HOUSE BILL No. 6241

 

June 8, 2010, Introduced by Reps. Ball and Corriveau and referred to the Committee on Health Policy.

 

     A bill to amend 1980 PA 350, entitled

 

"The nonprofit health care corporation reform act,"

 

by amending section 402b (MCL 550.1402b), as amended by 1999 PA 7,

 

and by adding section 220.

 

THE PEOPLE OF THE STATE OF MICHIGAN ENACT:

 

     Sec. 220. A health care corporation is subject to chapter 37A

 

of the insurance code of 1956, 1956 PA 218, MCL 500.3751 to

 

500.3767.

 

     Sec. 402b. (1) For Except as otherwise provided in section

 

3763 of the insurance code of 1956, 1956 PA 218, MCL 500.3763, for

 

an individual covered under a nongroup certificate or under a

 

certificate not covered under subsection (2), a health care

 

corporation may exclude or limit coverage for a condition only if

 

the exclusion or limitation relates to a condition for which

 


medical advice, diagnosis, care, or treatment was recommended or

 

received within 6 months before enrollment and the exclusion or

 

limitation does not extend for more than 6 months after the

 

effective date of the certificate.

 

     (2) A health care corporation shall not exclude or limit

 

coverage for a preexisting condition for an individual covered

 

under a group certificate or as provided in section 3763 of the

 

insurance code of 1956, 1956 PA 218, MCL 500.3763.

 

     (3) Notwithstanding subsection (1), a health care corporation

 

shall not issue a certificate to a person eligible for nongroup

 

coverage or eligible for a certificate not covered under subsection

 

(2) that excludes or limits coverage for a preexisting condition or

 

provides a waiting period if all of the following apply:

 

     (a) The person's most recent health coverage prior to applying

 

for coverage with the health care corporation was under a group

 

health plan.

 

     (b) The person was continuously covered prior to the

 

application for coverage with the health care corporation under 1

 

or more health plans for an aggregate of at least 18 months with no

 

break in coverage that exceeded 62 days.

 

     (c) The person is no longer eligible for group coverage and is

 

not eligible for medicare or medicaid.

 

     (d) The person did not lose eligibility for coverage for

 

failure to pay any required contribution or for an act to defraud a

 

health care corporation, a health insurer, or a health maintenance

 

organization.

 

     (e) If the person was eligible for continuation of health

 


coverage from that group health plan pursuant to the consolidated

 

omnibus budget reconciliation act of 1985, Public Law 99-272, 100

 

Stat. 82, he or she has elected and exhausted that coverage.

 

     (4) As used in this section, "group" means a group of 2 or

 

more subscribers.

 

     Enacting section 1. This amendatory act takes effect September

 

23, 2010.

 

     Enacting section 2. This amendatory act does not take effect

 

unless Senate Bill No.____ or House Bill No. 6240(request no.

 

06725'10) of the 95th Legislature is enacted into law.