November 8, 2005, Introduced by Reps. Gaffney, Mortimer, Hune and Ward and referred to the Committee on Insurance.
A bill to amend 1956 PA 218, entitled
"The insurance code of 1956,"
(MCL 500.100 to 500.8302) by adding section 3406s.
THE PEOPLE OF THE STATE OF MICHIGAN ENACT:
Sec. 3406s. (1) An insurer and a health maintenance
organization may offer a limited benefits policy that excludes
mandated health benefits from coverage under the policy.
(2) Before issuing a limited benefits policy, an insurer or
health maintenance organization shall provide to a prospective
policyholder for an individual limited benefits policy or to a
prospective group certificate holder for a group limited benefits
policy a written notice that does both of the following:
(a) Discloses that mandated health benefits are not covered by
the limited benefits policy.
(b) Lists and describes each mandated health benefit that is
not covered by the limited benefits policy.
(3) Before issuing a limited benefits policy, an insurer or
health maintenance organization shall obtain from the prospective
policyholder for an individual limited benefits policy or from a
group certificate holder for a group limited benefits policy a
signed written statement that acknowledges both of the following:
(a) That the disclosure statement required under subsection
(2) was provided.
(b) That the extent of the coverage under the limited benefits
policy was understood.
(4) Except as provided in this section, all provisions of this
act that apply to expense-incurred hospital, medical, or surgical
policies and certificates and health maintenance organization
contracts apply to limited benefits policies.
(5) Notwithstanding any other provision of this act, a limited
benefits policy is not subject to any mandated health benefit
requirement of this act.
(6) As used in this section:
(a) "Limited benefits policy" means an expense-incurred
hospital, medical, or surgical policy or certificate or health
maintenance organization contract that provides benefits under this
section.
(b) "Mandated health benefit" means a particular health care
service, benefit, coverage, or reimbursement for covered health
care services that an insurer or health maintenance organization is
required by statute to provide or offer in an expense-incurred
hospital, medical, or surgical policy or certificate or health
maintenance organization contract that is issued, renewed, or
delivered in this state.