SENATE BILL No. 283

 

 

February 27, 2007, Introduced by Senators BROWN, BIRKHOLZ, KUIPERS, RICHARDVILLE, KAHN, PAPPAGEORGE, GEORGE, GLEASON, SANBORN, HUNTER, SCOTT and THOMAS and referred to the Committee on Health Policy.

 

 

 

     A bill to amend 1956 PA 218, entitled

 

"The insurance code of 1956,"

 

by amending section 3519 (MCL 500.3519), as amended by 2005 PA 306,

 

and by adding sections 2264b and 3406s.

 

THE PEOPLE OF THE STATE OF MICHIGAN ENACT:

 

     Sec. 2264b. (1) Any policy, certificate, or contract

 

delivered, issued for delivery, or renewed in this state that

 

provides for hospital or medical care coverage or reimbursement for

 

hospital or medical care for dependent children shall permit

 

continuation of that coverage for a child until that child attains

 

age 26 even if the child is no longer considered a dependent.

 

     (2) Coverage under this section shall be provided at the same

 

rate as that charged for dependent child status.

 

     Sec. 3406s. (1) If the MI-HEART exchange board under the MI-


 

HEART act 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 8 of

 

the MI-HEART act, then the sections so identified by the board

 

under the MI-HEART act are not required to be provided or offered

 

in an eligible health coverage plan.

 

     (2) As used in this section:

 

     (a) "Eligible health coverage plan" means that term as defined

 

in section 3 of the MI-HEART act.

 

     (b) "MI-HEART exchange board" means that term as defined in

 

section 3 of the MI-HEART act.

 

     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 health maintenance organization contracts, except

 

health maintenance organization contracts that are eligible health

 

coverage plans offered through the MI-HEART exchange under the MI-

 

HEART act, shall include, at a minimum, basic health services.

 

     Enacting section 1. This amendatory act does not take effect

 

unless all of the following bills of the 94th Legislature are

 

enacted into law:

 

     (a) Senate Bill No. 278.                                   

 

         

 

     (b) Senate Bill No. 280.