Bill Text: MI HB4877 | 2013-2014 | 97th Legislature | Introduced

---

Bill Title: Insurance; third party administrators; health care benefits that require certain deductibles or copays; provide for certain restrictions on whether health care services can be listed as a health care benefit. Amends 1984 PA 218 (MCL 550.901 - 550.960) by adding sec. 33.

Spectrum: Slight Partisan Bill (Republican 10-6)

Status: (Introduced - Dead) 2013-07-03 - Per Rule 41 Referred To Committee On Health Policy [HB4877 Detail]

Download: Michigan-2013-HB4877-Introduced.html

---

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

HOUSE BILL No. 4877

 

June 20, 2013, Introduced by Reps. Foster, Jacobsen, Callton, Farrington, Yonker, Genetski, Haines, Darany, Stallworth, Zorn, Hooker, Hovey-Wright, Kivela, Kowall, Abed and Knezek and referred to the Committee on Insurance.

 

     A bill to amend 1984 PA 218, entitled

 

"Third party administrator act,"

 

(MCL 550.901 to 550.960) by adding section 33.

 

THE PEOPLE OF THE STATE OF MICHIGAN ENACT:

 

     Sec. 33. (1) A third party administrator shall not enter into

 

a service contract for a benefit plan if the benefit plan includes

 

a health care service as a covered health care benefit and either

 

of the following applies to the benefit plan:

 

     (a) The copayment or coinsurance for the health care service

 

payable by the covered individual is greater than 50% of the cost

 

of the health care service.

 

     (b) The deductible for the health care service payable by the

 

covered individual meets either of the following:

 

     (i) Is established in such a way as to provide de minimis

 

reimbursement for the service.

 

     (ii) Has an annual or other deductible amount that the plan

 

sponsor reasonably knows will not be met by at least 80% of the

 

covered individuals.

 

     (2) The director of insurance and financial services shall

 

investigate and issue a ruling on all complaints arising under this

 

section.

 

     Enacting section 1. This amendatory act applies to a service

 

contract entered into after the date this amendatory act is enacted

 

into law. For a service contract in effect on or before the date

 

this amendatory act is enacted into law, this amendatory act

 

applies on the date the service contract is next extended, renewed,

 

or modified in any manner.