Michigan Compiled Laws
218-1956-34 - Chapter 34 Disability Insurance Policies (500.3400...500.3480)
Section 500.3403 - Health Insurance Policy Offering Dependent Coverage; Required Provisions; Denial Prohibited; Grounds.

Sec. 3403.
(1) An insurer that delivers, issues for delivery, or renews in this state a health insurance policy that offers dependent coverage shall include both of the following provisions in the policy:
(a) That the health insurance benefits applicable for children are payable with respect to a newly born child of the insured from the moment of birth.
(b) That the coverage for newly born children consists of coverage of injury or sickness including the necessary care and treatment of medically diagnosed congenital defects and birth abnormalities.
(2) An insurer that delivers, issues for delivery, or renews in this state a health insurance policy that offers dependent coverage shall not deny enrollment to an insured's child on any of the following grounds:
(a) The child was born out of wedlock.
(b) The child is not claimed as a dependent on the insured's federal income tax return.
(c) The child does not reside with the insured or in the insurer's service area.
History: Add. 1975, Act 20, Imd. Eff. Apr. 3, 1975 ;-- Am. 2016, Act 276, Imd. Eff. July 1, 2016 Compiler's Notes: Section 2 of Act 20 of 1975 provides: “The requirements of this act shall apply to all insurance policies delivered or issued for delivery in this state more than 120 days after the effective date of the act.”Popular Name: Act 218

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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)

218-1956-34 - 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Section 500.3401 - Repealed. 2016, Act 276, Imd.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 500.3402b - Group or Nongroup Disability Insurance Policy; Coordination of Benefits; Provision; Limitation; "Other Coverage" Defined; Payment by Each Insurer.

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 500.3403 - Health Insurance Policy Offering Dependent Coverage; Required Provisions; Denial Prohibited; Grounds.

Section 500.3404 - Insurance Policy Issued for Delivery to Nonresident.

Section 500.3405 - Prudent Purchaser Agreements With Providers of Hospital, Nursing, Medical, Surgical, or Sick-Care Services; Rates; Discrimination Prohibited; Optometry, Chiropractic, and Physical Therapy Service.

Section 500.3405a - Use of Most Favored Nation Clause.

Section 500.3406 - Disability Insurance Policy; Provisions Required, Captions, Omissions, Substitutions.

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 500.3406d - Coverage for Breast Cancer Diagnostic Services, Breast Cancer Outpatient Treatment Services, and Breast Cancer Rehabilitative Services; Coverage for Breast Cancer Screening Mammography; Definitions.

Section 500.3406e - Coverage for Drug Used in Antineoplastic Therapy and Cost of Its Administration; Conditions.

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 500.3406h - Eligibility of Parent for Dependent Coverage; Health Coverage of Child Through Noncustodial Parent; Duties of Insurer; Court or Administrative Order and Notice Required.

Section 500.3406i - Individual Eligible Under Title XIX of Social Security Act; Assignment of Rights of Insured to Department of Social Services.

Section 500.3406j - Insured or Applicant as Victim of Domestic Violence; Refusal to Provide Coverage Prohibited; Liability; "Domestic Violence" Defined.

Section 500.3406k - Emergency Health Services; Medically Necessary Coverage; "Stabilization" Defined.

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 500.3406o - Insurer Providing Prescription Drug Coverage; Formulary Restrictions; Expedited Review of Coverage for Nonformulary Alternative; Determination; Subject to 500.3406w.

Section 500.3406p - Establishment of Program to Prevent Onset of Clinical Diabetes Required; Survey; Coverages; "Diabetes" Defined.

Section 500.3406q - Off-Label Use of Approved Drug; Coverage; Conditions; Compliance; Use of Copayment, Deductible, Sanction, or Utilization Control; Limitation; Definitions.

Section 500.3406r - Coverage for Obstetrical and Gynecological Services by Physician or Nurse Midwife.

Section 500.3406s - Diagnosis and Treatment of Autism Spectrum Disorders; Coverage; Prohibition; Availability of Other Benefits; Conditions; Qualified Health Plan Offered Through American Health Benefit Exchange Pursuant to Federal Law; Short-Term or...

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 500.3406w - Temporary Emergency and Early Refills for Prescription Drugs; Inapplicable After March 31, 2021.

Section 500.3406x - Nonopioid Directive Form; Website.

Section 500.3406y - Nonopioid Directive Form; Enrollment.

Section 500.3407 - Entire Contract; Changes.

Section 500.3407a - Conduct on Behalf of or Information Provided to Insured by Health Care Provider; Prohibition or Discouragement by Disability Insurer.

Section 500.3407b - Undergoing Genetic Testing as Condition of Issuing, Renewing, or Continuing Policy; Disclosure of Genetic Testing or Genetic Information; Definitions.

Section 500.3408 - Time Limit on Certain Defenses; Incontestable Policy.

Section 500.3409 - Disability Insurance Policy; Mandatory Notices as to Cancellation and Refund of Premium.

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 500.3425 - Health Insurance Policy; Coverage for Intermediate and Outpatient Care for Substance Use Disorder Required; Charges, Terms, and Conditions; Reduction of Coverage; Deductibles and Copayment Provisions; Definitions.

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 500.3464 - Foreign or Alien Insurers; Provision Required by Other State Law; Domestic Insurers; Provision Required by Other State or Country.

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 500.3471 - Provision and Nondisclosure of Large Employer Group Claims Utilization and Cost Information; Civil Liability Immunity; Definitions.

Section 500.3472 - Open Enrollment Period; Prohibitions; Establishment of Reasonable Periods for Health Insurance Policies; Minimum Standards for Frequency and Duration of Open Enrollment Periods; Denial of Coverage.

Section 500.3474 - Risk Classification; Rates; Filing Requirements.

Section 500.3474a - Premium Rate After January 1, 2014; Basis; Factors.

Section 500.3475 - Reimbursement for Services by Licensed Psychologist, Podiatrist, or Chiropractor; Section Inapplicable to Policy Involving Prudent Purchaser Agreement.

Section 500.3476 - Telemedicine Services; Provisions; Definitions.

Section 500.3477 - Use of Financial Incentive or Payment to Act as Inducement to Deny, Reduce, Limit, or Delay Services; Prohibition; Exception.

Section 500.3480 - Repealed. 1963, Act 127, Eff. Sept. 6, 1963.