Bill Text: MI HB4663 | 2015-2016 | 98th Legislature | Engrossed
Bill Title: Insurance; other; reporting requirements for short-term limited duration policies; modify. Amends sec. 2213b of 1956 PA 218 (MCL 500.2213b).
Spectrum: Partisan Bill (Republican 1-0)
Status: (Passed) 2016-05-04 - Assigned Pa 100'16 With Immediate Effect [HB4663 Detail]
Download: Michigan-2015-HB4663-Engrossed.html
HB-4663, As Passed Senate, April 19, 2016
HOUSE BILL No. 4663
June 2, 2015, Introduced by Rep. Runestad and referred to the Committee on Insurance.
A bill to amend 1956 PA 218, entitled
"The insurance code of 1956,"
by amending section 2213b (MCL 500.2213b), as amended by 2013 PA 5.
THE PEOPLE OF THE STATE OF MICHIGAN ENACT:
Sec. 2213b. (1) Except as otherwise provided in this section,
an insurer that delivers, issues for delivery, or renews in this
state an expense-incurred hospital, medical, or surgical individual
policy under chapter 34 shall renew or continue in force the policy
at the option of the individual.
(2) Except as otherwise provided in this section, an insurer
that delivers, issues for delivery, or renews in this state an
expense-incurred hospital, medical, or surgical group policy or
certificate under chapter 36 shall renew or continue in force the
policy or certificate at the option of the sponsor of the plan.
(3) Guaranteed renewal is not required in cases of fraud,
intentional misrepresentation of material fact, lack of payment, if
the insurer no longer offers that particular type of coverage in
the market, or if the individual or group moves outside the service
area.
(4) An insurer or health maintenance organization that offers
an expense-incurred hospital, medical, or surgical policy under
chapter 34 or 36 shall not discontinue offering a particular plan
or product in the nongroup or group market unless the insurer or
health maintenance organization does all of the following:
(a)
Provides notice to the commissioner director and to each
covered individual or group, as applicable, provided coverage under
the plan or product of the discontinuation at least 90 days before
the date of the discontinuation.
(b) Offers to each covered individual or group, as applicable,
provided coverage under the plan or product the option to purchase
any other plan or product currently being offered in the nongroup
market or group market, as applicable, by that insurer or health
maintenance organization without excluding or limiting coverage for
a preexisting condition or providing a waiting period.
(c) Acts uniformly without regard to any health status factor
of enrolled individuals or individuals who may become eligible for
coverage in making the determination to discontinue coverage and in
offering other plans or products.
(5) An insurer or health maintenance organization shall not
discontinue offering all coverage in the nongroup or group market
unless the insurer or health maintenance organization does all of
the following:
(a)
Provides notice to the commissioner director and to each
covered individual or group, as applicable, of the discontinuation
at least 180 days before the date of the expiration of coverage.
(b) Discontinues all health benefit plans issued in the
nongroup or group market from which the insurer or health
maintenance organization withdrew and does not renew coverage under
those plans.
(6) If an insurer or health maintenance organization
discontinues coverage under subsection (5), the insurer or health
maintenance organization shall not provide for the issuance of any
health benefit plans in the nongroup or group market from which the
insurer or health maintenance organization withdrew during the 5-
year period beginning on the date of the discontinuation of the
last plan not renewed under that subsection.
(7) Subsections (1) to (6) do not apply to a short-term or 1-
time limited duration policy or certificate of no longer than 6
months.
(8) For the purposes of this section and section 3406f, a
short-term or 1-time limited duration policy or certificate of no
longer than 6 months is an individual health policy that meets all
of the following:
(a) Is issued to provide coverage for a period of 185 days or
less, except that the health policy may permit a limited extension
of benefits after the date the policy ended solely for expenses
attributable to a condition for which a covered person incurred
expenses during the term of the policy.
(b) Is nonrenewable, provided that the health insurer may
provide coverage for 1 or more subsequent periods that satisfy
subdivision (a), if the total of the periods of coverage do not
exceed a total of 185 days out of any 365-day period, plus any
additional days permitted by the policy for a condition for which a
covered person incurred expenses during the term of the policy.
(c) Does not cover any preexisting conditions.
(d) Is available with an immediate effective date, without
underwriting, upon receipt by the insurer of a completed
application
indicating eligibility under the health insurer's
eligibility requirements, except that coverage that includes
optional benefits may be offered on a basis that does not meet this
requirement.
(9) By March 31 each year, an insurer that delivers, issues
for delivery, or renews in this state a short-term or 1-time
limited duration policy or certificate of no longer than 6 months
shall
provide to the commissioner director
a written annual report
that discloses both of the following:
(a) The gross written premium for short-term or 1-time limited
duration policies or certificates issued in this state during the
preceding calendar year.
(b) The gross written premium for all individual expense-
incurred hospital, medical, or surgical policies or certificates
issued or delivered in this state during the preceding calendar
year other than policies or certificates described in subdivision
(a).
(10)
The commissioner director shall maintain copies of
reports
prepared pursuant to under
subsection (9) on file with the
annual
statement of each reporting insurer. The commissioner shall
annually
compile the reports received under subsection (9). The
commissioner
shall provide this annual compilation to the senate
and
house of representatives standing committees on insurance
issues
no later than the June 1 immediately following the March 31
date
for which the reports under subsection (9) are provided.
(11)
In each calendar year, a health an
insurer shall not
continue to issue short-term or 1-time limited duration policies or
certificates if to do so the collective gross written premiums on
those policies or certificates would total more than 10% of the
collective gross written premiums for all individual expense-
incurred hospital, medical, or surgical policies or certificates
issued or delivered in this state either directly by that insurer
or
through a corporation an
entity that owns or is owned by that
insurer.
Enacting section 1. This amendatory act takes effect 90 days
after the date it is enacted into law.
