Bill Text: MI HB6037 | 2009-2010 | 95th Legislature | Introduced

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Bill Title: Insurance; health; individual health coverage; require guaranteed issue health plans. Amends secs. 3501, 3503, 3519 & 3537 of 1956 PA 218 (MCL 500.3501 et seq.) & adds sec. 3406s & ch. 37B. TIE BAR WITH: HB 6034'10, HB 6035'10, HB 6036'10, SB 1242'10, SB 1243'10, SB 1244'10, SB 1245'10

Spectrum: Slight Partisan Bill (Democrat 3-1)

Status: (Introduced - Dead) 2010-04-14 - Printed Bill Filed 04/14/2010 [HB6037 Detail]

Download: Michigan-2009-HB6037-Introduced.html

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HOUSE BILL No. 6037

 

April 13, 2010, Introduced by Reps. Corriveau, Ball, Johnson and Roy Schmidt and referred to the Committee on Health Policy.

 

     A bill to amend 1956 PA 218, entitled

 

"The insurance code of 1956,"

 

by amending sections 3501, 3503, 3519, and 3537 (MCL 500.3501,

 

500.3503, 500.3519, and 500.3537), sections 3501 and 3537 as added

 

by 2000 PA 252, section 3503 as amended by 2006 PA 366, and section

 

3519 as amended by 2005 PA 306, and by adding section 3406s and

 

chapter 37B.

 

THE PEOPLE OF THE STATE OF MICHIGAN ENACT:

 

     Sec. 3406s. (1) If the MI-Health board determines that section

 

3406a, 3406b, 3406c, 3406d, 3406e, 3406m, 3406n, 3406p, 3406q,

 

3406r, 3425, 3609a, 3613, 3614, 3615, 3616, or 3616a should be

 

waived as provided in section 3783, then the sections so identified

 

by the MI-Health board are not required to be provided or offered

 

in a standard guaranteed issue health plan or an enhanced

 

guaranteed issue health plan.

 

     (2) As used in this section:

 

     (a) "MI-Health board" means the MI-Health board created in

 

section 3782.

 

     (b) "Standard guaranteed issue health plan" and "enhanced

 

guaranteed issue health plan" mean those plans as regulated under

 

chapter 37B.

 

     Sec. 3501. As used in this chapter:

 

     (a) "Affiliated provider" means a health professional,

 

licensed hospital, licensed pharmacy, or any other institution,

 

organization, or person having a contract with a health maintenance

 

organization to render 1 or more health maintenance services to an

 

enrollee.

 

     (b) "Basic health services" means:

 

     (i) Physician services including consultant and referral

 

services by a physician, but not including psychiatric services.

 

     (ii) Ambulatory services.

 

     (iii) Inpatient hospital services, other than those for the

 

treatment of mental illness.

 

     (iv) Emergency health services.

 

     (v) Outpatient mental health services, not fewer than 20

 

visits per year.

 

     (vi) Intermediate and outpatient care for substance abuse as

 

follows:

 

     (A) For group contracts, if the fees for a group contract

 

would be increased by 3% or more because of the provision of

 

services under this subparagraph, the group subscriber may decline

 

the services. For individual contracts, if the total fees for all

 

individual contracts would be increased by 3% or more because of

 

the provision of the services required under this subparagraph in

 

all of those contracts, the named subscriber of each contract may

 

decline the services.

 

     (B) Charges, terms, and conditions for the services required

 

to be provided under this subparagraph shall not be less favorable

 

than the maximum prescribed for any other comparable service.

 

     (C) The services required to be provided under this

 

subparagraph shall not be reduced by terms or conditions that apply

 

to other services in a group or individual contract. This sub-

 

subparagraph shall not be construed to prohibit contracts that

 

provide for deductibles and copayment provisions for services for

 

intermediate and outpatient care for substance abuse.

 

     (D) The services required to be provided under this

 

subparagraph shall, at a minimum, provide for up to $2,968.00

 

$3,774.00 in services for intermediate and outpatient care for

 

substance abuse per individual per year. This minimum shall be

 

adjusted annually by March 31 each year in accordance with the

 

annual average percentage increase or decrease in the United States

 

consumer price index for the 12-month period ending the preceding

 

December 31.

 

     (E) As used in this subparagraph, "intermediate care",

 

"outpatient care", and "substance abuse" have those meanings

 

ascribed to them in section 3425.

 

     (vii) Diagnostic laboratory and diagnostic and therapeutic

 

radiological services.

 

     (viii) Home health services.

 

     (ix) Preventive health services.

 

     (c) "Credentialing verification" means the process of

 

obtaining and verifying information about a health professional and

 

evaluating that health professional when that health professional

 

applies to become a participating provider with a health

 

maintenance organization.

 

     (d) "Enrollee" means an individual who is entitled to receive

 

health maintenance services under a health maintenance contract.

 

     (e) "Health maintenance contract" means a contract between a

 

health maintenance organization and a subscriber or group of

 

subscribers, to provide, when medically indicated, designated

 

health maintenance services, as described in and pursuant to the

 

terms of the contract. , including, Except as otherwise provided, a

 

health maintenance contract shall include, at a minimum, basic

 

health maintenance services. However, a health maintenance contract

 

issued under chapter 37B does not have to include basic health

 

services and not more than 1 health maintenance contract issued

 

under chapter 37A has to include basic health services. Health

 

maintenance contract includes a prudent purchaser contract.

 

     (f) "Health maintenance organization" means an entity that

 

does the following:

 

     (i) Delivers health maintenance services that are medically

 

indicated to enrollees under the terms of its health maintenance

 

contract, directly or through contracts with affiliated providers,

 

in exchange for a fixed prepaid sum or per capita prepayment,

 

without regard to the frequency, extent, or kind of health

 

services.

 

     (ii) Is responsible for the availability, accessibility, and

 

quality of the health maintenance services provided.

 

     (g) "Health maintenance services" means services provided to

 

enrollees of a health maintenance organization under their health

 

maintenance contract.

 

     (h) "Health professional" means an individual licensed,

 

certified, or authorized in accordance with state law to practice a

 

health profession in his or her respective state.

 

     (i) "Primary verification" means verification by the health

 

maintenance organization of a health professional's credentials

 

based upon evidence obtained from the issuing source of the

 

credential.

 

     (j) "Prudent purchaser contract" means a contract offered by a

 

health maintenance organization to groups or to individuals under

 

which enrollees who select to obtain health care services directly

 

from the organization or through its affiliated providers receive a

 

financial advantage or other advantage by selecting those

 

providers.

 

     (k) "Secondary verification" means verification by the health

 

maintenance organization of a health professional's credentials

 

based upon evidence obtained by means other than direct contact

 

with the issuing source of the credential.

 

     (l) "Service area" means a defined geographical area in which

 

health maintenance services are generally available and readily

 

accessible to enrollees and where health maintenance organizations

 

may market their contracts.

 

     (m) "Subscriber" means an individual who enters into a health

 

maintenance contract, or on whose behalf a health maintenance

 

contract is entered into, with a health maintenance organization

 

that has received a certificate of authority under this chapter and

 

to whom a health maintenance contract is issued.

 

     Sec. 3503. (1) All of the provisions of this act that apply to

 

a domestic insurer authorized to issue an expense-incurred

 

hospital, medical, or surgical policy or certificate, including,

 

but not limited to, sections 223 and 7925 and chapters 34, and 36,

 

37A, and 37B apply to a health maintenance organization under this

 

chapter unless specifically excluded, or otherwise specifically

 

provided for in this chapter.

 

     (2) Sections 408, 410, 411, 901, and 5208, chapter 77, and,

 

except as otherwise provided in subsection (1), chapter 79 do not

 

apply to a health maintenance organization.

 

     Sec. 3519. (1) A health maintenance organization contract and

 

the contract's rates, including any deductibles, copayments, and

 

coinsurances, between the organization and its subscribers shall be

 

fair, sound, and reasonable in relation to the services provided,

 

and the procedures for offering and terminating contracts shall not

 

be unfairly discriminatory.

 

     (2) A health maintenance organization contract and the

 

contract's rates shall not discriminate on the basis of race,

 

color, creed, national origin, residence within the approved

 

service area of the health maintenance organization, lawful

 

occupation, sex, handicap, or marital status, except that marital

 

status may be used to classify individuals or risks for the purpose

 

of insuring family units. The commissioner may approve a rate

 

differential based on sex, age, residence, disability, marital

 

status, or lawful occupation, if the differential is supported by

 

sound actuarial principles, a reasonable classification system, and

 

is related to the actual and credible loss statistics or reasonably

 

anticipated experience for new coverages. A healthy lifestyle

 

program as defined in section 3517(2) is not subject to the

 

commissioner's approval under this subsection and is not required

 

to be supported by sound actuarial principles, a reasonable

 

classification system, or be related to actual and credible loss

 

statistics or reasonably anticipated experience for new coverages.

 

     (3) All Except as otherwise provided, all health maintenance

 

organization contracts shall include, at a minimum, basic health

 

services. However, a health maintenance contract issued under

 

chapter 37B does not have to include basic health services and not

 

more than 1 health maintenance contract issued under chapter 37A

 

has to include basic health services.

 

     Sec. 3537. (1) After the initial 24 months of operation, a

 

health maintenance organization shall have an open enrollment

 

period of not less than 30 days at least once during each

 

consecutive 12-month period. During each enrollment period, the

 

health maintenance organization shall accept up to its capacity as

 

determined by the organization and submitted to the commissioner

 

not less than 60 days before the commencement of the enrollment

 

period, individuals in the order in which they apply for enrollment

 

in a manner that does not unfairly discriminate on the basis of

 

age, sex, race, health, or economic status. The commissioner may

 

waive compliance by the organization with this open enrollment

 

requirement for any 12-month period for which the organization

 

demonstrates to the commissioner's satisfaction that either of the

 

following will occur:

 

     (a) It has enrolled, or will be compelled to enroll, a

 

disproportionate number of individuals who are likely to utilize

 

its services more often than an actuarially determined average as

 

determined under rules promulgated by the commissioner, and

 

enrollment during an open enrollment period of an additional number

 

of those individuals will jeopardize its economic viability.

 

     (b) If it maintained an open enrollment period, it would not

 

be able to comply with the rules promulgated under this chapter.

 

     (2) A health maintenance organization providing health

 

maintenance services to specified groups of individuals may accept

 

members of the groups before accepting other individuals in the

 

order in which they apply.

 

     (3) A health maintenance organization which, under this

 

section, enrolls individuals who are not members of a group may

 

rate this nongroup membership on the basis of actual and credible

 

loss experience.

 

     (4) The commissioner shall waive compliance by a health

 

maintenance organization with this section for any 12-month period

 

for which the organization demonstrates to the commissioner's

 

satisfaction that the number of individuals enrolled under section

 

3785 is not less than the number of individuals it would have

 

enrolled under this section.

 

CHAPTER 37B

 

GUARANTEED ISSUE HEALTH PLANS

 

     Sec. 3780. As used in this chapter:

 

     (a) "Board" means the MI-Health board created in section 3782.

 

     (b) "Carrier" means a person that provides a health benefit

 

plan to an individual in this state. For the purposes of this

 

chapter, carrier includes a health insurance company authorized to

 

do business in this state, a health care corporation, a health

 

maintenance organization, or any other person providing a plan of

 

health benefits, coverage, or insurance subject to state insurance

 

regulation. Carrier does not include a health maintenance

 

organization that provides only medicaid coverage.

 

     (c) "Federal poverty level" means the poverty guidelines

 

published periodically in the federal register by the United States

 

department of health and human services under its authority to

 

revise the poverty line under 42 USC 9902.

 

     (d) "Geographic area" means an area in this state that

 

includes not less than 4 entire counties, established by the board

 

and used for adjusting premium for a standard guaranteed issue

 

health plan or enhanced guaranteed issue health plan. Each county

 

in the geographic area shall be contiguous with at least 1 other

 

county in that geographic area.

 

     (e) "Health benefit plan" or "plan" means that term as defined

 

in section 3751.

 

     (f) "Health care affordability fund" or "fund" means the fund

 

created in section 3787.

 

     (g) "Health care corporation" means a nonprofit health care

 

corporation operating pursuant to the nonprofit health care

 

corporation reform act, 1980 PA 350, MCL 550.1101 to 550.1704.

 

     (h) "Medicaid" means a program for medical assistance

 

established under title XIX of the social security act, 42 USC 1396

 

to 1396w-2.

 

     (i) "Medicare" means the federal medicare program established

 

under title XVIII of the social security act, 42 USC 1395 to

 

1395iii.

 

     (j) "Resident" means an individual who lives in this state

 

voluntarily with the intention of making his or her home in this

 

state and not for a temporary purpose and who is not receiving

 

public assistance from another state. Resident does not include an

 

individual who has moved into this state for the sole purpose of

 

securing coverage under a health benefit plan under this chapter.

 

     (k) "Short-term or 1-time limited duration plan of no longer

 

than 6 months" means that term as defined in section 3751.

 

     Sec. 3782. (1) The MI-Health board is created within the

 

office of financial and insurance regulation.

 

     (2) The MI-Health board shall consist of the following 13

 

members:

 

     (a) The director of the department of community health or his

 

or her designee.

 

     (b) The director of the department of human services or his or

 

her designee, who shall serve as an ex officio nonvoting member.

 

     (c) The commissioner or his or her designee.

 

     (d) The deputy director for medical services administration or

 

his or her designee, who shall serve as an ex officio nonvoting

 

member.

 

     (e) Three members appointed by the governor with the advice

 

and consent of the senate, 1 of whom shall be a member in good

 

standing of the American academy of actuaries who is not employed

 

by a carrier, hospital, or health professional, 1 of whom shall be

 

a health economist who is not employed by a carrier, hospital, or

 

health professional, and 1 of whom shall represent a health care

 

corporation.

 

     (f) Three members appointed by the senate majority leader, 1

 

of whom shall represent health maintenance organizations but shall

 

not be from a health maintenance organization owned by a health

 

care corporation, 1 of whom shall represent low-income health care

 

advocacy organizations but shall not be employed by a carrier,

 

hospital, or health professional, and 1 of whom shall represent

 

health professionals.

 

     (g) Three members appointed by the speaker of the house of

 

representatives, 1 of whom shall represent the general public but

 

shall not be employed by a carrier, hospital, or health

 

professional, 1 of whom shall represent carriers who are not health

 

maintenance organizations or health care corporations, and 1 of

 

whom shall represent hospitals.

 

     (3) The members first appointed to the board shall be

 

appointed within 30 days after the effective date of this chapter.

 

Appointed board members shall serve for terms of 4 years or until a

 

successor is appointed, whichever is later, except that of the

 

members first appointed 2 shall serve for 1 year, 2 shall serve for

 

2 years, 2 shall serve for 3 years, and 3 shall serve for 4 years.

 

     (4) If a vacancy occurs on the board, the vacancy shall be

 

filled for the unexpired term in the same manner as the original

 

appointment. An appointed board member is eligible for

 

reappointment.

 

     (5) The governor may remove an appointed member of the board

 

for incompetency, dereliction of duty, malfeasance, misfeasance, or

 

nonfeasance in office, or any other good cause.

 

     (6) The first meeting of the board shall be called by the

 

director of the department of community health, who shall serve as

 

chairperson. After the first meeting, the board shall meet at least

 

monthly, or more frequently at the call of the chairperson or if

 

requested by 7 or more members.

 

     (7) Seven members of the board constitute a quorum for the

 

transaction of business at a meeting of the board. An affirmative

 

vote of 7 board members is necessary for official action of the

 

board.

 

     (8) The business that the board may perform shall be conducted

 

at a public meeting of the board held in compliance with the open

 

meetings act, 1976 PA 267, MCL 15.261 to 15.275.

 

     (9) A writing prepared, owned, used, in the possession of, or

 

retained by the board in the performance of an official function is

 

subject to the freedom of information act, 1976 PA 442, MCL 15.231

 

to 15.246.

 

     (10) Board members shall serve without compensation. However,

 

board members may be reimbursed for their actual and necessary

 

expenses incurred in the performance of their official duties as

 

board members.

 

     Sec. 3783. (1) The board shall develop a standard guaranteed

 

issue health plan and an enhanced guaranteed issue health plan. The

 

standard guaranteed issue health plan shall approximate the minimum

 

level of coverage provided in this state by all carriers on January

 

1, 2009 in the individual health market, which coverage satisfies

 

subdivisions (a) to (c). The enhanced guaranteed issue health plan

 

shall approximate the average level of coverage provided in the

 

state by a health care corporation on January 1, 2009 in the

 

individual health market. In developing the plans, the board shall

 

examine patient-centered medical home models. Both plans shall do

 

all of the following:

 

     (a) Provide inpatient services.

 

     (b) Provide outpatient services and preventive care.

 

     (c) Provide a value-based pharmaceutical benefit.

 

     (d) Minimize nonemergency emergency room use.

 

     (e) Encourage health and wellness and incorporate the

 

principles of value-based insurance design, promote healthy

 

behaviors, and strive for improvements in both health outcomes and

 

health care cost containments.

 

     (f) Use incentives to provide health promotion, including, but

 

not limited to, smoking cessation programs; programs promoting

 

nutrition and physical exercise; chronic care management; and

 

disease prevention. Incentives may include rewards, premium

 

discounts, or rebates or may otherwise waive or modify copayments,

 

coinsurances, deductibles, or other cost-sharing measures.

 

Incentives shall be available to all similarly situated

 

individuals, shall be designed to promote health and prevent

 

disease, and shall not be used to impose higher costs on an

 

individual based on a health factor.

 

     (2) A standard guaranteed issue health plan and an enhanced

 

guaranteed issue health plan shall meet all requirements of health

 

coverage plans required under state law, rule, and regulation

 

except that, in order to satisfy the goal of universal health care

 

coverage in this state, the board may permit a standard guaranteed

 

issue health plan and an enhanced guaranteed issue health plan to

 

not provide for the coverages or offerings required under section

 

3406a, 3406b, 3406c, 3406d, 3406e, 3406m, 3406n, 3406p, 3406q,

 

3406r, 3425, 3609a, 3613, 3614, 3615, 3616, or 3616a of the

 

insurance code of 1956, 1956 PA 218, MCL 500.3406a, 500.3406b,

 

500.3406c, 500.3406d, 500.3406e, 500.3406m, 5003406n, 500.3406p,

 

500.3406q, 500.3604r, 500.3425, 500.3609a, 500.3613, 500.3614,

 

500.3615, 500.3616, and 500.3616a, or section 401b, 401f, 401g,

 

414a, 415, 416, 416a, 416b, 416c, 416d, or 417 of the nonprofit

 

health care corporation reform act of 1980, 1980 PA 350, MCL

 

550.1401b, 550.1401f, 550.1401g, 550.1414a, 550.1415, 550.1416,

 

550.1416a, 550.1416b, 550.1416c, 550.1416d, and 550.1417. In making

 

the determination of which provisions of section 3406a, 3406b,

 

3406c, 3406d, 3406e, 3406m, 3406n, 3406p, 3406q, 3406r, 3425,

 

3609a, 3613, 3614, 3615, 3616, or 3616a of the insurance code of

 

1956, 1956 PA 218, MCL 500.3406a, 500.3406b, 500.3406c, 500.3406d,

 

500.3406e, 500.3406m, 500.3406n, 500.3406p, 500.3406q, 500.3604r,

 

500.3425, 500.3609a, 500.3613, 500.3614, 500.3615, 500.3616, and

 

500.3616a, or section 401b, 401f, 401g, 414a, 415, 416, 416a, 416b,

 

416c, 416d, or 417 of the nonprofit health care corporation reform

 

act of 1980, 1980 PA 350, MCL 550.1401b, 550.1401f, 550.1401g,

 

550.1414a, 550.1415, 550.1416, 550.1416a, 550.1416b, 550.1416c,

 

550.1416d, and 550.1417, are not required to be provided in a

 

standard guaranteed issue health plan and an enhanced guaranteed

 

issue health plan, the board shall determine whether real cost

 

savings will be achieved and affordability maximized.

 

     (3) The rates charged to individuals for a standard guaranteed

 

issue health plan and an enhanced guaranteed issue health plan

 

shall be established annually by the board and shall be based on

 

sound actuarial principles. The rates established may include rate

 

differentials based only on geographic area, age, tobacco use, body

 

mass index, and other healthy behaviors and only if the

 

differentials are supported by sound actuarial principles and a

 

reasonable classification system and are related to actual and

 

credible loss statistics or reasonably anticipated experience. The

 

variation in rates based on age shall not exceed a 4 to 1 ratio.

 

     (4) Each standard guaranteed issue health plan and enhanced

 

guaranteed issue health plan shall contain a detailed description

 

of benefits offered, including maximums, limitations, exclusions,

 

and other benefit limits. Each standard guaranteed issue health

 

plan and enhanced guaranteed issue health plan shall reimburse

 

health care professionals and health facilities at not less than

 

100% of medicare reimbursement rates.

 

     (5) A standard guaranteed issue health plan and an enhanced

 

guaranteed issue health plan shall not exclude an individual from

 

coverage based on race, color, religion, national origin, sex,

 

sexual orientation, marital status, health status, personal

 

appearance, political affiliation, source of income, or age.

 

     Sec. 3785. (1) As a condition of transacting business in this

 

state, each carrier providing health benefit plans in this state

 

shall make available and offer the standard guaranteed issue health

 

plan and the enhanced guaranteed issue health plan developed under

 

section 3783 to individuals in this state.

 

     (2) A health plan offered pursuant to this section shall be

 

clearly identified as a "standard guaranteed issue health plan" or

 

an "enhanced guaranteed issue health plan".

 

     (3) A carrier shall guarantee issue to an individual the

 

standard guaranteed issue health plan and the enhanced guaranteed

 

issue health plan offered by the carrier and shall not refuse to

 

issue the health plan to an individual for any reason, including

 

any past, present, or future health condition, except as follows:

 

     (a) As otherwise permitted under section 3755.

 

     (b) Because of fraud or intentional misrepresentation of the

 

applicant.

 

     (c) Because of lack of premium payment.

 

     (d) Because the applicant resides outside of the geographic

 

coverage area.

 

     (e) As otherwise permitted under section 401 of the nonprofit

 

health care corporation reform act, 1980 PA 350, MCL 550.1401.

 

     (4) The number of individuals required to be covered under the

 

standard guaranteed issue health plan and enhanced guaranteed issue

 

health plan by each carrier shall be determined by the commissioner

 

on an equitable basis in proportion to each carrier's share of the

 

individual health coverage market.

 

     Sec. 3787. (1) A health care affordability fund is created

 

within the state treasury. 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. Money in the fund at the close of the fiscal year

 

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

 

The commissioner shall be the administrator of the fund for

 

auditing purposes.

 

     (2) Each health care corporation shall present to the

 

commissioner by April 1, 2011 and annually thereafter the amount of

 

local tax and tax levied under the Michigan business tax act, 2007

 

PA 36, MCL 208.1101 to 208.1601, as certified by an independent

 

certified public accountant, that the health care corporation would

 

have been required to pay in the immediately preceding calendar

 

year if the health care corporation was subject to those taxes. The

 

commissioner may retain legal, financial, and examination services

 

from outside the office of financial and insurance regulation to

 

examine and investigate the amount submitted by the health care

 

corporation, the reasonable cost of which may be charged to the

 

corporation. By May 1, 2011 and annually thereafter, the

 

commissioner shall assess each health care corporation with an

 

assessment fee equivalent to the amount of local tax and tax levied

 

under the Michigan business tax act, 2007 PA 36, MCL 208.1101 to

 

208.1601, that the health care corporation would have been required

 

to pay in the immediately preceding calendar year if the

 

corporation was subject to those taxes. However, in determining the

 

amount of the assessment under this subsection, the commissioner

 

shall consider the amount of cost transfers incurred by the health

 

care corporation pursuant to section 609(6) of the nonprofit health

 

care corporation reform act, 1980 PA 350, MCL 550.1609.

 

     (3) A health care corporation assessed under subsection (2)

 

shall pay the assessment fee to the commissioner by no later than

 

60 days after the assessment fee notice is issued. The commissioner

 

shall deposit assessment fees into the health care affordability

 

fund.

 

     (4) Money in the health care affordability fund shall be

 

expended to subsidize the cost of standard guaranteed issue health

 

plans and enhanced guaranteed issue health plans for individuals

 

with a household income of not more than 300% of the federal

 

poverty level.

 

     (5) A subsidy granted under this section shall not be used

 

except to lower premiums or proposed premium increases for standard

 

guaranteed issue health plans or enhanced guaranteed issue health

 

plans as described in subsection (4) and shall not be used as

 

follows:

 

     (a) If the individual has not been a resident of the state for

 

the previous 6 months.

 

     (b) If the individual is eligible for any government program

 

providing health coverage, medicaid, medicare, or the state

 

children's health insurance program authorized under title XXI of

 

the social security act, 42 USC 1397aa to 1397jj.

 

     (c) If the individual's or family member's employer has

 

provided health coverage in the last 6 months for which the

 

individual is eligible. This subdivision does not apply if health

 

coverage was not provided due to the individual's or family

 

member's loss of employment, loss of eligibility for coverage due

 

to loss of employment hours, or loss of dependency status.

 

     (d) If the individual has accepted a financial incentive from

 

his or her employer to decline his or her employer's subsidized

 

health coverage plan.

 

     (6) The commissioner shall report by November 1, 2011 and

 

annually thereafter to the governor and all members of the senate

 

and house of representatives standing committees on appropriations,

 

insurance, and health issues on the amounts of the assessment fees

 

collected under this section and the amount of subsidies granted

 

under this section.

 

     Sec. 3788. A carrier that issues only short-term or 1-time

 

limited duration plans of no longer than 6 months is not subject to

 

this chapter.

 

     Enacting section 1. This amendatory act does not take effect

 

unless all of the following bills of the 95th Legislature are

 

enacted into law:

 

     (a) Senate Bill No. 1244 or House Bill No.____ (request no.

 

00083'09).

 

     (b) Senate Bill No.____ or House Bill No. 6036(request no.

 

H00083'09 *).

 

     (c) Senate Bill No. 1245 or House Bill No.____ (request no.

 

S06174'10 *).

 

     (d) Senate Bill No. 1243 or House Bill No.____ (request no.

 

06472'10).

 

     (e) Senate Bill No.____ or House Bill No. 6034(request no.

 

H06472'10 *).

 

     (f) Senate Bill No.____ or House Bill No. 6035(request no.

 

06473'10).

 

     (g) Senate Bill No. 1242 or House Bill No.____ (request no.

 

S06473'10 *).