Bill Text: MI SB0029 | 2017-2018 | 99th Legislature | Introduced

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Bill Title: Insurance; health insurers; health insurance claims assessment rate; modify under certain circumstances. Amends sec. 3 of 2011 PA 142 (MCL 550.1733) & repeals 2011 PA 142 (MCL 550.1731 - 550.1741). TIE BAR WITH: SB 0030'17, SB 0031'17, SB 0032'17

Spectrum: Partisan Bill (Republican 1-0)

Status: (Introduced - Dead) 2017-01-24 - Reassigned To Committee On Michigan Competitiveness [SB0029 Detail]

Download: Michigan-2017-SB0029-Introduced.html

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SENATE BILL No. 29

 

 

January 18, 2017, Introduced by Senators HORN, STAMAS, MACGREGOR, SHIRKEY and PROOS and referred to the Committee on Health Policy.

 

 

     A bill to amend 2011 PA 142, entitled

 

"Health insurance claims assessment act,"

 

by amending section 3 (MCL 550.1733), as amended by 2016 PA 50; 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 July 1, 2020, May 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 July 1, 2020, June 1, 2017 and

 

ending on December 31, 2018, subject to this subsection and

 

subsections (2), (3), and (4), the assessment levied under this

 

subsection will increase to 1.0% is reduced to 0.0%. However, if

 

the federal government informs provides a written notification and

 

explanation to 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 managed care organizations under section 3f of the use tax

 

act, 1937 PA 94, MCL 205.93f, will not be federally reimbursed. are

 

not permissible and as a result federal Medicaid funding will be

 

reduced beginning on a date certain after all waivers have been

 

denied and the state has exhausted all appeals, then beginning on

 

that date certain or when federal reimbursement is actually

 

reduced, whichever occurs first, there is levied upon and shall be

 

collected from every carrier and third party administrator an

 

assessment of 1.0% on that carrier's or third party administrator's

 

paid claims. 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.

 

     Enacting section 1. The health insurance claims assessment

 

act, 2011 PA 142, MCL 550.1731 to 550.1741, is repealed effective

 

January 1, 2019.

 

     Enacting section 2. This amendatory act does not take effect

 

unless all of the following bills of the 99th Legislature are

 

enacted into law:

 

     (a) Senate Bill No. 30.                                    

 

         

 

     (b) Senate Bill No. 31.                                    

 

         

 

     (c) Senate Bill No. 32.