Sec. 3426.
(1) An insurer that delivers, issues for delivery, or renews in this state a group health insurance policy may offer group wellness coverage. An insurer may provide for an appropriate rebate or reduction in premiums or for reduced copayments, coinsurance, or deductibles, or a combination of these incentives, for participation in any health behavior wellness, maintenance, or improvement program offered by the employer. The employer shall provide evidence of demonstrative maintenance or improvement of the insureds' or enrollees' health behaviors as determined by assessments of agreed-upon health status indicators between the employer and the insurer. Any rebate of premium provided by the insurer is presumed to be appropriate unless credible data demonstrate otherwise, but must not exceed 50% of paid premiums for tobacco cessation programs or 30% of paid premiums for other wellness programs, unless otherwise approved by the director. An insurer shall make available to employers all wellness coverage plans that the insurer markets to employers in this state.
(2) An insurer that delivers, issues for delivery, or renews in this state an individual or family health insurance policy may offer individual and family wellness coverage. An insurer may provide for an appropriate rebate or reduction in premiums or for reduced copayments, coinsurance, or deductibles, or a combination of these incentives, for participation in any health behavior wellness, maintenance, or improvement program approved by the insurer. The insured or enrollee shall provide evidence of demonstrative maintenance or improvement of the individual's or family's health behaviors as determined by assessments of agreed-upon health status indicators between the insured and the insurer. Any rebate of premium provided by the insurer is presumed to be appropriate unless credible data demonstrate otherwise, but must not exceed 50% of paid premiums, unless otherwise approved by the director. An insurer shall make available to individuals and families all wellness coverage plans that the insurer markets to individuals and families in this state.
(3) An insurer is not required to continue any health behavior wellness, maintenance, or improvement program or to continue any incentive associated with a health behavior wellness, maintenance, or improvement program.
(4) A health behavior wellness, maintenance, or improvement program under this section may include other requirements in addition to those that are specific to health behavior wellness, maintenance, or improvement, if the program, taken as a whole, meets the intent of this section.
History: Add. 2006, Act 412, Eff. Mar. 30, 2007 ;-- Am. 2013, Act 5, Imd. Eff. Mar. 18, 2013 ;-- Am. 2016, Act 276, Imd. Eff. July 1, 2016 Compiler's Notes: Enacting section 2 of Act 412 of 2006 provides:"Enacting section 2. It is only the intent of this amendatory act to promote the availability of health behavior wellness, maintenance, and improvement programs."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.