MCL - Index of Chapter 550
NOTE: Dates reflect any modification to item, not necessarily a change in law.
| Title | Subject |
|---|---|
| Chapter 550 | GENERAL INSURANCE LAWS |
| Act 66 of 1933 | EMERGENCY INSURANCE LEGISLATION (550.1 - 550.8) |
| Section 550.1 | Declaration of emergency. |
| Section 550.2 | Insurance company disbursement limitations. |
| Section 550.3 | Insurance commissioner regulatory powers. |
| Section 550.4 | Foreign insurance companies; other states' regulations, application. |
| Section 550.5 | Purposes of act. |
| Section 550.6 | Suits against insurance companies; statute of limitations, extension. |
| Section 550.7 | Duration of emergency; proclamations. |
| Section 550.8 | Violation of act; misdemeanor; license revocation, grounds. |
| Act 385 of 1996 | Repealed-INTERSTATE INSURANCE RECEIVERSHIP COMPACT (550.11 - 550.13) |
| Act 233 of 1984 | PRUDENT PURCHASER ACT (550.51 - 550.63) |
| Section 550.51 | Short title. |
| Section 550.52 | Definitions. |
| Section 550.53 | Prudent purchaser agreement; number; location of health care provider; membership on provider panel; written standards; notice procedures; provider application period; providing standards on request; notice of acceptance or rejection; reasons for termination; professional review program; evaluation; 2 or more classes of health care providers providing same health care service; removal from provider panel; membership in more than 1 provider panel; provider panel including health care providers and facilities outside state; required information; emergency episode of illness or injury; limiting number of prudent purchaser agreements; benefits for services within scope of practice of optometry, chiropractic, or physical therapy. |
| Section 550.53a | Disclosure of financial relationships between organization and participating health care providers, health care facilities, or other entities. |
| Section 550.53b | Prudent purchaser agreement services; providing requested information to insurer. |
| Section 550.54 | Discrimination prohibited; complaint of violation; hearing; penalty. |
| Section 550.55 | Notice of membership in provider panels; display. |
| Section 550.56 | Reporting certain information on standard forms required; availability of information to appropriate state agencies; confidentiality. |
| Section 550.57 | Agreements between health care providers and purchasers of health care services. |
| Section 550.58 | Organization subject to enabling act; financial records. |
| Section 550.59 | Report on competition in retail pharmacy industry. |
| Section 550.60 | Repealed. 2005, Act 203, Imd. Eff. Nov. 10, 2005. |
| Section 550.61 | Repealed. 1988, Act 282, Imd. Eff. July 27, 1988. |
| Section 550.62 | Provisions inapplicable to certain contracts and renewal thereof. |
| Section 550.63 | Conditional effective date. |
| Act 266 of 1895 | Repealed-SURETY COMPANIES (550.101 - 550.111) |
| Act 151 of 1893 | Repealed-MUTUAL INSURANCE COMPANIES; APPROVAL FEE (550.151 - 550.152) |
| Act 158 of 1943 | Repealed-UNIFORM INSURERS LIQUIDATION ACT (550.201 - 550.213) |
| Act 143 of 1935 | OFFICE AGENT; SET-OFF FOR DAMAGES (550.231 - 550.233) |
| Section 550.231 | Office agent of insurance company taken over by insurance commissioner or receiver; off-set for damages. |
| Section 550.232 | Applicability of act. |
| Section 550.233 | Construction of act. |
| Act 64 of 1984 | THE COORDINATION OF BENEFITS ACT (550.251 - 550.255) |
| Section 550.251 | Short title. |
| Section 550.252 | Definitions. |
| Section 550.253 | Coverage by 2 or more plans; order of benefit payments; length of time covered under plan; inability to agree on order of benefits; amount to be paid by insurer issuing secondary plan; amount to be paid by insurer issuing secondary dental plan; payment of claims or coordination of benefits not provided or authorized by health maintenance organization. |
| Section 550.253a | Contract issued before effective date of amendatory act; compliance with changes; transition period. |
| Section 550.254 | Rules. |
| Section 550.255 | Repealed. 2016, Act 275, Imd. Eff. July 1, 2016. |
| Act 593 of 2006 | SHARING HEALTH CARE INFORMATION (550.281 - 550.289) |
| Section 550.281 | Definitions. |
| Section 550.283 | Determination that health coverage recipient is also medical assistance recipient; information to be provided by health insurer. |
| Section 550.285 | Determination that health coverage recipient is also medical assistance recipient; actions by department. |
| Section 550.287 | Violation of act; administrative fine; notice; right to hearing. |
| Section 550.289 | Rules. |
| Act 108 of 1939 | Repealed-NONPROFIT MEDICAL CARE CORPORATIONS (550.301 - 550.316) |
| Act 125 of 1963 | NONPROFIT DENTAL CARE CORPORATIONS (550.351 - 550.373) |
| Section 550.351 | Nonprofit dental care corporation; formation; purpose; types of dental care plans; services in other states; corporation subject to nonprofit corporation act. |
| Section 550.352 | Subscriber contract payment regulations; prohibited provisions. |
| Section 550.353 | Supervision by insurance commissioner; incorporation procedures. |
| Section 550.354 | Articles of incorporation; contents. |
| Section 550.355 | Articles of incorporation; execution, filing, fee, approval, amendment. |
| Section 550.356 | Contracts; statement to insurance commissioner; contents, examination. |
| Section 550.357 | Certificate of authority to commence business and issue contracts; requirements. |
| Section 550.358 | Certificate of authority; revocation; liquidation. |
| Section 550.359 | Corporation examination by insurance commissioner; expenses. |
| Section 550.359a | Nonprofit dental care corporation subject to MCL 500.224 and 500.225; costs and expenses. |
| Section 550.360 | Annual statement; filing. |
| Section 550.361 | Providing dental services outside state. |
| Section 550.362 | Dental care service contracts; preliminary requirements; payments. |
| Section 550.363 | Dental care corporation; board of directors; membership, consideration of candidates recommended by Michigan Dental Association; composition of board; hearing to determine compliance; findings; order; failure to comply with order; civil fine; information to be provided by dental care corporation. |
| Section 550.364 | Contract limitations; service classes; county residents. |
| Section 550.365 | Dentists; eligibility; agreements with corporation. |
| Section 550.366 | Subscriber-dentist relationship; choice of dentist; refusal to place name of dentist on register; removal of name from register. |
| Section 550.366a | Prudent purchaser agreements; rates; provisions inapplicable to certain contracts and renewal thereof. |
| Section 550.367 | Reserve funds; maintenance; investment. |
| Section 550.368 | Dental care to be in accordance with accepted dental practice. |
| Section 550.369 | Dental care for needy and other persons; payments; contracts. |
| Section 550.369a | Coordination of benefits. |
| Section 550.370 | Dentist-patient relationship; civil actions. |
| Section 550.371 | Previously existing corporations merger; agreement, approval. |
| Section 550.372 | Dental care corporations; tax exemption. |
| Section 550.373 | False statement; penalty. |
| Act 109 of 1939 | Repealed-NONPROFIT HOSPITAL SERVICE CORPORATIONS (550.501 - 550.517) |
| Act 386 of 1996 | VIATICAL SETTLEMENT CONTRACTS (550.521 - 550.528) |
| Section 550.521 | Definitions. |
| Section 550.522 | Records; production; maintenance; availability for inspection; payment of expenses. |
| Section 550.523 | Disclosure of information. |
| Section 550.524 | Documents to be obtained by provider; right to avoid or rescind contract. |
| Section 550.524a | Agreement to commit suicide; payment prohibited. |
| Section 550.525 | Disposition of contract consideration. |
| Section 550.526 | Double or additional indemnity. |
| Section 550.527 | Offer to purchase policy or certificate; notice to insurer. |
| Section 550.528 | Order prohibiting provider from entering viatical settlement contract; additional orders. |
| Act 182 of 2013 | Repealed-ABORTION INSURANCE OPT-OUT ACT (550.541 - 550.551) |
| Act 173 of 1958 | CREDIT INSURANCE ACT (550.601 - 550.624) |
| Section 550.601 | Credit insurance act; short title. |
| Section 550.602 | Scope of act. |
| Section 550.603 | Credit insurance act; definitions. |
| Section 550.604 | Credit life insurance, credit accident and health insurance; forms. |
| Section 550.605 | Credit life insurance; amount. |
| Section 550.606 | Periodic indemnity payable. |
| Section 550.607 | Term; refund on termination prior to expiration. |
| Section 550.608 | Evidence of insurance; policy or certificate delivery. |
| Section 550.609 | Policy or certificate; contents. |
| Section 550.610 | Policy or certificate; delivery to debtor. |
| Section 550.611 | Policy or certificate; application, contents. |
| Section 550.612 | Papers filed with commissioner of issuing state. |
| Section 550.613 | Papers filed with commissioner of issuing state; disapproval. |
| Section 550.614 | Papers filed with commissioner of issuing state; use, hearing, prior written approval. |
| Section 550.615 | Papers filed with commissioner of issuing state; withdrawal of approval. |
| Section 550.616 | Papers filed with commissioner of issuing state; use after withdrawal of approval. |
| Section 550.617 | Papers filed with commissioner of issuing state; judicial review. |
| Section 550.618 | Schedule of premium rates; refunds; nonissuance credit. |
| Section 550.619 | Policies issuable only by authorized insurers. |
| Section 550.620 | Payment of claims; claim files; group insurance claims. |
| Section 550.621 | Procurement of insurance by debtor. |
| Section 550.622 | Rules; violation, notice of hearing, finding, order. |
| Section 550.623 | Violation; penalty; license or authority, suspension or revocation. |
| Section 550.624 | Effect of act; scope of act. |
| Act 388 of 1913 | STATE INSURANCE (550.701 - 550.711) |
| Section 550.701 | Insurance of state property; determination; approval; bids; purchase of deductible or catastrophe insurance; payment of premiums. |
| Section 550.702, 550.703 | Repealed. 1965, Act 365, Imd. Eff. July 23, 1965. |
| Section 550.704 | Loss in case of damage; fixing amount. |
| Section 550.705 | Loss in case of damage; payment, release of additional amounts necessary to rebuild or restore. |
| Section 550.706 | Repealed. 1993, Act 199, Eff. Dec. 28, 1994. |
| Section 550.707, 550.708 | Repealed. 1965, Act 365, Imd. Eff. July 23, 1965. |
| Section 550.709 | Self-liquidation projects exempted; applicability of act. |
| Section 550.710 | Election of coverage. |
| Section 550.711 | State insurance fund abolished; reversion of funds. |
| Act 176 of 1895 | Repealed-REPAIR OF DESTROYED STATE PROPERTY (550.801 - 550.805) |
| Act 11 of 2022 | PHARMACY BENEFIT MANAGER LICENSURE AND REGULATION ACT (550.811 - 550.845) |
| Section 550.811 | Short title. |
| Section 550.815 | Definitions; A to I. |
| Section 550.817 | Definitions; M to P. |
| Section 550.819 | Definitions; R to W. |
| Section 550.821 | Pharmacy benefit manager; licensure; application requirements; modification notice; grounds for refusal, revocation, denial, or suspension; fines; notice and hearings; investigation of officers, directors and owners; renewal. |
| Section 550.823 | Promulgation of rules. |
| Section 550.825 | Contractual responsibilities; conflict of interest; exception for certain audits. |
| Section 550.827 | Pharmacy benefit manager network; report; waiver; prohibition on spread pricing and fees for electronic processing. |
| Section 550.829 | Prohibited conduct. |
| Section 550.831 | Contractual restrictions and limitations with pharmacists or pharmacies; disclosure of costs; payment at point of sale. |
| Section 550.833 | Transparency report; requirements; exempt from freedom of information act; report to legislature; inapplicable to Medicaid contracts. |
| Section 550.837 | Maximum allowable costs; pharmacy benefit manager duties. |
| Section 550.838 | Authorization to conduct audit; process and duties; written report; extrapolation audit prohibition; inapplicable to certain investigations; carrier pharmacy audits not impaired or superseded. |
| Section 550.839 | Retail pharmacies; contractual restrictions and limitations; use of untrue, deceptive, or misleading advertisements; reversal and resubmission of claims; termination of pharmacy from pharmacy benefit manager network; retaliation prohibited; "personal representative" defined. |
| Section 550.840 | Enforcement of act; examination and audit. |
| Section 550.841 | Contract compliance; license requirement. |
| Section 550.843 | Retention schedule; records, books, papers, and other data; destruction or disposal of certain documents prohibited. |
| Section 550.845 | Scope of act. |
| Act 218 of 1984 | THIRD PARTY ADMINISTRATOR ACT (550.901 - 550.962) |
| Section 550.901 | Short title. |
| Section 550.902 | Definitions. |
| Section 550.910 | Third party administrator; certificate required; requirements; instances in which TPA subject to act; name. |
| Section 550.912 | Application for certificate of authority; form, verification, and contents; filing notice of modification. |
| Section 550.914 | Certificate of authority; issuance; notice of disapproval; continued compliance with subsection (1). |
| Section 550.916 | Repealed. 2002, Act 74, Imd. Eff. Mar. 15, 2002. |
| Section 550.918 | Fees; payment; collection; and designation. |
| Section 550.919 | TPA advisory board; creation; appointment, qualifications, and terms of members; expenses; duty of board; report. |
| Section 550.920 | Authority of commissioner. |
| Section 550.922 | Hearings. |
| Section 550.924 | Destruction or disposal of records, books, papers, and other data. |
| Section 550.926 | 340B Program entities; reimbursement, co-pay, and discrimination prohibitions; definitions. |
| Section 550.927 | Disclosure of current selling prices; prohibited contract provisions. |
| Section 550.930 | Provision of administrative services pursuant to written service contract; maintenance of books and records; TPA and manager as fiduciary. |
| Section 550.932 | Benefit plan; notice; plan covering less than 500 individuals; service contract between TPA and governmental entity not subject to ERISA; construction of act. |
| Section 550.934 | Confidentiality. |
| Section 550.936 | Annual statement; report. |
| Section 550.940 | Prohibited conduct generally. |
| Section 550.942 | Additional prohibited conduct. |
| Section 550.944 | Additional prohibited conduct. |
| Section 550.950 | Violation; probable cause; notice; conference; disposition of matter upon agreement of parties; action for damages; hearing; findings and decision; cease and desist order; additional order. |
| Section 550.952 | Civil fine; suspension or revocation of certificate or license; refusal to issue; grounds for denial, suspension, revocation, or cease and desist order; definition. |
| Section 550.954 | Alteration, modification, or setting aside of order. |
| Section 550.956 | Judicial review; petition for review; transcript of record and copy of order or decision; hearing cause as civil case in equity; evidence; duty of court; incomplete record; stay of order or decision; jurisdiction. |
| Section 550.958 | Self-incrimination; false oath or affirmation. |
| Section 550.960 | Rules. |
| Section 550.962 | Repealed. 2002, Act 74, Imd. Eff. Mar. 15, 2002. |
| E.R.O. No. 2009-22 | EXECUTIVE REORGANIZATION ORDER (550.971 - 550.971) |
| Section 550.971 | Transfer of third party administrator advisory board to department of energy, labor, and economic growth by type III transfer; abolishment of third party administrator advisory board. |
| Act 289 of 1994 | Repealed-MEDICAL CARE SAVINGS ACCOUNT ACT (550.981 - 550.988) |
| E.R.O. No. 2013-1 | EXECUTIVE REORGANIZATION ORDER (550.991 - 550.991) |
| Section 550.991 | Creation of department of insurance and financial services; transfer of powers and duties of commissioner of office of financial and insurance regulation to director of department of insurance and financial services by type III transfer; abolishment; transfer of autism coverage reimbursement program from department of licensing and regulatory affairs to department of insurance and financial services. |
| Act 252 of 1986 | THE HEALTH BENEFIT AGENT ACT (550.1001 - 550.1020) |
| Section 550.1001 | Short title. |
| Section 550.1002 | Definitions. |
| Section 550.1003 | Persons authorized to sell health benefits; packaging health benefits with insurance; notify agent of record; annual appointment fee; "agent of record" defined. |
| Section 550.1004 | Influencing agent prohibited. |
| Section 550.1004a | Applicability of certain statutory provisions. |
| Section 550.1005 | Compensation of health benefit agents. |
| Section 550.1006 | Authorized agents; requirements, duties, and restrictions; powers of commissioner. |
| Section 550.1008 | Contracts or other arrangements for packaging of health benefits with insurance; policy supplementing health benefits of health maintenance organization. |
| Section 550.1009 | Licensing affiliate of health benefit corporation as insurance agent prohibited. |
| Section 550.1010 | Health benefit agent as fiduciary; evidence of violation of fiduciary responsibility; use of reasonable accounting methods; records required; examination of records; prohibited conduct. |
| Section 550.1012 | Notice of termination of agent's authority; liability; duration of agent's responsibility; cancellation or refusal to renew certificate of subscriber; certain referrals or communications prohibited; records, names of subscribers, and expiration dates of certificates and contracts as property of agent; copies of written communications between health benefit corporations and subscribers; grounds for cancellation of agent's contract or termination of agent's authority; authorizing licensed accident and health insurance agent to sell health benefits. |
| Section 550.1014 | Suspension, revocation, refusal to grant, or refusal to renew accident and health insurance license; grounds; notice; hearing; summary suspension; subpoenas. |
| Section 550.1016 | Violation of act; orders; penalties for violation of cease and desist order; injunction. |
| Section 550.1018 | Construction of act. |
| Section 550.1020 | Conditional effective date. |
| Act 350 of 1980 | THE NONPROFIT HEALTH CARE CORPORATION REFORM ACT (550.1101 - 550.1704) |
| 350-1980-1 | PART 1 (550.1101...550.1108) |
| Section 550.1101 | Short title. |
| Section 550.1102 | Legislative intent and policy. |
| Section 550.1103 | Meanings of words and phrases. |
| Section 550.1104 | Definitions; A to C. |
| Section 550.1105 | Definitions; H. |
| Section 550.1106 | Definitions; L to O. |
| Section 550.1107 | Definitions; P. |
| Section 550.1108 | Definitions; R, S. |
| 350-1980-2 | PART 2 (550.1201...550.1220) |
| Section 550.1201 | Health care corporation; incorporation; number of persons; payment of cash or other material benefit to subscriber; applicable laws; charitable and benevolent institution; exemption from taxation; certificate of authority; health care benefits and certificates. |
| Section 550.1201a | Formation of health care corporation after January 1, 2014; prohibition. |
| Section 550.1202 | Articles of incorporation; contents; number; forms; examination and certification by attorney general; fees. |
| Section 550.1203 | Amendment or restatement of articles; review; approval. |
| Section 550.1204 | Filing of statements and documents; examination; investigation; additional information; conditions; duties of commissioner. |
| Section 550.1204a | Unimpaired surplus. |
| Section 550.1205 | Repealed. 2003, Act 59, Eff. July 23, 2003. |
| Section 550.1205a | Actuarial practices and accounting principles; financial report. |
| Section 550.1206 | Funds, property, and business of health care corporation; investments; insurance; prepaid health care benefits. |
| Section 550.1207 | Powers of health care corporation; interests of senior citizens; validity of corporate acts. |
| Section 550.1208 | Action by member; complaint. |
| Section 550.1209 | Action by member; discontinuance, compromise, or settlement; notice; expense. |
| Section 550.1210 | Action by member; reasonable expenses; attorney's fees. |
| Section 550.1211 | Administrative services only and cost-plus arrangements; service contracts; fees; administrative costs; marketing policy; notice; coverage, rights, and obligations under collective bargaining agreement; liability of individual; report; “noninsured benefit plan” defined. |
| Section 550.1211a | Definitions; prohibited acts by corporation; processing claims for benefits on timely basis; claim form; notice to covered individuals; notice to corporation of complaint and proceedings contemplated; hearing; findings; order; violation of order; penalty; action and award of actual monetary damages; review; stay of enforcement. |
| Section 550.1212 | Action without notice or lapse of time periods; waiver; attorney-in-fact. |
| Section 550.1213 | Indemnification. |
| Section 550.1214 | Rate of interest. |
| Section 550.1215 | Health care corporation as shareholder in other nonprofit corporation; rights, powers, privileges, and liabilities. |
| Section 550.1216, 550.1217 | Repealed. 2002, Act 559, Imd. Eff. Sept. 27, 2002. |
| Section 550.1218 | Health care corporation; prohibited actions. |
| Section 550.1219 | Provisions superseded. |
| Section 550.1220 | Merger of health care corporation with nonprofit mutual disability insurer. |
| 350-1980-3 | PART 3 (550.1301...550.1313) |
| Section 550.1301 | Board of directors; powers and duties generally; appointment, qualifications, and terms of members; vacancy; officer or employee as voting or nonvoting director; method of selection; definitions; prohibition. |
| Section 550.1302 | Bylaws generally. |
| Section 550.1303 | Meetings; required provisions in bylaws; notice; waiver; participation by conference telephone or similar communications equipment; quorum; action by board; actions requiring majority vote; record roll call vote; recording vote in minutes. |
| Section 550.1304 | Books, records, and minutes; copy of minutes; disclosure, publication, and dissemination of minutes; compelling production of books or records. |
| Section 550.1305 | Establishment and composition of corporate body; service of members on committees; membership on board of directors. |
| Section 550.1306 | Effect of common directorship, officership, or interest on validity of contract or other transaction; burden of establishing validity of contract; exclusion of common or interested directors in determination of quorum; compensation of directors; bylaws regarding conflict of interest. |
| Section 550.1307 | Advisory councils; committees of board of directors; bylaws regarding membership and emergency meetings and actions. |
| Section 550.1308 | Committees of board of directors; powers and authority; prohibited activities; emergency actions. |
| Section 550.1309 | Officers and assistants; selection; restriction; authority and duties; removal; contractual rights; bond; vacancies; compensation; pension. |
| Section 550.1310 | Fiduciary duties; scope and manner of discharge; removal of director for breach of fiduciary duty; notice and hearing. |
| Section 550.1311 | Liability for misapplication or misuse of corporate money or property. |
| Section 550.1312 | Action for failure to perform duties; commencement. |
| Section 550.1313 | False statement as misdemeanor; liability for false statement or report; commencement of action for civil liability. |
| 350-1980-4 | PART 4 (550.1400...550.1439) |
| Section 550.1400 | Use of most favored nation clause in provider contract. |
| Section 550.1401 | Offering of health care benefits; limiting benefits; division of benefits into classes or kinds; prohibited conduct; grounds for denial of coverage; coordination of benefits, subrogation, and nonduplication of benefits; health care corporation as party in interest; limiting or denying coverage or participation status; requirements for participation and reimbursement; determination by commissioner; definitions. |
| Section 550.1401a | Health care service rendered by dentist; benefits or reimbursement; “dentist” defined; certificates to which section applicable. |
| Section 550.1401b | Certificate providing benefits for mental health services; requirements. |
| Section 550.1401c | Replacement group certificate with preexisting condition limitation; elimination, reduction, or limitation of benefits; “disability coverage” defined. |
| Section 550.1401d | Services performed by physician's assistant; reimbursement; conditions; applicability of section; supervision by physician; definitions. |
| Section 550.1401e | Group certificate issued by health care corporation; renewal or continuation; guaranteed renewal; discontinuing plan, product, or coverage in nongroup or group market; conditions. |
| Section 550.1401f | Health care corporation; access to obstetrician-gynecologist. |
| Section 550.1401g | Health care corporation; access to pediatric care services. |
| Section 550.1401h | Health care corporation providing prescription drug coverage; formulary restrictions. |
| Section 550.1401i | Prescription drug coverage; pilot project; provisions; interim report; determination; evaluation. |
| Section 550.1401j | Prescription drug coverage; rate differentials; filing. |
| Section 550.1401k | Telemedicine services; provisions; definition; applicability. |
| Section 550.1401m | Offer of health care benefits to all residents regardless of health status. |
| Section 550.1402 | Health care corporation; prohibited conduct; commission or compensation; new preexisting condition limitation waiting period; readjusting rates; participation in trade practice conference for disability insurers; provider class plan not altered or superseded; probable cause to believe provisions violated; notice; disposition of matter by agreement of parties; action for damages; hearing; issuance of cease and desist order; violation of cease and desist order; civil fine; action for actual monetary damage; attorneys' fees. |
| Section 550.1402a | Terms and conditions of certificate; form; description; requested information; written request; “board certified” defined. |
| Section 550.1402b | Preexisting condition limitation or exclusion; prohibition; exception; “group” defined. |
| Section 550.1402c | Termination of participation between primary care physician and health care corporation; notice to member; effect of termination; definitions. |
| Section 550.1402d | Applicability of MCL 500.2212c to health care corporation. |
| Section 550.1403 | Payment of benefits; interest; claim form; exception. |
| Section 550.1403a | Benefits paid by check or written instrument; escheat. |
| Section 550.1403b | Advertising material prohibited. |
| Section 550.1404 | Violation of MCL 550.1402 or MCL 550.1403; private informal managerial-level conference; review by commissioner; internal procedures; determination by commissioner; expedited grievance procedure; procedural rules; hearing matter as contested case; authorization to act on behalf of member. |
| Section 550.1405 | Single billing form; development; explanation of total bill for services. |
| Section 550.1406 | Confidentiality of records; disclosures; consent; policy regarding protection of privacy and confidentiality of personal data; violation as misdemeanor; penalty; civil action for damages; effect of section on governmental agencies; compliance with federal law and regulations; "health care operations" defined. |
| Section 550.1407 | Complaint system; procedures; response to complaint; access to complaints and responses; record of complaints; annual report; other legal remedies. |
| Section 550.1408 | False, dishonest, or fraudulent claim for payment as misdemeanor; penalty; civil action; prosecution. |
| Section 550.1409 | Civil action for negligence. |
| Section 550.1409a | Coverage for children who are full-time or part-time students; continuing coverage if dependent student takes leave of absence due to illness or injury; eligibility; requirements. |
| Section 550.1410 | Certificate providing coverage of dependent terminating at specified age; exceptions. |
| Section 550.1410a | Provisions of group certificate; electing coverage under group conversion certificate; notice of conversion privilege; requirements of group conversion certificate; premium; issuance; compliance. |
| Section 550.1410b | Premium for group conversion certificate after January 1, 2014; determination; rating factors. |
| Section 550.1411-550.1413a | Repealed. 1994, Act 40, Imd. Eff. Mar. 14, 1994. |
| Section 550.1414 | Expired. 1980, Act 430, Eff. Jan. 1, 1982. |
| Section 550.1414a | Treatment of substance abuse; contracts; qualifications of provider; coverage for intermediate and outpatient care for substance abuse required; demonstration projects; substance abuse advisory committee; report; contracts based on final report; reimbursement; group and nongroup certificates; exceptions; option to decline coverage; charges, terms, and conditions; reduction of coverage; deductibles and copayment provision; minimum coverage; adjustment; definitions; effective date of section. |
| Section 550.1414b | Offer of wellness coverage by health care corporation. |
| Section 550.1415 | Benefits for prosthetic devices. |
| Section 550.1416 | Coverage for breast cancer diagnostic services, breast cancer outpatient services, and breast cancer rehabilitative services; coverage for breast cancer screening mammography; definitions; effective date of section. |
| Section 550.1416a | Coverage for drug used in antineoplastic therapy and cost of its administration; conditions. |
| Section 550.1416b | Establishment of program to prevent onset of clinical diabetes required; report; coverages; “diabetes” defined. |
| Section 550.1416c | Off-label use of approved drug; coverage; conditions; compliance; use of copayment, deductible, sanction, or utilization control; limitation; definitions. |
| Section 550.1416d | Coverage for obstetrical and gynecological services by physician or nurse midwife. |
| Section 550.1416e | Diagnosis and treatment of autism spectrum disorders; coverage; prohibition; availability of other benefits; conditions; qualified health plan offered through American health benefit exchange pursuant to federal law; prescription drug plan; coordinated benefits; definitions. |
| Section 550.1417 | Hospice care; contracts with health care corporation; description of benefit. |
| Section 550.1418 | Emergency health services; medical coverage required; “stabilization” defined. |
| Section 550.1419 | Certificate offering dependent coverage to child; denial of enrollment on certain grounds prohibited. |
| Section 550.1419a | Eligibility of parent for dependent coverage; health coverage of child through noncustodial parent; court or administrative order and notice required. |
| Section 550.1419b | Individual eligible under title XIX of social security act; assignment of rights of subscriber to department of social services. |
| Section 550.1420-550.1430 | Repealed. 2006, Act 441, Imd. Eff. Oct. 19, 2006. |
| Section 550.1435 | “Program” defined. |
| Section 550.1436 | Michigan caring programs for children; creation; contribution requirements; rating methodologies; supersedure of inconsistent provisions. |
| Section 550.1437 | Eligibility of child for enrollment in program. |
| Section 550.1438 | Limitation of benefits; provision of other health care benefits. |
| Section 550.1439 | Fees prohibited; exception; funding; enrollment of children. |
| 350-1980-4A | PART 4A MEDICARE SUPPLEMENT CERTIFICATES (550.1451...550.1499a) |
| Section 550.1451-550.1499a | Repealed. 2002, Act 559, Imd. Eff. Sept. 27, 2002;—2006, Act 462, Imd. Eff. Dec. 20, 2006. |
| 350-1980-5 | PART 5 (550.1501...550.1518) |
| Section 550.1501 | Contracts with health care facilities. |
| Section 550.1501a | Special participating contracts with health care providers for provision of primary health care benefits to children enrolled in Michigan caring program. |
| Section 550.1501b | Conduct on behalf of or information provided to subscriber by health care provider; prohibition or discouragement by health care corporation. |
| Section 550.1501c | Provider network. |
| Section 550.1502 | Contracts for reimbursement with professional health care providers; private provider-patient relationship; methods of diagnosis or treatment not to be restricted; refusal to reimburse for overutilized services; list of providers; recommendation of provider as misdemeanor; symbol of participation; health maintenance organization not impeded; contracts subject to MCL 550.1504 to 550.1518; participation of freestanding surgical outpatient facility; optometry services; status of license or registration; chiropractic service; physical therapist or physical therapist assistant services. |
| Section 550.1502a | Prudent purchaser agreements; group contracts; option; group contracts under which financial or other advantage realized; additional option; applicability of subsection (5); individual contracts; rates; contracts subject to MCL 550.1504 to 550.1518; discrimination against class of health care providers; provisions inapplicable to certain contracts or renewals; optometry, chiropractic, and physical therapist or physical therapist assistant services. |
| Section 550.1503 | Uniform reporting by health care providers. |
| Section 550.1504 | Reimbursement arrangements; goals; definitions; supplemental efforts. |
| Section 550.1505 | Provider class plan; development, modification, implementation, or review; procedures to obtain advice and consultation. |
| Section 550.1506 | Provider class plan; transmitting to commissioner; examination; determination; notice; placing plan into effect; retention of plan for commissioner's records. |
| Section 550.1507 | Provider class plan; inclusion and transmittal of items omitted. |
| Section 550.1508 | Provider class plan; modifications. |
| Section 550.1509 | Achievement of goals and objectives; determinations by commissioner. |
| Section 550.1510 | Additional determinations by commissioner. |
| Section 550.1511 | Provider class plan; transmittal to commissioner; preparation by commissioner. |
| Section 550.1512 | Extension of 6-month period provided in MCL 550.511(1); determination. |
| Section 550.1513 | Provider class plan; examination; automatic retention; placing plan into effect; preparation of plan by commissioner; notice. |
| Section 550.1514 | Appeal; selection and qualifications of hearing officer; consolidation; annual report. |
| Section 550.1515 | Appeal; parties; request; time; relief; transmittal of provider class plan to hearing officer; determinations. |
| Section 550.1516 | Provider class plan; standards. |
| Section 550.1517 | Annual report. |
| Section 550.1518 | Considerations and standards; applicability; appeal. |
| 350-1980-6 | PART 6 (550.1601...550.1620) |
| Section 550.1601 | Regulation and supervision of health care corporation; delegation of authority. |
| Section 550.1602 | Statement of condition; statistical, financial, and other reports. |
| Section 550.1603 | Visitation and examination; access to books, papers, and documents; witnesses; expenses; disclosure of information; reporting violation; action by attorney general; ex parte order directing compliance. |
| Section 550.1603a | Health care corporation subject to MCL 500.224 and 500.225; costs and expenses. |
| Section 550.1604 | Confidentiality; violation as misdemeanor; penalty. |
| Section 550.1605 | Certificate of authority; suspension or limitation; circumstances; order; hearing; notice. |
| Section 550.1606 | Authority of commissioner regarding officers and directors; authority as to dissolution, taking over, or liquidation of corporations; insolvency defined. |
| Section 550.1607 | Submission of new or revised certificate and applicable proposed rates; approval or disapproval; exemption; circumstances and conditions; notice; implementation of certificates and rates. |
| Section 550.1608 | Rates charged to nongroup subscribers for certificate; methodology and definitions of rating system, formula, component, and factor used to calculate rates for group subscribers for certificate; filing; approval, disapproval, or modification; standard; burden of proof; effective date of proposed rate; rate adjustments; implementation prior to approval; examination of financial arrangement; formulae, and factors. |
| Section 550.1609 | Excessive rate; administrative expense budget; equitable rate; adequate rate; line of business to be self-sustaining; cost transfers for benefit of senior citizens and group conversion subscribers. |
| Section 550.1610 | Filing of information and materials relative to proposed rate; notice; approval, approval with modifications, or disapproval; additional information and materials; determination; notice; visitation and examination; expenses; order; effect of inability to approve 1 or more rating classes of business within line of business; information in support of nongroup rate filing; public inspection of information; forms and instructions for filing proposed rates. |
| Section 550.1611 | Legislative intent. |
| Section 550.1612 | Notice of rate filing; contents of request for hearing; advertisements; limitation on fee for copy of rate filing; waiver or reduction of fee; calculation of costs. |
| Section 550.1613 | Request for hearing; standing of person; access to filing; confidentiality; penalty; appointment and qualifications of independent hearing officer; commencement of hearing; discovery; conducting hearing; burden of proving compliance; factors in rendering proposal for decision; order rendering decision; withdrawal of order. |
| Section 550.1614 | Interim rates; petition; determination; granting interim rate; final rate determination; refunds or adjustments; limitation on order establishing interim rate adjustment; rates to which section applicable. |
| Section 550.1615 | Review of final order or decision. |
| Section 550.1616 | Endorsing, filing, and indexing documents; notice of refusal to file; judicial review; certificate of correction; persons adversely affected by correction; documents to which section inapplicable. |
| Section 550.1617 | Rules. |
| Section 550.1618 | Compliance with new procedures, benefits, or contracts. |
| Section 550.1619 | Injunction; declaratory and equitable relief; enforcement of act or rules. |
| Section 550.1620 | Certificate subject to policy and certificate issuance and rate filing requirements; establishment of reasonable open enrollment periods; frequency and duration; denial, condition, or discrimination. |
| 350-1980-6A | PART 6A HEALTH ENDOWMENT FUND CORPORATIONS (550.1651...550.1655) |
| Section 550.1651 | Definitions. |
| Section 550.1652 | Health endowment fund corporation; incorporation; conflict of interest; appointment of board members; vacancy; terms; quorum; vote; business open to public; notice; meeting in closed session; minutes; compensation. |
| Section 550.1653 | Charitable purpose nonprofit corporation; receipt and administration of funds; articles of incorporation; grants; conflict with other provisions of law; social mission contributions; fund as private, nonprofit corporation. |
| Section 550.1654 | Executive director. |
| Section 550.1655 | Disbursement, expenditure, and investment of money by fund; system of financial accounting, controls, audits, and reports; appointment of audit committee; duties of executive director; requirement to keep accurate accounting; cooperation with investigation. |
| 350-1980-7 | PART 7 (550.1701...550.1704) |
| Section 550.1701 | Formal reorganization not required; duties of health care corporation; amendments to articles and bylaws; description of board restructuring; review; certification; statement of reasons for disapproval; judicial remedies; effect of noncompliance; extension of corporate existence; powers undiminished. |
| Section 550.1702 | Discontinuation of certain rules; continuation of certain orders and approvals. |
| Section 550.1703 | Repeal of MCL 550.301 to 550.316 and 550.501 to 550.517. |
| Section 550.1704 | Effective date. |
| Act 142 of 2011 | Repealed-HEALTH INSURANCE CLAIMS ASSESSMENT ACT (550.1731 - 550.1741) |
| Act 175 of 2018 | INSURANCE PROVIDER ASSESSMENT ACT (550.1751 - 550.1767) |
| Section 550.1751 | Short title. |
| Section 550.1753 | Definitions. |
| Section 550.1755 | Waiver request; notification of member months, rate, and insurance providers by tier. |
| Section 550.1757 | Assessment; levy; rates; payment method. |
| Section 550.1759 | Records; failure to file return or keep proper records; right of department to impose assessment. |
| Section 550.1761 | Administration of assessment; conflicting provisions of law; rules; annual report. |
| Section 550.1763 | Insurance provider fund; establishment; creation; deposit; transfer of money. |
| Section 550.1765 | Appropriation for administration. |
| Section 550.1767 | Failure to pay assessment, interest, or penalty; final determination; written notice to director; suspension or revocation of certificate of authority to transact insurance. |
| Act 239 of 1995 | GROUP HEALTH PLAN ACT (550.1801 - 550.1811) |
| Section 550.1801 | Short title. |
| Section 550.1803 | “Plan” defined. |
| Section 550.1805 | Plan offering dependent coverage to child; denial of enrollment on certain grounds prohibited. |
| Section 550.1807 | Eligibility of parent for dependent coverage; health coverage of child through noncustodial parent; duties of plan administrator; court or administrative order and notice required. |
| Section 550.1809 | Individual eligible under title XIX of social security act; assignment of rights of insured to department of social services. |
| Section 550.1811 | Violation; fine. |
| Act 101 of 2012 | AUTISM COVERAGE REIMBURSEMENT ACT (550.1831 - 550.1841) |
| Section 550.1831 | Short title. |
| Section 550.1833 | Definitions. |
| Section 550.1835 | Autism coverage reimbursement program; creation; operation; development of application, approval, and compliance process; forms; approval or denial of application; limitation on amount of coverage; receipt of funding by third party administrator; increase in rates by carrier. |
| Section 550.1837 | Autism coverage fund; creation within state treasury; investment; credit of interest and earnings; administration of fund by department for auditing purposes; expenditures; reimbursement; insufficient money in fund; notice of insufficient funds; money in fund at close of fiscal year; payment of claim approved under MCL 550.1835; reimbursement to carrier or third party administrator; formula. |
| Section 550.1838 | University autism programs and autism family assistance services; appropriation; reimbursement. |
| Section 550.1839 | Annual report. |
| Section 550.1841 | Implementation of program. |
| Act 530 of 2012 | HEALTH CARE SHARING MINISTRIES FREEDOM TO SHARE ACT (550.1861 - 550.1869) |
| Section 550.1861 | Short title. |
| Section 550.1863 | Definitions. |
| Section 550.1865 | Health care sharing ministry; establishment; operation; business of insurance prohibited. |
| Section 550.1867 | Health care sharing ministry; requirements. |
| Section 550.1869 | Effective date. |
| Act 251 of 2000 | PATIENT'S RIGHT TO INDEPENDENT REVIEW ACT (550.1901 - 550.1929) |
| Section 550.1901 | Short title. |
| Section 550.1903 | Definitions. |
| Section 550.1905 | Scope. |
| Section 550.1907 | Right to request external review for adverse determination; written notice. |
| Section 550.1909 | Written request to director; manner; electronic communication. |
| Section 550.1911 | Request for external review; commencement; preliminary review; notice of acceptance; duties of director; incomplete request; nonacceptance; assignment of independent review organization; duty of health carrier to provide documents; reconsideration by health carrier of its adverse determination; recommendation; considerations; review by director; notice of decision. |
| Section 550.1913 | Expedited external review. |
| Section 550.1915 | Decision as final administrative remedy; other remedies. |
| Section 550.1917 | Approved independent review organizations; application; form; fee; expiration; termination; updated list. |
| Section 550.1919 | Approved independent review organization; requirements. |
| Section 550.1921 | Independent review organization; liability for damages. |
| Section 550.1923 | Maintenance of records; report to director. |
| Section 550.1925 | Description of internal grievance and external review procedures; inclusion with materials provided to covered persons. |
| Section 550.1927 | Rules. |
| Section 550.1929 | Cease and desist order; additional orders; fines; hearing; injunction; creation of cancer clinical trials; disposition of funds. |
| Act 495 of 2006 | CONTRACTS WITH STATE AND LOCAL GOVERNMENT SUBJECT TO PATIENT'S RIGHT TO INDEPENDENT REVIEW (550.1951 - 550.1953) |
| Section 550.1951 | "Local unit of government" defined. |
| Section 550.1952 | Entities contracting with state or local government for costs of health care services under self-funded plan; duties. |
| Section 550.1953 | Exceptions. |
| Act 499 of 2000 | ELDER PRESCRIPTION INSURANCE COVERAGE ACT (550.2001 - 550.2009) |
| Section 550.2001 | Short title; intent; establishment. |
| Section 550.2002 | Definitions. |
| Section 550.2003 | EPIC program; provisions; eligibility requirements; enrollment; assessment for medicaid; “institution” explained; business with not more than 1 employee and less than $200,000.00 in assets. |
| Section 550.2004 | Expedited enrollment process; temporary eligibility card or voucher; eligibility requirements. |
| Section 550.2005 | Brand name drug; copayment. |
| Section 550.2006 | Program benefits; duties of department. |
| Section 550.2007 | Other senior focused entities; utilization and assistance; establishment of advisory committee. |
| Section 550.2008 | Reports. |
| Section 550.2009 | Program not as entitlement; limitation on benefits; EPIC as payer of last resort; use of automated system; pharmacy dispensing fee. |