Michigan Compiled Laws
218-1956-22 - Chapter 22 the Insurance Contract (500.2204...500.2266)
Section 500.2242 - Group Disability Policy; Filing and Approval of Form; Grounds for Disapproval; Notice, Hearing, and Appeal Requirements; Withdrawal of Approval; Quarterly Filing; Applicability of Section to Forms Filed by Nonprofit Dental Corporat...

Sec. 2242.
(1) Except as otherwise provided in section 2236(8)(d), a group disability policy must not be issued or delivered in this state unless a copy of the form has been filed with the director and approved by him or her.
(2) The director may within 60 days after the filing of a disability insurance policy form applicable to individual or family expense coverage, disapprove the form for any of the following, subject to the requirements as to notice, hearing, and appeal set forth in sections 244 and 2236:
(a) The benefits provided under the policy are unreasonable in relation to the premium charged.
(b) The policy contains a provision that is unjust, unfair, inequitable, misleading, or deceptive or that encourages misrepresentation of the policy.
(c) The policy does not comply with other provisions of law.
(3) The director may at any time withdraw his or her approval of an individual or family expense policy form on any of the grounds stated in subsection (2), subject to the requirements as to notice, hearing, and appeal set forth in sections 244 and 2236. An insurer shall not issue the form after the effective date of the withdrawal of approval.
(4) Subject to the requirements of this section, an insurer may file health insurance policies, certificates, riders, and rates quarterly. This subsection does not limit or restrict an insurer's ability to file large group health insurance policies, certificates, or riders at any time during the year.
(5) After December 31, 2016, this section applies to forms filed by a nonprofit dental care corporation operating under 1963 PA 125, MCL 550.351 to 550.373.
History: 1956, Act 218, Eff. Jan. 1, 1957 ;-- Am. 1987, Act 52, Imd. Eff. June 22, 1987 ;-- Am. 1990, Act 305, Imd. Eff. Dec. 14, 1990 ;-- Am. 2013, Act 5, Imd. Eff. Mar. 18, 2013 ;-- Am. 2016, Act 276, Imd. Eff. July 1, 2016 Compiler's Notes: Section 2 of Act 52 of 1987 provides:“The amendments to sections 2236, 2242, 3440, 3606, 3610, and 4430 of Act No. 218 of the Public Acts of 1956, being sections 500.2236, 500.2242, 500.3440, 500.3606, 500.3610, and 500.4430 of the Michigan Compiled Laws, pursuant to this amendatory act apply to all insurance policies issued on or after January 1, 1957 that were either approved by the commissioner on or after January 1, 1957 or subject to an order of the commissioner exempting policies from filing on or after September 1, 1968. The amendments to sections 2236, 2242, 3440, 3606, 3610, and 4430 of Act No. 218 of the Public Acts of 1956, being sections 500.2236, 500.2242, 500.3440, 500.3606, 500.3610, and 500.4430 of the Michigan Compiled Laws, pursuant to this amendatory act are intended to codify and approve long-standing administrative and commercial practice taken and approved by the commissioner pursuant to his or her legal authority. This amendatory act shall serve to cure and clarify any misinterpretation of the operation of such sections since the effective date of their original enactment. It is the intent of this amendatory act to rectify the misconstruction of the insurance code of 1956 by the court of appeals in Bill v Northwestern National Life Insurance Company, 143 Mich App 766, with respect to the power of the insurance commissioner to exempt certain insurance documents from filing requirements and the offsetting of social security benefits against disability income insurance benefits. This amendatory act does not affect the relationship between disability insurance benefits and personal protection insurance benefits as provided in Federal Kemper v Health Insurance Administration Inc., 424 Mich 537.”Enacting section 3 of Act 276 of 2016 provides:"Enacting section 3. On the effective date of this amendatory act, an insurer may submit to the director of the department of insurance and financial services for approval any modification to policies and certificates that were approved before or on the effective date of this amendatory act, to conform with amendments made to the insurance code of 1956, 1956 PA 218, MCL 500.100 to 500.8302, by this amendatory act. This enacting section does not apply to rates and rating methodologies."Popular Name: Act 218

Structure Michigan Compiled Laws

Michigan Compiled Laws

Chapter 500 - Insurance Code of 1956

Act 218 of 1956 - The Insurance Code of 1956 (500.100 - 500.8302)

218-1956-22 - Chapter 22 the Insurance Contract (500.2204...500.2266)

Section 500.2204 - Settlement of Action Brought by Third Party Against Person Insured Under Commercial Liability Insurance Policy; Notice to Insured Required.

Section 500.2205 - Minor's Contracts for Insurance.

Section 500.2206 - Repealed. 2014, Act 140, Eff. Mar. 31, 2015.

Section 500.2207 - Insurable Interest; Personal Insurance; Rights of Beneficiaries, Creditors.

Section 500.2209 - Insurable Interest; Married Woman; Right to Proceeds, Devise.

Section 500.2210 - Definitions; Insurable Interest; Employer; Trust; Exemption From Claims.

Section 500.2210a - Trustee Having Insurable Interest Under MCL 700.7114.

Section 500.2211 - Consent of Insured.

Section 500.2212 - Insurable Interest in Life of Individual.

Section 500.2212a - Health Insurance Policy; Description of Terms, Conditions, and Information; Written Request; Style, Arrangement and Appearance of Policy; "Board Certified" Defined.

Section 500.2212b - Policy Issued Under MCL 550.3405 and to Health Maintenance Organization Contract; Applicability; Termination of Affiliation or Participation Between Primary Care Physician and Insurer; Notice to Insured; Effect of Termination; Def...

Section 500.2212c - Prescription Drug Prior Authorization Workgroup; Creation; Development of Methodology; Prior Authorization Request; Definitions.

Section 500.2212d - National or Regional Certification of Physician; Condition of Payment or Reimbursement by Insurer or Health Maintenance Organization; Prohibited.

Section 500.2212e - Standard Electronic Prior Authorization Transaction Process; Requirements; Adverse Determination Process; Denial and Appeals; Standard Report; Modification Program; Definitions.

Section 500.2213 - Internal Formal Grievance Procedure; Approval by Director; Provisions; Person Authorized to Act on Behalf of Insured or Enrollee; Section Inapplicable to Provider Complaint and Insurance Listed in Right to Independent Review Act; W...

Section 500.2213a - Expenses Incurred by Director; Calculation; Assessment; "Insurer" Defined.

Section 500.2213b - Renewal or Continuation of Policy; Modification; Guaranteed Renewal; Discontinuing Plan or Product in Nongroup or Group Market; Short-Term or 1-Time Limited Duration Policy or Certificate; Reports.

Section 500.2213c - Disability Income Insurer; Internal Grievance Procedure; Establishment; Contents; “Grievance” Defined.

Section 500.2213d - Uniform Prescription Drug Information Card or Other Technology.

Section 500.2214 - Disability Insurance; Application, Use as Evidence.

Section 500.2216 - Life or Disability Insurance; Alteration of Application.

Section 500.2218 - Disability Insurance; False Statement in Application; Effect.

Section 500.2220 - Life Insurance; Solicitor as Agent of Insurer.

Section 500.2226 - Life Insurance; Benefits, Manner of Payment, Period, and Premiums to Be Contained in Policy.

Section 500.2227 - Withholding Final Settlement Amount; Notice; Escrow Procedure to Be Followed by City, Village, or Township; Disposition of Money by Local Treasurer; Commingling Funds Prohibited; Retention of Interest to Defray Expenses; Forwarding...

Section 500.2228 - Automobile Insurance; Contents of Policy.

Section 500.2230 - Mutual Insurers Other Than Life; Contents of Policy.

Section 500.2232 - Reciprocal Insurers; Contents of Policy.

Section 500.2235 - Written Notice to Insured Under Worker's Compensation Insurance Policy.

Section 500.2236 - Forms Generally; Filing; Approval; Type Size; Membership in or Subscription to Rating Organization; Substitute Form; Readability Score and Other Requirements; Approval of Changes or Additions; Notice of Disapproval or Withdrawal of...

Section 500.2236a - Interest Indexed Universal Life Insurance; Information to Be Maintained on File.

Section 500.2237 - Policy Issued Under Chapter 34; Prohibited Restriction of Liability.

Section 500.2238 - Repealed. 1970, Act 180, Imd. Eff. Aug. 3, 1970.

Section 500.2239 - Health Care Service Rendered by Dentist; Benefits or Reimbursement; “Dentist” Defined; Policies to Which Section Applicable.

Section 500.2242 - Group Disability Policy; Filing and Approval of Form; Grounds for Disapproval; Notice, Hearing, and Appeal Requirements; Withdrawal of Approval; Quarterly Filing; Applicability of Section to Forms Filed by Nonprofit Dental Corporat...

Section 500.2243 - Group Policies; Optometric Service; Coverage.

Section 500.2246 - Insured or Applicant for Life Insurance Policy as Victim of Domestic Violence; Refusal to Provide Coverage Prohibited; Exceptions; Liability; Applicability to Policies on or After June 1, 1998; “Domestic Violence” Defined.

Section 500.2248 - Automobile Insurance; Delivery of Policy to Insured.

Section 500.2250 - Binders or Other Contracts for Temporary Insurance; Applicability.

Section 500.2254 - Action Against Domestic Insurer by Member or Beneficiary; Conditions.

Section 500.2260 - Life or Disability Insurance; Acts Not Constituting Waiver of Defenses.

Section 500.2264 - Termination of Dependent Coverage at Specified Age; Exception.

Section 500.2264a - Hospital or Medical Care Coverage or Reimbursement for Children Who Are Full-Time or Part-Time Students and Take Leave of Absence.

Section 500.2265-500.2290 - Repealed. 1992, Act 84, Imd. Eff. June 2, 1992.

Section 500.2266 - Electronic Delivery of Insurance Documents; Requirements; Withdrawal of Consent; Civil Liability; Applicability to Health Insurer or Health Maintenance Organization; Definitions.