Bill Text: MI HB4057 | 2011-2012 | 96th Legislature | Introduced

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Bill Title: Insurance; health care corporations; health care benefits that require certain deductibles or copays; provide for certain restrictions on whether health care service can be listed as a health care benefit. Amends 1980 PA 350 (MCL 550.1101 - 550.1704) by adding sec. 420.

Spectrum: Partisan Bill (Republican 1-0)

Status: (Introduced - Dead) 2011-01-18 - Printed Bill Filed 01/14/2011 [HB4057 Detail]

Download: Michigan-2011-HB4057-Introduced.html

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HOUSE BILL No. 4057

 

January 13, 2011, Introduced by Rep. Callton and referred to the Committee on Health Policy.

 

     A bill to amend 1980 PA 350, entitled

 

"The nonprofit health care corporation reform act,"

 

(MCL 550.1101 to 550.1704) by adding section 420.

 

THE PEOPLE OF THE STATE OF MICHIGAN ENACT:

 

     Sec. 420. (1) A health care corporation providing a nongroup

 

or group certificate shall not include a health care service as a

 

covered health care benefit under the terms and conditions of the

 

certificate or in any other communication concerning the

 

certificate if either of the following applies:

 

     (a) The copayment or coinsurance for a health care service

 

payable by the member is greater than 50% of the cost of the health

 

care service.

 

     (b) The deductible for a health care service payable by the

 

member meets either of the following:

 

     (i) Is established in such a way as to provide de minimus

 

reimbursement for the service by the health care corporation.

 

     (ii) Has an annual or other deductible amount that the insurer

 

or health care corporation reasonably knows will not be met by at

 

least 80% of the members.

 

     (2) The commissioner shall investigate and issue a ruling on

 

all complaints arising under this section.

 

     Enacting section 1. This amendatory act applies to a

 

certificate entered into after the date this amendatory act is

 

enacted into law. For a certificate in effect on or before the date

 

this amendatory act is enacted into law, this amendatory act

 

applies on the date the certificate is next extended, renewed, or

 

modified in any manner.