Bill Text: MI HB5014 | 2015-2016 | 98th Legislature | Introduced

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Bill Title: Insurance; health insurers; health insurance claims assessment; remove cap and sunset. Amends secs. 3 & 7 of 2011 PA 142 (MCL 550.1733 & 550.1737) & repeals enacting section 2 of 2011 PA 142.

Spectrum: Partisan Bill (Republican 1-0)

Status: (Introduced - Dead) 2015-10-27 - Printed Bill Filed 10/23/2015 [HB5014 Detail]

Download: Michigan-2015-HB5014-Introduced.html

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HOUSE BILL No. 5014

October 22, 2015, Introduced by Rep. Howrylak and referred to the Committee on Appropriations.

 

     A bill to amend 2011 PA 142, entitled

 

"Health insurance claims assessment act,"

 

by amending sections 3 and 7 (MCL 550.1733 and 550.1737), section 3

 

as amended by 2014 PA 162; and to repeal acts and parts of acts.

 

THE PEOPLE OF THE STATE OF MICHIGAN ENACT:

 

     Sec. 3. (1) For dates of service beginning on or after January

 

1, 2012 and ending on June 30, 2014, subject to subsections (2),

 

(3), and (4), there is levied upon and there shall be collected

 

from every carrier and third party administrator an assessment of

 

1% on that carrier's or third party administrator's paid claims.

 

For dates of service beginning on or after July 1, 2014, and ending

 

on December 31, 2017, subject to this subsection and subsections

 

(2), (3), and (4), there is levied upon and there shall be

 

collected from every carrier and third party administrator an

assessment of 0.75% on that carrier's or third party

 

administrator's paid claims. For dates of service beginning on or

 

after July 1, 2014, and ending on December 31, 2017, subject to

 

this subsection and subsections (2), (3), and (4), the assessment

 

levied under this subsection will increase to 1.0% if the federal

 

government informs this state that the use tax revenues assessed on

 

entities under section 3f of the use tax act, 1937 PA 94, MCL

 

205.93f, will not be federally reimbursed. If the assessment is

 

increased as provided in this subsection, the increased assessment

 

levied is effective on the date that the federal government informs

 

this state that the revenue collected from the use tax assessed on

 

medicaid Medicaid managed care organizations under section 3f of

 

the use tax act, 1937 PA 94, MCL 205.93f, will not be federally

 

reimbursed. For the purposes of this subsection, a fiscal quarter

 

begins on the first day of January, April, July, or October.

 

     (2) A carrier with a suspension or exemption under section

 

3717 of the insurance code of 1956, 1956 PA 218, MCL 500.3717, on

 

September 20, 2011 is subject to an assessment of 0.1%.

 

     (3) All of the following apply to a group health plan that

 

uses the services of a third party administrator or excess loss or

 

stop loss insurer:

 

     (a) A group health plan sponsor is not responsible for an

 

assessment under this section for a paid claim if the assessment on

 

that claim has been paid by a third party administrator or excess

 

loss or stop loss insurer, except as otherwise provided in section

 

3a(2).

 

     (b) Except as otherwise provided in subdivision (d), the third

party administrator is responsible for all assessments on paid

 

claims paid by the third party administrator.

 

     (c) Except as otherwise provided in subdivision (d), the

 

excess loss or stop loss insurer is responsible for all assessments

 

on paid claims paid by the excess loss or stop loss insurer.

 

     (d) If there is both a third party administrator and an excess

 

loss or stop loss insurer servicing the group health plan, the

 

third party administrator is responsible for all assessments for

 

paid claims that are not reimbursed by the excess loss or stop loss

 

insurer and the excess loss or stop loss insurer is responsible for

 

all assessments for paid claims that are reimbursable to the excess

 

loss or stop loss insurer.

 

     (4) The assessment under this section shall not exceed

 

$10,000.00 per insured individual or covered life annually.

 

     (5) To the extent an assessment paid under this section for

 

paid claims for a group health plan or individual subscriber is

 

inaccurate due to subsequent claim adjustments or recoveries,

 

subsequent filings shall be adjusted to accurately reflect the

 

correct assessment based on actual claims paid.

 

     (6) Through June 30, 2014, if the assessment under this

 

section collects revenue in an amount greater than $400,000,000.00,

 

adjusted annually by the medical inflation rate since 2011, each

 

carrier and third party administrator that paid the assessment

 

shall receive a proportional credit against the carrier's or third

 

party administrator's assessment in the immediately succeeding

 

year. Beginning July 1, 2014, if the sum of the assessment under

 

this section and the portion of the use tax assessed on entities

under section 3f of the use tax act, 1937 PA 94, MCL 205.93f, that

 

is dedicated to the general fund, less the general fund amount

 

necessary to reimburse those entities for the cost of the use tax,

 

is greater than $400,000,000.00, as adjusted annually by the

 

medical inflation rate since 2011 but not to exceed an amount

 

greater than $450,000,000.00, each carrier and third party

 

administrator that paid the assessment shall receive a proportional

 

credit against the carrier's or third party administrator's

 

assessment in the immediately succeeding year. The department shall

 

send a notice of credit to each carrier or third party

 

administrator entitled to a credit under this subsection not later

 

than July 1. A carrier or third party administrator entitled to a

 

credit under this subsection shall apply that credit to the July 30

 

payment. Any unused credit shall be carried forward and applied to

 

subsequent payments. If a carrier or third party administrator

 

entitled to a credit under this subsection has no liability under

 

this act in the immediately succeeding year or if this act is no

 

longer in effect, the department shall issue that carrier or third

 

party administrator a refund in the amount of any unused credit. If

 

a third party administrator receives a credit or refund under this

 

subsection, the third party administrator shall apply that credit

 

or refund to the benefit of the entity for which it processed the

 

claims under a service contract.

 

     Sec. 7. (1) All money received and collected under this act

 

shall be deposited by the department in the health insurance claims

 

assessment fund established in this section.

 

     (2) The health insurance claims assessment fund is created

within the department.

 

     (3) The state treasurer may receive money or other assets from

 

any of the following sources for deposit into the fund:

 

     (a) Money received by the department under this act.

 

     (b) Interest and earnings from fund investments. The state

 

treasurer shall direct the investment of the fund. The state

 

treasurer shall credit to the fund interest and earnings from fund

 

investments.

 

     (c) Donations of money made to the fund from any source.

 

     (4) Money in the fund at the close of the fiscal year shall

 

remain in the fund and shall not lapse to the general fund. and

 

shall remain available after this act is repealed January 1, 2014

 

to pay any remaining credits or refunds due under section 3(6)

 

until all pending appeals and claims are resolved.

 

     (5) Except as otherwise provided in this act, the department

 

shall transfer money from the fund, upon appropriation in the

 

respective departments, only for the following:

 

     (a) To to finance the expenditures of medicaid Medicaid

 

managed care organizations that include medicaid Medicaid

 

contracted health plans and specialty prepaid health plans.

 

     (b) To pay any credits or refunds due under section 3(6).

 

     Enacting section 1. Enacting section 2 of 2011 PA 142 is

 

repealed.

 

     Enacting section 2. This amendatory act takes effect 90 days

 

after the date it is enacted into law.