Apr. 3, 1981
Popular Name:
Blue Cross-Blue Shield
Popular Name:
Act 350
2023 Michigan Compiled Laws › Chapter 550 - General Insurance Laws › Act 350 of 1980 - The Nonprofit Health Care Corporation Reform Act (550.1101 - 550.1704) › 350-1980-6 - Part 6 (550.1601...550.1620) › Section 550.1615 - Review of Final Order or Decision.

550.1615 Review of final order or decision.
Sec. 615.
Any final order or decision made, issued, or executed by the commissioner under this act after a hearing held before the commissioner or a deputy commissioner pursuant to the administrative procedures act shall be subject to review as provided in chapter 6 of the administrative procedures act without leave by the circuit court for Ingham county.
History:
1980, Act 350, Eff. Apr. 3, 1981
Popular Name:
Blue Cross-Blue Shield
Popular Name:
Act 350
2023 Michigan Compiled Laws › Chapter 550 - General Insurance Laws › Act 350 of 1980 - The Nonprofit Health Care Corporation Reform Act (550.1101 - 550.1704) › 350-1980-6 - Part 6 (550.1601...550.1620) › Section 550.1617 - Rules.

550.1617 Rules.
Sec. 617.
The commissioner may promulgate rules which the commissioner considers necessary to carry out the purposes of, and to execute and enforce this act. The rules shall be promulgated pursuant to the administrative procedures act.
History:
1980, Act 350, Eff. Apr. 3, 1981
Popular Name:
Blue Cross-Blue Shield
Popular Name:
Act 350
2023 Michigan Compiled Laws › Chapter 550 - General Insurance Laws › Act 350 of 1980 - The Nonprofit Health Care Corporation Reform Act (550.1101 - 550.1704) › 350-1980-6 - Part 6 (550.1601...550.1620) › Section 550.1618 - Compliance With New Procedures, Benefits, or Contracts.

550.1618 Compliance with new procedures, benefits, or contracts.
Sec. 618.
Whenever any section of this act requires a health care corporation to implement any new procedure, provide any new benefit, or enter into any new contract, the commissioner shall give the health care corporation a reasonable time to comply with the requirements.
History:
1980, Act 350, Eff. Apr. 3, 1981
Popular Name:
Blue Cross-Blue Shield
Popular Name:
Act 350
2023 Michigan Compiled Laws › Chapter 550 - General Insurance Laws › Act 350 of 1980 - The Nonprofit Health Care Corporation Reform Act (550.1101 - 550.1704) › 350-1980-6 - Part 6 (550.1601...550.1620) › Section 550.1619 - Injunction; Declaratory and Equitable Relief; Enforcement of Act or Rules.

550.1619 Injunction; declaratory and equitable relief; enforcement of act or rules.
Sec. 619.
(1) The attorney general may bring an action, or apply to the circuit court for a court order, to enjoin a health care corporation from transacting business, receiving, collecting, or disbursing money, or acquiring, holding, protecting, or conveying property if that corporate activity is not authorized under this act.
(2) The attorney general may apply to the circuit court for a court order enjoining an alleged violation of this act or other equitable or extraordinary relief to enforce this act.
(3) A political subdivision of this state, an agency of this state, or any person may bring an action in the circuit court for Ingham county for declaratory and equitable relief against the commissioner or to compel the commissioner to enforce this act or rules promulgated under this act.
History:
1980, Act 350, Eff. Apr. 3, 1981
Popular Name:
Blue Cross-Blue Shield
Popular Name:
Act 350
2023 Michigan Compiled Laws › Chapter 550 - General Insurance Laws › Act 350 of 1980 - The Nonprofit Health Care Corporation Reform Act (550.1101 - 550.1704) › 350-1980-6 - Part 6 (550.1601...550.1620) › Section 550.1620 - Certificate Subject to Policy and Certificate Issuance and Rate Filing Requirements; Establishment of Reasonable Open Enrollment Periods; Frequency and Duration; Denial, Condition, or Discrimination.

550.1620 Certificate subject to policy and certificate issuance and rate filing requirements; establishment of reasonable open enrollment periods; frequency and duration; denial, condition, or discrimination.
Sec. 620.
(1) Notwithstanding any provision of this act to the contrary, a certificate delivered, issued for delivery, or renewed in this state on or after January 1, 2014 by a health care corporation is subject to the policy and certificate issuance and rate filing requirements of the insurance code of 1956, 1956 PA 218, MCL 500.100 to 500.8302, including the rating factor requirements of section 3474a of the insurance code of 1956, 1956 PA 218, MCL 500.3474a.
(2) For a certificate delivered, issued for delivery, or renewed in this state on or after January 1, 2014, subject to the prior approval of the commissioner, a health care corporation may establish reasonable open enrollment periods.
(3) The commissioner shall establish minimum standards for the frequency and duration of open enrollment periods established under subsection (2). The commissioner shall uniformly apply the minimum standards for the frequency and duration of open enrollment periods established under this subsection to all health care corporations.
(4) A health care corporation offering coverage during an open enrollment period established under subsection (2) shall not deny or condition the issuance or effectiveness of a certificate and shall not discriminate in the pricing of the certificate on the basis of health status, claims experience, receipt of health care, or medical condition.
History:
Add. 2013, Act 4, Imd. Eff. Mar. 18, 2013
Popular Name:
Blue Cross-Blue Shield
Popular Name:
Act 350
2023 Michigan Compiled Laws › Chapter 550 - General Insurance Laws › Act 350 of 1980 - The Nonprofit Health Care Corporation Reform Act (550.1101 - 550.1704) › 350-1980-6A - Part 6a Health Endowment Fund Corporations (550.1651...550.1655) › Section 550.1651 - Definitions.

550.1651 Definitions.
Sec. 651.
As used in this part:
(a) "Board" means the board of a health endowment fund corporation incorporated under this part.
(b) "Executive director" means the executive director of a fund appointed by the board.
(c) "Fund" means a health endowment fund corporation organized as a nonprofit corporation under section 653.
History:
Add. 2013, Act 4, Imd. Eff. Mar. 18, 2013
Popular Name:
Blue Cross-Blue Shield
Popular Name:
Act 350
2023 Michigan Compiled Laws › Chapter 550 - General Insurance Laws › Act 350 of 1980 - The Nonprofit Health Care Corporation Reform Act (550.1101 - 550.1704) › 350-1980-6A - Part 6a Health Endowment Fund Corporations (550.1651...550.1655) › Section 550.1654 - Executive Director.

550.1654 Executive director.
Sec. 654.
(1) A board shall appoint an executive director to serve as the chief executive officer of the fund. The executive director shall serve at the pleasure of the board. The executive director may employ staff and hire consultants as necessary with the approval of the board. The board shall determine compensation for the executive director and staff employed under this subsection and shall approve contracts under this subsection.
(2) The executive director shall display on the fund internet website information relevant to the public, as defined by the board, concerning the fund's operations and efficiencies, as well as the board's assessments of those activities.
History:
Add. 2013, Act 4, Imd. Eff. Mar. 18, 2013
Popular Name:
Blue Cross-Blue Shield
Popular Name:
Act 350
2023 Michigan Compiled Laws › Chapter 550 - General Insurance Laws › Act 350 of 1980 - The Nonprofit Health Care Corporation Reform Act (550.1101 - 550.1704) › 350-1980-7 - Part 7 (550.1701...550.1704) › Section 550.1702 - Discontinuation of Certain Rules; Continuation of Certain Orders and Approvals.

550.1702 Discontinuation of certain rules; continuation of certain orders and approvals.
Sec. 702.
Rules which were promulgated under former Act No. 108 or 109 of the Public Acts of 1939, shall not continue in effect under this act. Orders issued and approvals granted by the commissioner under former Act No. 108 or 109 of the Public Acts of 1939, shall continue in effect until rescinded or withdrawn by the commissioner under this act.
History:
1980, Act 350, Eff. Apr. 3, 1981
Compiler's Notes:
Acts 108 and 109 of 1939, referred to in this section, were repealed by Act 350 of 1980.
Popular Name:
Blue Cross-Blue Shield
Popular Name:
Act 350
2023 Michigan Compiled Laws › Chapter 550 - General Insurance Laws › Act 350 of 1980 - The Nonprofit Health Care Corporation Reform Act (550.1101 - 550.1704) › 350-1980-7 - Part 7 (550.1701...550.1704) › Section 550.1703 - Repeal of MCL 550.301 to 550.316 and 550.501 to 550.517.

550.1703 Repeal of MCL 550.301 to 550.316 and 550.501 to 550.517.
Sec. 703.
The following acts and parts of acts are repealed:
(a) Act No. 108 of the Public Acts of 1939, as amended, being sections 550.301 to 550.316 of the Compiled Laws of 1970.
(b) Act No. 109 of the Public Acts of 1939, as amended, being sections 550.501 to 550.517 of the Compiled Laws of 1970.
History:
1980, Act 350, Eff. Apr. 3, 1981
Popular Name:
Blue Cross-Blue Shield
Popular Name:
Act 350
2023 Michigan Compiled Laws › Chapter 550 - General Insurance Laws › Act 350 of 1980 - The Nonprofit Health Care Corporation Reform Act (550.1101 - 550.1704) › 350-1980-7 - Part 7 (550.1701...550.1704) › Section 550.1704 - Effective Date.

550.1704 Effective date.
Sec. 704.
This act shall take effect April 3, 1981.
History:
1980, Act 350, Eff. Apr. 3, 1981
Popular Name:
Blue Cross-Blue Shield
Popular Name:
Act 350
2023 Michigan Compiled Laws › Chapter 550 - General Insurance Laws › Repealed - Act 142 of 2011 - Health Insurance Claims Assessment Act (550.1731 - 550.1741)

HEALTH INSURANCE CLAIMS ASSESSMENT ACT
Act 142 of 2011
550.1731-550.1741 Repealed. 2018, Act 173, Eff. Oct. 1, 2018
2023 Michigan Compiled Laws › Chapter 550 - General Insurance Laws › Act 175 of 2018 - Insurance Provider Assessment Act (550.1751 - 550.1767) › Section 550.1751 - Short Title.

550.1751 Short title.
Sec. 1.
This act shall be known and may be cited as the "insurance provider assessment act".
History:
2018, Act 175, Imd. Eff. June 11, 2018
2023 Michigan Compiled Laws › Chapter 550 - General Insurance Laws › Act 175 of 2018 - Insurance Provider Assessment Act (550.1751 - 550.1767) › Section 550.1753 - Definitions.

550.1753 Definitions.
Sec. 3.
As used in this act:
(a) "Department" means the department of treasury.
(b) "Excess loss" or "stop loss" means coverage that provides insurance protection against the accumulation of total claims exceeding a stated level for a group as a whole or protection against a high-dollar claim on any 1 individual.
(c) "Federal employee health benefit" means the program of health benefits plans, as defined in 5 USC 8901, available to federal employees under 5 USC 8901 to 8914.
(d) "Fund" means the insurance provider fund created in section 13.
(e) "Health insurer" means an insurer authorized under the insurance code of 1956, 1956 PA 218, MCL 500.100 to 500.8302, to deliver, issue for delivery, or renew in this state a health insurance policy. Health insurer includes a health maintenance organization. Health insurer does not include a state department or agency administering a plan of medical assistance under the social welfare act, 1939 PA 280, MCL 400.1 to 400.119b, or a person administering a self-funded plan.
(f) "Insurance provider" means a Medicaid managed care organization or a health insurer.
(g) "Medicaid contracted health plan" means a contracted health plan as that term is defined in section 106 of the social welfare act, 1939 PA 280, MCL 400.106.
(h) "Medicaid managed care organization" means a Medicaid contracted health plan or a specialty prepaid health plan.
(i) "Medicare" means the federal Medicare program established under title XVIII of the social security act, 42 USC 1395 to 1395lll.
(j) "Member months" means the total number of individuals for whom the insurance provider has recognized revenue for 1 month. If revenue is recognized for only part of a month for an individual, a prorated partial member month may be counted. Member months are determined by the department of insurance and financial services and do not include individuals enrolled in short-term medical, 1-time limited duration, noncomprehensive medical, specified disease, limited benefit, accident only, accidental death and dismemberment, disability income, long-term care, Medicare supplement, stand-alone dental, dental, Medicare, Medicare advantage, Medicare part D, vision, prescription, other individual write-in coverage, federal employee health benefit, Tricare, other group write-in coverage, credit, stop loss, excess loss, administrative services only, or administrative services contracts.
(k) "Specialty prepaid health plan" means an entity designated by the department of health and human services as a regional entity pursuant to section 204b of the mental health code, 1974 PA 258, MCL 330.1204b, or a specialty prepaid health plan pursuant to section 232b of the mental health code, 1974 PA 258, MCL 330.1232b, to provide mental health services, services to individuals with developmental disabilities, and substance use disorder services.
History:
2018, Act 175, Imd. Eff. June 11, 2018
2023 Michigan Compiled Laws › Chapter 550 - General Insurance Laws › Act 175 of 2018 - Insurance Provider Assessment Act (550.1751 - 550.1767) › Section 550.1755 - Waiver Request; Notification of Member Months, Rate, and Insurance Providers by Tier.

550.1755 Waiver request; notification of member months, rate, and insurance providers by tier.
Sec. 5.
(1) If the department of health and human services has not already submitted an application to the federal Centers for Medicare and Medicaid Services to request a waiver, for a period of not less than 5 years, of the broad-based and uniformity provisions of section 1903(w)(3)(B) and (C) of title XIX of the social security act, 42 USC 1396b, relating to the assessment imposed under this act, the department of health and human services shall submit the request before October 1, 2018 and as necessary thereafter to implement this act.
(2) Within 30 days after the effective date of this act, the department of health and human services shall notify the department of the number of member months and the rate to be imposed on these member months under section 7(1)(a)(i) for the 2018-2019 state fiscal year and identify the specialty prepaid health plans subject to the assessment under this act.
(3) Within 30 days after the effective date of this act, the department of insurance and financial services shall provide the department with a list of insurance providers by tier that are subject to the assessment under this act.
History:
2018, Act 175, Imd. Eff. June 11, 2018
2023 Michigan Compiled Laws › Chapter 550 - General Insurance Laws › Act 175 of 2018 - Insurance Provider Assessment Act (550.1751 - 550.1767) › Section 550.1759 - Records; Failure to File Return or Keep Proper Records; Right of Department to Impose Assessment.

550.1759 Records; failure to file return or keep proper records; right of department to impose assessment.
Sec. 9.
(1) An insurance provider liable for the assessment under this act shall keep accurate and complete records and pertinent documents as may be required by the department. Records required by the department shall be retained for a period of 4 years after the assessment imposed under this act to which the records apply is due or as otherwise provided by law.
(2) If the department considers it necessary, the department may require a person, by notice served upon that person, to make a return, render under oath certain statements, or keep certain records the department considers sufficient to show whether that person is liable for the assessment under this act.
(3) If an insurance provider fails to file a return or keep proper records as may be required under this section, or if the department has reason to believe that any records kept or returns filed are inaccurate or incomplete and that additional assessments are due, the department may compute the amount of the assessment due from the insurance provider based on information that is available or that may become available to the department. An assessment under this subsection is considered prima facie correct under this act, and an insurance provider has the burden of proof for refuting the assessment.
History:
2018, Act 175, Imd. Eff. June 11, 2018
2023 Michigan Compiled Laws › Chapter 550 - General Insurance Laws › Act 175 of 2018 - Insurance Provider Assessment Act (550.1751 - 550.1767) › Section 550.1761 - Administration of Assessment; Conflicting Provisions of Law; Rules; Annual Report.

550.1761 Administration of assessment; conflicting provisions of law; rules; annual report.
Sec. 11.
(1) The department shall administer the assessment imposed under this act under 1941 PA 122, MCL 205.1 to 205.31, and this act. If 1941 PA 122, MCL 205.1 to 205.31, and this act conflict, the provisions of this act apply. The assessment imposed under this act is a tax for the purpose of 1941 PA 122, MCL 205.1 to 205.31.
(2) The department is authorized to promulgate rules to implement this act under the administrative procedures act of 1969, 1969 PA 306, MCL 24.201 to 24.328.
(3) The assessment imposed under this act shall not be considered an assessment or burden for purposes of the tax, or as a credit toward or payment in lieu of the tax under section 476a of the insurance code of 1956, 1956 PA 218, MCL 500.476a.
(4) The department shall submit an annual report to the state budget director, the senate and house of representatives standing committees on appropriations, and the senate and house fiscal agencies not later than 120 days after May 15 that states the amount of revenue collected from insurance providers under this act for the immediately preceding state fiscal year and the costs incurred for administration and compliance requirements under this act for the immediately preceding state fiscal year.
History:
2018, Act 175, Imd. Eff. June 11, 2018
2023 Michigan Compiled Laws › Chapter 550 - General Insurance Laws › Act 175 of 2018 - Insurance Provider Assessment Act (550.1751 - 550.1767) › Section 550.1763 - Insurance Provider Fund; Establishment; Creation; Deposit; Transfer of Money.

550.1763 Insurance provider fund; establishment; creation; deposit; transfer of money.
Sec. 13.
(1) All money received and collected under this act shall be deposited by the department in the insurance provider fund established in this section.
(2) The insurance provider fund is created within the state treasury and shall be administered by the department for auditing purposes.
(3) The state treasurer may receive money or other assets from any source for deposit into the fund. The state treasurer shall direct the investment of the fund. The state treasurer shall credit to the fund interest and earnings from fund investments.
(4) The department shall expend money from the fund, upon appropriation, only for 1 or more of the following purposes:
(a) Beginning in the 2018-2019 state fiscal year, the first $14,000,000.00 to be appropriated for the payment of actuarially sound capitation rates to Medicaid managed care organizations, and each state fiscal year thereafter, the amount necessary to continue to support the payment of actuarially sound capitation rates to Medicaid managed care organizations.
(b) For the 2018-2019 state fiscal year, to appropriate an amount not to exceed $315,000,000.00 to offset the net revenue lost under the health insurance claims assessment act, 2011 PA 142, MCL 550.1731 to 550.1741.
(c) For the 2019-2020 state fiscal year, to appropriate an amount not to exceed $240,000,000.00 to offset the net revenue lost under the health insurance claims assessment act, 2001 PA 142, MCL 550.1731 to 550.1741.
(d) To pay administrative and compliance costs in accordance with section 15.
(e) The balance of the fund remaining after the appropriations described in subdivisions (a), (b), (c), and (d) shall be transferred to a separate restricted account within the insurance provider fund and only used as appropriated by the legislature.
(5) Money in the fund at the close of the fiscal year shall remain in the fund and shall not lapse to the general fund.
History:
2018, Act 175, Imd. Eff. June 11, 2018
2023 Michigan Compiled Laws › Chapter 550 - General Insurance Laws › Act 175 of 2018 - Insurance Provider Assessment Act (550.1751 - 550.1767) › Section 550.1765 - Appropriation for Administration.

550.1765 Appropriation for administration.
Sec. 15.
For administration and compliance requirements created by this act, in the 2018-2019 state fiscal year and each fiscal year thereafter, the department shall receive from the insurance provider fund created in section 13 an amount not to exceed 1/2 of 1% of the annual remittances under this act in the 2018-2019 state fiscal year, subject to annual appropriation by the legislature.
History:
2018, Act 175, Imd. Eff. June 11, 2018
2023 Michigan Compiled Laws › Chapter 550 - General Insurance Laws › Act 175 of 2018 - Insurance Provider Assessment Act (550.1751 - 550.1767) › Section 550.1767 - Failure to Pay Assessment, Interest, or Penalty; Final Determination; Written Notice to Director; Suspension or Revocation of Certificate of Authority to Transact Insurance.

550.1767 Failure to pay assessment, interest, or penalty; final determination; written notice to director; suspension or revocation of certificate of authority to transact insurance.
Sec. 17.
The department shall provide the director of the department of insurance and financial services with written notice of any final determination that an insurance provider has failed to pay an assessment, interest, or penalty when due. The director of the department of insurance and financial services may suspend or revoke, after notice and hearing, the certificate of authority to transact insurance in this state, or the license to operate in this state, of any insurance provider that fails to pay an assessment, interest, or penalty due under this act. A suspension of a certificate of authority to transact insurance in this state or a license to operate in this state under this section shall not be withdrawn unless any delinquent assessment, interest, or penalty has been paid.
History:
2018, Act 175, Imd. Eff. June 11, 2018
2023 Michigan Compiled Laws › Chapter 550 - General Insurance Laws › Act 239 of 1995 - Group Health Plan Act (550.1801 - 550.1811) › Section 550.1801 - Short Title.

550.1801 Short title.
Sec. 1.
This act shall be known and may be cited as the "group health plan act".
History:
1995, Act 239, Eff. Mar. 28, 1996
2023 Michigan Compiled Laws › Chapter 550 - General Insurance Laws › Act 239 of 1995 - Group Health Plan Act (550.1801 - 550.1811) › Section 550.1803 - “Plan” Defined.

550.1803 “Plan” defined.
Sec. 3.
As used in this act, "plan" means a group health plan as defined in section 607 of part 6 of subtitle B of title 1 of the employee retirement income security act of 1974, Public Law 93-406, 29 U.S.C. 1167, and subject to that act.
History:
1995, Act 239, Eff. Mar. 28, 1996
2023 Michigan Compiled Laws › Chapter 550 - General Insurance Laws › Act 239 of 1995 - Group Health Plan Act (550.1801 - 550.1811) › Section 550.1805 - Plan Offering Dependent Coverage to Child; Denial of Enrollment on Certain Grounds Prohibited.

550.1805 Plan offering dependent coverage to child; denial of enrollment on certain grounds prohibited.
Sec. 5.
A plan that offers dependent coverage shall not deny enrollment to a covered individual's child on any of the following grounds:
(a) The child was born out of wedlock.
(b) The child is not claimed as a dependent on the covered individual's federal income tax return.
(c) The child does not reside with the covered individual or in the plan's service area.
History:
1995, Act 239, Eff. Mar. 28, 1996
2023 Michigan Compiled Laws › Chapter 550 - General Insurance Laws › Act 239 of 1995 - Group Health Plan Act (550.1801 - 550.1811) › Section 550.1807 - Eligibility of Parent for Dependent Coverage; Health Coverage of Child Through Noncustodial Parent; Duties of Plan Administrator; Court or Administrative Order and Notice Required.

550.1807 Eligibility of parent for dependent coverage; health coverage of child through noncustodial parent; duties of plan administrator; court or administrative order and notice required.
Sec. 7.
(1) If a parent is eligible for dependent coverage through a plan, the plan administrator shall:
(a) Permit the parent to enroll, under the dependent coverage, a child who is otherwise eligible for coverage without regard to any enrollment season restrictions.
(b) If the parent is enrolled but fails to make application to obtain coverage for the child, enroll the child under dependent coverage upon application by the friend of the court or by the child's other parent through the friend of the court.
(c) Not eliminate the child's coverage unless premiums have not been paid as required by the plan or the plan administrator is provided with satisfactory written evidence of either of the following:
(i) The court or administrative order is no longer in effect.
(ii) The child is or will be enrolled in comparable health coverage through another plan, insurer, health care corporation, or health maintenance organization that will take effect not later than the effective date of the cancellation of the existing coverage.
(2) If a child has health coverage through the plan of a noncustodial parent, that plan administrator shall do all of the following:
(a) Provide the custodial parent with information necessary for the child to obtain benefits through that coverage.
(b) Permit the custodial parent or, with the custodial parent's approval, the provider to submit a claim for covered services without the noncustodial parent's approval.
(c) Make payment on claims submitted under subdivision (b) directly to the custodial parent or medical provider.
(3) This section applies only if a parent is required by a court or administrative order to provide health coverage for a child and the plan is notified of that court or administrative order.
History:
1995, Act 239, Eff. Mar. 28, 1996
2023 Michigan Compiled Laws › Chapter 550 - General Insurance Laws › Act 239 of 1995 - Group Health Plan Act (550.1801 - 550.1811) › Section 550.1809 - Individual Eligible Under Title XIX of Social Security Act; Assignment of Rights of Insured to Department of Social Services.

550.1809 Individual eligible under title XIX of social security act; assignment of rights of insured to department of social services.
Sec. 9.
(1) A plan shall not consider whether an individual is eligible for or has available medical assistance under title XIX of the social security act, chapter 531, 49 Stat. 620, 42 U.S.C. 1396 to 1396g and 1396i to 1396v, in this or another state when considering eligibility for coverage or making payments for eligible covered individuals.
(2) If a plan has a legal liability to make payments, and payment for covered expenses for medical goods or services furnished to an individual has been made under the medical assistance program established under section 105 of the social welfare act, Act No. 280 of the Public Acts of 1939, being section 400.105 of the Michigan Compiled Laws, the department of social services has the rights of the individual to payment by the plan to the extent payment was made by the department of social services's medical assistance program for those medical goods or services.
(3) If the department of social services has been assigned the rights of a covered individual who is eligible for medical assistance under section 105 of Act No. 280 of the Public Acts of 1939 and is covered by the plan, the plan shall not impose requirements on the department of social services that are different from requirements that apply to an agent or assignee of any other covered individual.
History:
1995, Act 239, Eff. Mar. 28, 1996
2023 Michigan Compiled Laws › Chapter 550 - General Insurance Laws › Act 239 of 1995 - Group Health Plan Act (550.1801 - 550.1811) › Section 550.1811 - Violation; Fine.

550.1811 Violation; fine.
Sec. 11.
A violation of this act is subject to a civil fine of not more than $500.00 for each violation.
History:
1995, Act 239, Eff. Mar. 28, 1996
2023 Michigan Compiled Laws › Chapter 550 - General Insurance Laws › Act 101 of 2012 - Autism Coverage Reimbursement Act (550.1831 - 550.1841) › Section 550.1831 - Short Title.

550.1831 Short title.
Sec. 1.
This act shall be known and may be cited as the "autism coverage reimbursement act".
History:
2012, Act 101, Imd. Eff. Apr. 18, 2012
Compiler's Notes:
For transfer of autism coverage reimbursement program from department of licensing and regulatory affairs to department of insurance and financial services, see E.R.O. No. 2013-1, compiled at MCL 550.991.
2023 Michigan Compiled Laws › Chapter 550 - General Insurance Laws › Act 101 of 2012 - Autism Coverage Reimbursement Act (550.1831 - 550.1841) › Section 550.1838 - University Autism Programs and Autism Family Assistance Services; Appropriation; Reimbursement.

550.1838 University autism programs and autism family assistance services; appropriation; reimbursement.
Sec. 8.
In addition to any other use for money in the fund under section 7, for the 2014-2015 fiscal year only, up to $8,500,000.00 may be expended from the fund, upon appropriation, for university autism programs and autism family assistance services as specified in section 1902 of article IV of 2014 PA 252. It is the intent of the legislature that for the 2015-2016 fiscal year, $5,500,000.00 or the amount expended from the fund under this section if less than $5,500,000.00 will be appropriated to reimburse the fund for the expenditures authorized for the 2014-2015 fiscal year under this section.
History:
Add. 2014, Act 401, Imd. Eff. Dec. 29, 2014 ;-- Am. 2015, Act 8, Imd. Eff. Apr. 1, 2015
2023 Michigan Compiled Laws › Chapter 550 - General Insurance Laws › Act 101 of 2012 - Autism Coverage Reimbursement Act (550.1831 - 550.1841) › Section 550.1839 - Annual Report.

550.1839 Annual report.
Sec. 9.
The department shall submit an annual report to the state budget director and the senate and house of representatives standing committees on appropriations not later than April 1 of each year that includes, but is not limited to, all of the following:
(a) The total number of applications received under this program in the immediately preceding calendar year.
(b) The number of applications approved and the total amount of funding awarded under this program in the immediately preceding calendar year.
(c) The amount of administrative costs used to administer the program in the immediately preceding calendar year.
History:
2012, Act 101, Imd. Eff. Apr. 18, 2012
Compiler's Notes:
For transfer of autism coverage reimbursement program from department of licensing and regulatory affairs to department of insurance and financial services, see E.R.O. No. 2013-1, compiled at MCL 550.991.
2023 Michigan Compiled Laws › Chapter 550 - General Insurance Laws › Act 101 of 2012 - Autism Coverage Reimbursement Act (550.1831 - 550.1841) › Section 550.1841 - Implementation of Program.

550.1841 Implementation of program.
Sec. 11.
(1) The department shall not implement the program under this act until the legislature has appropriated sufficient funds to cover the same.
(2) Not more than 1% of the annual appropriation made to the autism coverage fund may be used for the purpose of administering the program authorized under this act.
History:
2012, Act 101, Imd. Eff. Apr. 18, 2012
Compiler's Notes:
For transfer of autism coverage reimbursement program from department of licensing and regulatory affairs to department of insurance and financial services, see E.R.O. No. 2013-1, compiled at MCL 550.991.
2023 Michigan Compiled Laws › Chapter 550 - General Insurance Laws › Act 530 of 2012 - Health Care Sharing Ministries Freedom to Share Act (550.1861 - 550.1869) › Section 550.1861 - Short Title.

550.1861 Short title.
Sec. 1.
This act shall be known and may be cited as the "health care sharing ministries freedom to share act".
History:
2012, Act 530, Eff. Jan. 1, 2013
2023 Michigan Compiled Laws › Chapter 550 - General Insurance Laws › Act 530 of 2012 - Health Care Sharing Ministries Freedom to Share Act (550.1861 - 550.1869) › Section 550.1863 - Definitions.

550.1863 Definitions.
Sec. 3.
As used in this act:
(a) "Eligible entity" means a faith-based, nonprofit entity that maintains tax-exempt status under section 501(c) of the internal revenue code, 26 USC 501.
(b) "Health care sharing ministry" or "ministry" means a program established by an eligible entity for the sharing of finances and health care in compliance with this act.
History:
2012, Act 530, Eff. Jan. 1, 2013
2023 Michigan Compiled Laws › Chapter 550 - General Insurance Laws › Act 530 of 2012 - Health Care Sharing Ministries Freedom to Share Act (550.1861 - 550.1869) › Section 550.1865 - Health Care Sharing Ministry; Establishment; Operation; Business of Insurance Prohibited.

550.1865 Health care sharing ministry; establishment; operation; business of insurance prohibited.
Sec. 5.
An eligible entity may establish and operate a health care sharing ministry under this act. An eligible entity that establishes and operates a health care sharing ministry in compliance with this act is not engaged in the business of insurance in this state and the entity and ministry are not subject to the insurance laws of this state.
History:
2012, Act 530, Eff. Jan. 1, 2013
2023 Michigan Compiled Laws › Chapter 550 - General Insurance Laws › Act 530 of 2012 - Health Care Sharing Ministries Freedom to Share Act (550.1861 - 550.1869) › Section 550.1867 - Health Care Sharing Ministry; Requirements.

550.1867 Health care sharing ministry; requirements.
Sec. 7.
To be considered a health care sharing ministry under this act, the ministry shall meet all of the following requirements:
(a) Limit participation in the ministry to individuals who are of a similar faith.
(b) Provide that the ministry act as a facilitator by matching its participants who have financial or medical needs with participants who have the ability to assist in meeting those needs according to criteria established for the ministry by the eligible entity.
(c) Provide for the financial or medical needs of a participant through voluntary contributions by its participants.
(d) Provide amounts that participants may contribute with no assumption of risk or promise to pay among its participants.
(e) Provide financial assistance to participants who have financial or medical needs with no assumption of risk or promise to pay by the ministry to its participants.
(f) Provide a monthly written statement to its participants that lists the total dollar amount of qualified financial or medical needs that were submitted to the ministry, as well as the amount actually published or assigned to participants for their contribution.
(g) Provide, in substantially similar form and language, the following written disclaimer on or accompanying all applications and guideline materials distributed by or on behalf of the ministry:
"Notice: The [insert name of eligible entity] that operates this health care sharing ministry is not an insurance company and the financial assistance provided through the ministry is not insurance and is not provided through an insurance company. Whether any participant in the ministry chooses to assist another participant who has financial or medical needs is totally voluntary. A participant will not be compelled by law to contribute toward the financial or medical needs of another participant. This document is not a contract of insurance or a promise to pay for the financial or medical needs of a participant by the ministry. A participant who receives assistance from the ministry for his or her financial or medical needs remains personally responsible for the payment of all of his or her medical bills and other obligations incurred in meeting his or her financial or medical needs.".
History:
2012, Act 530, Eff. Jan. 1, 2013
2023 Michigan Compiled Laws › Chapter 550 - General Insurance Laws › Act 530 of 2012 - Health Care Sharing Ministries Freedom to Share Act (550.1861 - 550.1869) › Section 550.1869 - Effective Date.

550.1869 Effective date.
Sec. 9.
This act takes effect January 1, 2013.
History:
2012, Act 530, Eff. Jan. 1, 2013
2023 Michigan Compiled Laws › Chapter 550 - General Insurance Laws › Act 251 of 2000 - Patient's Right to Independent Review Act (550.1901 - 550.1929) › Section 550.1901 - Short Title.

550.1901 Short title.
Sec. 1.
This act shall be known and may be cited as the "patient's right to independent review act".
History:
2000, Act 251, Eff. Oct. 1, 2000
2023 Michigan Compiled Laws › Chapter 550 - General Insurance Laws › Act 251 of 2000 - Patient's Right to Independent Review Act (550.1901 - 550.1929) › Section 550.1905 - Scope.

550.1905 Scope.
Sec. 5.
(1) Except as otherwise provided in subsection (2), this act applies to all health carriers.
(2) This act does not apply to a policy or certificate that provides coverage only for specified accident or accident-only coverage, credit, disability income, hospital indemnity, long-term care insurance, as that term is defined in section 3901 of the insurance code of 1956, 1956 PA 218, MCL 500.3901, or any other limited supplemental benefit other than specified disease, dental, vision care, or care provided pursuant to a system of health care delivery and financing operating under section 3573 of the insurance code of 1956, 1956 PA 218, MCL 500.3573, Medicare supplement policy of insurance, coverage under a plan through Medicare, or the federal employees health benefits program, any coverage issued under 10 USC 1071 to 1110b, and any coverage issued as supplement to that coverage, any coverage issued as supplemental to liability insurance, worker's disability compensation or similar insurance, automobile medical-payment insurance, or any insurance under which benefits are payable with or without regard to fault, whether written on a group blanket or individual basis.
History:
2000, Act 251, Eff. Oct. 1, 2000 ;-- Am. 2016, Act 274, Eff. Sept. 29, 2016
2023 Michigan Compiled Laws › Chapter 550 - General Insurance Laws › Act 251 of 2000 - Patient's Right to Independent Review Act (550.1901 - 550.1929) › Section 550.1909 - Written Request to Director; Manner; Electronic Communication.

550.1909 Written request to director; manner; electronic communication.
Sec. 9.
(1) Except for a request for an expedited external review under section 13, all requests for external review must be made in writing to the director.
(2) A written notice required to be provided under this act must be provided in a culturally and linguistically appropriate manner, as required under 45 CFR 147.136(b)(2)(ii)(E).
(3) A health carrier may satisfy a requirement for the delivery of a notice to a covered person under this act by complying with 29 CFR 2520.104b-1(c) with respect to the use of electronic communication.
History:
2000, Act 251, Eff. Oct. 1, 2000 ;-- Am. 2016, Act 274, Eff. Sept. 29, 2016
2023 Michigan Compiled Laws › Chapter 550 - General Insurance Laws › Act 251 of 2000 - Patient's Right to Independent Review Act (550.1901 - 550.1929) › Section 550.1915 - Decision as Final Administrative Remedy; Other Remedies.

550.1915 Decision as final administrative remedy; other remedies.
Sec. 15.
(1) An external review decision and an expedited external review decision are the final administrative remedies available under this act. A person aggrieved by an external review decision or an expedited external review decision may seek judicial review no later than 60 days from the date of the decision in the circuit court for the county where the covered person resides or in the circuit court of Ingham county.
(2) Subsection (1) does not preclude a health carrier from seeking other remedies available under applicable state law.
(3) Subsection (1) does not preclude a covered person from seeking other remedies available under applicable federal or state law.
(4) A covered person or the covered person's authorized representative may not file a subsequent request for external review involving the same adverse determination or final adverse determination for which the covered person has already received an external review decision under this act.
History:
2000, Act 251, Eff. Oct. 1, 2000 ;-- Am. 2000, Act 398, Imd. Eff. Jan. 8, 2001
2023 Michigan Compiled Laws › Chapter 550 - General Insurance Laws › Act 251 of 2000 - Patient's Right to Independent Review Act (550.1901 - 550.1929) › Section 550.1917 - Approved Independent Review Organizations; Application; Form; Fee; Expiration; Termination; Updated List.

550.1917 Approved independent review organizations; application; form; fee; expiration; termination; updated list.
Sec. 17.
(1) The director shall approve independent review organizations eligible to be assigned to conduct external reviews under this act to ensure that an independent review organization satisfies the minimum standards established under section 19.
(2) The director shall develop an application form for initially approving and for reapproving independent review organizations to conduct external reviews.
(3) Any independent review organization wishing to be approved to conduct external reviews under this act shall submit the application form developed under subsection (2) and include with the form all documentation and information necessary for the director to determine if the independent review organization satisfies the minimum qualifications established under section 19. The director may charge an application fee that independent review organizations shall submit to the director with an application for approval or reapproval.
(4) An approval under this section is effective for 2 years, unless the director determines before expiration of the approval that the independent review organization is not satisfying the minimum standards established under section 19. If the director determines that an independent review organization no longer satisfies the minimum standards established under section 19, the director shall terminate the approval of the independent review organization and remove the independent review organization from the list of independent review organizations approved to conduct external reviews under this act that is maintained by the director under subsection (5).
(5) The director shall maintain and periodically update a list of approved independent review organizations.
History:
2000, Act 251, Eff. Oct. 1, 2000 ;-- Am. 2016, Act 274, Eff. Sept. 29, 2016
2023 Michigan Compiled Laws › Chapter 550 - General Insurance Laws › Act 251 of 2000 - Patient's Right to Independent Review Act (550.1901 - 550.1929) › Section 550.1921 - Independent Review Organization; Liability for Damages.

550.1921 Independent review organization; liability for damages.
Sec. 21.
An independent review organization or clinical peer reviewer working on behalf of an independent review organization is not liable in damages to any person for any opinions rendered during or upon completion of an external review conducted under this act, unless the opinion was rendered in bad faith or involved gross negligence.
History:
2000, Act 251, Eff. Oct. 1, 2000
2023 Michigan Compiled Laws › Chapter 550 - General Insurance Laws › Act 251 of 2000 - Patient's Right to Independent Review Act (550.1901 - 550.1929) › Section 550.1925 - Description of Internal Grievance and External Review Procedures; Inclusion With Materials Provided to Covered Persons.

550.1925 Description of internal grievance and external review procedures; inclusion with materials provided to covered persons.
Sec. 25.
(1) A health carrier shall include a description of the internal grievance and external review procedures in or attached to the policy, certificate, membership booklet, outline of coverage, or other evidence of coverage it provides to covered persons.
(2) The description under subsection (1) must include all of the following:
(a) A statement informing the covered person of his or her right to file a request for an internal grievance and external review of an adverse determination.
(b) The director's toll-free telephone number and address.
(c) A statement informing the covered person that, when filing a request for an external review, the covered person will be required to authorize the release of any medical records that may be required to be reviewed to reach a decision on the external review.
History:
2000, Act 251, Eff. Oct. 1, 2000 ;-- Am. 2016, Act 274, Eff. Sept. 29, 2016
2023 Michigan Compiled Laws › Chapter 550 - General Insurance Laws › Act 251 of 2000 - Patient's Right to Independent Review Act (550.1901 - 550.1929) › Section 550.1927 - Rules.

550.1927 Rules.
Sec. 27.
The director may promulgate rules under the administrative procedures act of 1969, 1969 PA 306, MCL 24.201 to 24.328, necessary to carry out this act.
History:
2000, Act 251, Eff. Oct. 1, 2000 ;-- Am. 2016, Act 274, Eff. Sept. 29, 2016
2023 Michigan Compiled Laws › Chapter 550 - General Insurance Laws › Act 495 of 2006 - Contracts With State and Local Government Subject to Patient's Right to Independent Review (550.1951 - 550.1953) › Section 550.1951 - "Local Unit of Government" Defined.

550.1951 "Local unit of government" defined.
Sec. 1.
As used in this act, "local unit of government" means any political subdivision of this state, including, but not limited to, school districts, community and junior colleges, state universities, cities, villages, townships, charter townships, counties, charter counties, authorities created by the state, and authorities created by other local units of government.
History:
2006, Act 495, Imd. Eff. Dec. 29, 2006