Bill Text: MI HB6538 | 2017-2018 | 99th Legislature | Introduced

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Bill Title: Insurance; health insurers; short-term limited duration health insurance; extend coverage period. Amends sec. 2213b of 1956 PA 218 (MCL 500.2213b).

Spectrum: Partisan Bill (Republican 1-0)

Status: (Introduced - Dead) 2018-11-29 - Per Rule 41 Referred To Committee On Michigan Competitiveness [HB6538 Detail]

Download: Michigan-2017-HB6538-Introduced.html

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HOUSE BILL No. 6538

 

 

November 28, 2018, Introduced by Rep. Lilly and referred to the Committee on Commerce and Trade.

 

     A bill to amend 1956 PA 218, entitled

 

"The insurance code of 1956,"

 

by amending section 2213b (MCL 500.2213b), as amended by 2016 PA

 

276.

 

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 a health insurance policy shall renew the policy or continue

 

the policy in force at the option of the individual or, for a group

 

plan, at the option of the plan sponsor.

 

     (2) At the time of renewal of an individual health insurance

 

policy, the insurer may modify the policy if the modification is

 

consistent with state and federal law and is effective on a uniform

 

basis among all individuals with coverage under the policy.

 

     (3) At the time of renewal of a group health insurance policy

issued under chapter 34, the insurer may modify the policy.

 

     (4) Guaranteed renewal of a health insurance policy is not

 

required in cases of fraud, intentional misrepresentation of

 

material fact, lack of payment, noncompliance with minimum

 

contribution requirements, or noncompliance with minimum

 

participation requirements, 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.

 

     (5) An insurer that delivers, issues for delivery, or renews

 

in this state a health insurance policy shall not discontinue

 

offering a particular plan or product in the nongroup or group

 

market unless the insurer does all of the following:

 

     (a) Provides notice to the 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 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.

 

     (6) An insurer shall not discontinue offering all coverage in

the nongroup or group market unless the insurer does all of the

 

following:

 

     (a) Provides notice to the 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 withdrew and does

 

not renew coverage under those plans.

 

     (7) If an insurer discontinues coverage under subsection (6),

 

the insurer shall not provide for the issuance of any health

 

benefit plans in the nongroup or group market from which the

 

insurer withdrew during the 5-year period beginning on the date of

 

the discontinuation of the last plan not renewed under that

 

subsection.

 

     (8) Subsections (1) to (7) do not apply to a short-term or 1-

 

time limited duration policy or certificate of no longer than 6 12

 

months.

 

     (9) For the purposes of this section, a short-term or 1-time

 

limited duration policy or certificate of no longer than 6 12

 

months is an individual health policy that meets all of the

 

following:

 

     (a) Is issued to provide coverage for a period of 185 365 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 May be renewable. 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 185 365 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 May, but is not required to, cover any

 

preexisting conditions.

 

     (d) Includes coverage for emergency care, hospital services,

 

physician services, laboratory services, and X-ray services. The

 

health insurer shall provide a description of plan services covered

 

that must be prominently displayed on the application for coverage

 

and the coverage agreement.

 

     (e) (d) Is available with an immediate effective date ,

 

without underwriting, upon within 15 days on receipt by the insurer

 

of a completed application indicating eligibility under the

 

insurer's eligibility requirements, except that coverage that

 

includes optional benefits may be offered on a basis that does not

 

meet this requirement.

 

     (f) Includes a 10-day free look period to return a certificate

 

of coverage for a full refund. A cancellation received within the

 

10-day free look period described in this subdivision will be

 

eligible for a full refund, including enrollment fee, forfeiting

 

any claims in lieu of a full refund.

 

     (g) Includes, inserted prominently on the evidence of

 

coverage, the contract information for the Michigan health

 

insurance consumer assistance program established by the

department.

 

     (10) 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 12

 

months shall provide to the 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 health

 

insurance policies issued, or delivered, or renewed in this state

 

during the preceding calendar year other than policies or

 

certificates described in subdivision (a).

 

     (11) The director shall maintain copies of reports prepared

 

under subsection (10) on file with the annual statement of each

 

reporting insurer.

 

     (12) In each calendar year, 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 health

 

insurance policies issued or delivered in this state either

 

directly by the insurer or through a person that owns or is owned

 

by the insurer.