Sec. 3400.
(1) As used in this chapter:
(a) "Affiliated provider" means a health professional, licensed hospital, licensed pharmacy, or other person that has entered into a participating provider contract, directly or indirectly, with a health maintenance organization to render 1 or more health services to an enrollee. Affiliated provider includes a person described in this subdivision that has entered into a written arrangement with another person, including, but not limited to, a physician hospital organization or physician organization, that contracts directly with a health maintenance organization.
(b) "Disability insurance policy" includes an insurance policy or insurance contract that insures against loss resulting from sickness or from bodily injury or death by accident, or both, including also the granting of specific hospital benefits and medical, surgical, and sick-care benefits to an individual, family, or group, subject to the exclusions provided in this section.
(2) This chapter does not apply to or affect any of the following:
(a) A liability or worker's disability compensation insurance policy, regardless of whether supplementary expense coverage is included.
(b) A reinsurance policy or contract.
(c) Life insurance, endowment, or annuity contracts, or contracts supplemental to life insurance, endowment, or annuity contracts, that only contain provisions relating to disability insurance that do any of the following:
(i) Provide additional benefits in case of death or dismemberment or loss of sight by accident.
(ii) Operate to safeguard the contracts against lapse or to give a special surrender value, special benefit, or annuity in the event that the insured or annuitant becomes totally and permanently disabled, as defined by the contract or supplemental contract. A supplemental contract described in this subparagraph must be issued under the authority of section 602.
(3) An insurer may omit the provisions required under sections 3407, 3411, and 3420 from ticket policies sold only to passengers by common carriers.
(4) Section 3475 applies to group, blanket, or family expense disability insurance contracts and the remaining provisions of this chapter apply to group, blanket, or family expense disability insurance contracts only as provided in this chapter.
History: 1956, Act 218, Eff. Jan. 1, 1957 ;-- Am. 1963, Act 56, Eff. Sept. 6, 1963 ;-- Am. 2016, Act 276, Imd. Eff. July 1, 2016 Popular Name: Act 218
Structure Michigan Compiled Laws
Chapter 500 - Insurance Code of 1956
Act 218 of 1956 - The Insurance Code of 1956 (500.100 - 500.8302)
218-1956-34 - Chapter 34 Disability Insurance Policies (500.3400...500.3480)
Section 500.3400 - Definitions; Scope of Chapter, Exemptions, Exceptions.
Section 500.3401 - Repealed. 2016, Act 276, Imd. Eff. July 1, 2016.
Section 500.3401a - Group Disability Insurance; Issuance; Filing and Approval of Form.
Section 500.3402 - Disability Insurance Policy; Provisions Required.
Section 500.3402a - Group Disability Insurance Policy; Provisions Required.
Section 500.3402c - Family Expense Insurance Policy.
Section 500.3402d - Blanket Disability Insurance; Coverage.
Section 500.3402e - Blanket Disability Insurance Policies; Issuance.
Section 500.3402f - Blanket Disability Insurance Policy; Provisions.
Section 500.3402g - Blanket Disability Insurance Policy; Certificate; Payment of Benefits.
Section 500.3402h - Legal Liability of Policyholder.
Section 500.3404 - Insurance Policy Issued for Delivery to Nonresident.
Section 500.3405a - Use of Most Favored Nation Clause.
Section 500.3406a - Reconstructive Surgery Following Mastectomy; Prosthetic Device.
Section 500.3406b - Coverage for Mental Health Services by Mental Health Care Provider.
Section 500.3406c - Hospice Care; Definition; Description of Coverage.
Section 500.3406f - Repealed. 2016, Act 276, Imd. Eff. July 1, 2016.
Section 500.3406g - Repealed. 2016, Act 276, Imd. Eff. July 1, 2016.
Section 500.3406l - Medical Transportation Services; Reimbursement; Exception.
Section 500.3406m - Access by Insured to Obstetrician-Gynecologist.
Section 500.3406n - Access to Pediatric Care Services.
Section 500.3406t - Synchronizing Insured's or Enrollee's Multiple Maintenance Prescription Drugs.
Section 500.3406u - Coverage for Prescription Eyedrops; Requirements; "Prescriber" Defined.
Section 500.3406v - Coverage for Emergency Supply of Insulin.
Section 500.3406x - Nonopioid Directive Form; Website.
Section 500.3406y - Nonopioid Directive Form; Enrollment.
Section 500.3407 - Entire Contract; Changes.
Section 500.3408 - Time Limit on Certain Defenses; Incontestable Policy.
Section 500.3410 - Grace Period; Provision Required.
Section 500.3411 - Reinstatement; Provision Required.
Section 500.3412 - Notice of Claim; Provision Required.
Section 500.3413 - Claim Forms; Provision Required.
Section 500.3414 - Proofs of Loss; Provision Required.
Section 500.3416 - Time of Payment of Claims; Provision Required.
Section 500.3418 - Payment of Claims; Provision Required.
Section 500.3420 - Physical Examinations and Autopsy; Provision Required.
Section 500.3422 - Legal Actions; Provision Required.
Section 500.3424 - Change of Beneficiary; Provision Required.
Section 500.3426 - Offer of Wellness Coverage by Insurer.
Section 500.3428 - Provider Network.
Section 500.3430 - Optional Policy Provisions; Insurance Commissioner's Approval.
Section 500.3432 - Change of Occupation; Optional Provision.
Section 500.3434 - Misstatement of Age; Optional Provision.
Section 500.3436 - Other Insurance With Same Insurer; Optional Provision.
Section 500.3438 - Insurance With Other Insurers; Optional Provision; Expense Incurred Benefits.
Section 500.3439 - Repealed. 2016, Act 276, Imd. Eff. July 1, 2016.
Section 500.3440 - Insurance With Other Insurers; Other Benefits.
Section 500.3444 - Relation of Earnings to Insurance; Optional Provision.
Section 500.3446 - Unpaid Premium; Optional Provision.
Section 500.3448 - Cancellation; Optional Provision.
Section 500.3450 - Conformity With State Statutes; Optional Provision.
Section 500.3452 - Illegal Occupation or Criminal Activity; Optional Provision; Definitions.
Section 500.3454 - Repealed. 1980, Act 429, Eff. Mar. 31, 1981.
Section 500.3460 - Order of Certain Policy Provisions.
Section 500.3462 - Third Party Ownership of Policy.
Section 500.3466 - Filing Procedure; Insurance Commissioner, Regulatory Powers.
Section 500.3468 - Provisions Violating Code; Construction of Noncomplying Policies and Provisions.
Section 500.3470 - Age of Insured; Provision Regulations.
Section 500.3474 - Risk Classification; Rates; Filing Requirements.
Section 500.3474a - Premium Rate After January 1, 2014; Basis; Factors.
Section 500.3476 - Telemedicine Services; Provisions; Definitions.
Section 500.3480 - Repealed. 1963, Act 127, Eff. Sept. 6, 1963.