November 28, 2018, Introduced by Senators MACGREGOR and SHIRKEY and referred to the Committee on Michigan Competitiveness.
A bill to amend 1956 PA 218, entitled
"The insurance code of 1956,"
by amending section 2213b (MCL 500.2213b), as amended by 2016 PA
276.
THE PEOPLE OF THE STATE OF MICHIGAN ENACT:
Sec. 2213b. (1) Except as otherwise provided in this section,
an insurer that delivers, issues for delivery, or renews in this
state a health insurance policy shall renew the policy or continue
the policy in force at the option of the individual or, for a group
plan, at the option of the plan sponsor.
(2) At the time of renewal of an individual health insurance
policy, the insurer may modify the policy if the modification is
consistent with state and federal law and is effective on a uniform
basis among all individuals with coverage under the policy.
(3) At the time of renewal of a group health insurance policy
issued under chapter 34, the insurer may modify the policy.
(4) Guaranteed renewal of a health insurance policy is not
required in cases of fraud, intentional misrepresentation of
material fact, lack of payment, noncompliance with minimum
contribution requirements, or noncompliance with minimum
participation requirements, if the insurer no longer offers that
particular type of coverage in the market, or if the individual or
group moves outside the service area.
(5) An insurer that delivers, issues for delivery, or renews
in this state a health insurance policy shall not discontinue
offering a particular plan or product in the nongroup or group
market unless the insurer does all of the following:
(a) Provides notice to the director and to each covered
individual or group, as applicable, provided coverage under the
plan or product of the discontinuation at least 90 days before the
date of the discontinuation.
(b) Offers to each covered individual or group, as applicable,
provided coverage under the plan or product the option to purchase
any other plan or product currently being offered in the nongroup
market or group market, as applicable, by that insurer without
excluding or limiting coverage for a preexisting condition or
providing a waiting period.
(c) Acts uniformly without regard to any health status factor
of enrolled individuals or individuals who may become eligible for
coverage in making the determination to discontinue coverage and in
offering other plans or products.
(6) An insurer shall not discontinue offering all coverage in
the nongroup or group market unless the insurer does all of the
following:
(a) Provides notice to the director and to each covered
individual or group, as applicable, of the discontinuation at least
180 days before the date of the expiration of coverage.
(b) Discontinues all health benefit plans issued in the
nongroup or group market from which the insurer withdrew and does
not renew coverage under those plans.
(7) If an insurer discontinues coverage under subsection (6),
the insurer shall not provide for the issuance of any health
benefit plans in the nongroup or group market from which the
insurer withdrew during the 5-year period beginning on the date of
the discontinuation of the last plan not renewed under that
subsection.
(8) Subsections (1) to (7) do not apply to a short-term or 1-
time
limited duration policy or certificate of no longer than 6 12
months.
(9) For the purposes of this section, a short-term or 1-time
limited
duration policy or certificate of no longer than 6 12
months is an individual health policy that meets all of the
following:
(a)
Is issued to provide coverage for a period of 185 365 days
or less, except that the health policy may permit a limited
extension of benefits after the date the policy ended solely for
expenses attributable to a condition for which a covered person
incurred expenses during the term of the policy.
(b)
Is nonrenewable, provided that the May be renewable. The
health insurer may provide coverage for 1 or more subsequent
periods that satisfy subdivision (a), if the total of the periods
of
coverage do not exceed a total of 185 365 days out of any 365-
day period, plus any additional days permitted by the policy for a
condition for which a covered person incurred expenses during the
term of the policy.
(c)
Does not May, but is not
required to, cover any
preexisting conditions.
(d) Includes coverage for emergency care, hospital services,
physician services, laboratory services, and X-ray services. The
health insurer shall provide a description of plan services covered
that must be prominently displayed on the application for coverage
and the coverage agreement.
(e) (d)
Is available with an immediate effective
date ,
without
underwriting, upon within 15
days on receipt by the insurer
of a completed application indicating eligibility under the
insurer's eligibility requirements, except that coverage that
includes optional benefits may be offered on a basis that does not
meet this requirement.
(f) Includes a 10-day free look period to return a certificate
of coverage for a full refund. A cancellation received within the
10-day free look period described in this subdivision will be
eligible for a full refund, including enrollment fee, forfeiting
any claims in lieu of a full refund.
(g) Includes, inserted prominently on the evidence of
coverage, the contract information for the Michigan health
insurance consumer assistance program established by the
department.
(10) By March 31 each year, an insurer that delivers, issues
for delivery, or renews in this state a short-term or 1-time
limited
duration policy or certificate of no longer than 6 12
months shall provide to the director a written annual report that
discloses both of the following:
(a) The gross written premium for short-term or 1-time limited
duration policies or certificates issued in this state during the
preceding calendar year.
(b) The gross written premium for all individual health
insurance
policies issued, or delivered, or renewed in this state
during the preceding calendar year other than policies or
certificates described in subdivision (a).
(11) The director shall maintain copies of reports prepared
under subsection (10) on file with the annual statement of each
reporting insurer.
(12) In each calendar year, an insurer shall not continue to
issue short-term or 1-time limited duration policies or
certificates if to do so the collective gross written premiums on
those policies or certificates would total more than 10% of the
collective gross written premiums for all individual health
insurance policies issued or delivered in this state either
directly by the insurer or through a person that owns or is owned
by the insurer.