Sec. 3515.
(1) A health maintenance organization may provide additional health services or any other related health care service or treatment not required under this act.
(2) A health maintenance organization may have health maintenance contracts with deductibles. A health maintenance organization may have health maintenance contracts that include copayments, stated as dollar amounts for the cost of covered services, and coinsurance, stated as percentages for the cost of covered services. This subsection does not limit the director's authority to regulate and establish fair, sound, and reasonable copayment and coinsurance limits including out of pocket maximums.
(3) A health maintenance organization shall not require that contributions be made to a deductible for preventive health care services. As used in this subsection, "preventive health care services" means services designated to maintain an individual in optimum health and to prevent unnecessary injury, illness, or disability.
(4) A health maintenance organization may accept from governmental agencies and from private persons payments covering any part of the cost of health maintenance contracts.
History: Add. 2000, Act 252, Imd. Eff. June 29, 2000 ;-- Am. 2002, Act 304, Imd. Eff. May 10, 2002 ;-- Am. 2002, Act 621, Imd. Eff. Dec. 23, 2002 ;-- Am. 2005, Act 306, Imd. Eff. Dec. 21, 2005 ;-- Am. 2016, Act 97, Eff. Aug. 1, 2016 ;-- Am. 2016, Act 276, Imd. Eff. July 1, 2016 Popular Name: Act 218Popular Name: HMO
Structure Michigan Compiled Laws
Chapter 500 - Insurance Code of 1956
Act 218 of 1956 - The Insurance Code of 1956 (500.100 - 500.8302)
218-1956-35 - Chapter 35 Health Maintenance Organizations (500.3501...500.3580)
Section 500.3501 - Definitions.
Section 500.3503 - Applicability of Provisions to Health Maintenance Organization.
Section 500.3505 - Health Maintenance Contract; Use of Descriptive Words; Restrictions.
Section 500.3508 - Quality Assessment Program; Quality Improvement Program.
Section 500.3509 - Certificate of Authority; Application; Form; Limitation; Change of Service Area.
Section 500.3511 - Governing Body; Election of Enrollee Board Members; Requirements; Meetings.
Section 500.3521 - Prepayment Rates; Filing and Approval of Methodology; Schedule.
Section 500.3523 - Repealed. 2016, Act 276, Imd. Eff. July 1, 2016.
Section 500.3527 - Repealed. 2016, Act 276, Imd. Eff. July 1, 2016.
Section 500.3535 - Solicitation or Advertising.
Section 500.3537 - Repealed. 2016, Act 276, Imd. Eff. July 1, 2016.
Section 500.3539 - Repealed. 2016, Act 276, Imd. Eff. July 1, 2016.
Section 500.3541 - Repealed. 2016, Act 276, Imd. Eff. July 1, 2016.
Section 500.3542 - Repealed. 2016, Act 276, Imd. Eff. July 1, 2016.
Section 500.3543 - Repealed. 2016, Act 276, Imd. Eff. July 1, 2016.
Section 500.3544 - Noninsured Benefit Plan; Processing and Payment of Claims.
Section 500.3545 - Acquisition of Obligations From Another Managed Care Entity.
Section 500.3548 - Maintenance of Books, Records, Files, and Financial Records; Funds and Assets.
Section 500.3549 - Repealed. 2016, Act 276, Imd. Eff. July 1, 2016.
Section 500.3551 - Health Maintenance Organization; Net Worth.
Section 500.3553 - Certificate of Authority; Deposit Requirements.
Section 500.3555 - Financial Plan.
Section 500.3557 - Notice of Changes in Operations.
Section 500.3561 - Insolvency; Continuation of Benefits.
Section 500.3565 - Repealed. 2016, Act 276, Imd. Eff. July 1, 2016.
Section 500.3567 - Repealed. 2016, Act 276, Imd. Eff. July 1, 2016.
Section 500.3569 - Assumption of Financial Risk.
Section 500.3571 - State or Federal Health Programs.
Section 500.3580 - Repealed. 2016, Act 276, Imd. Eff. July 1, 2016.