Michigan Compiled Laws
218-1956-38 - Chapter 38 Medicare Supplement Policies and Certificates (500.3801...500.3861)
Section 500.3861 - Probable Cause of Violation; Notice of Hearing; Opportunity to Confer and Discuss; Hearing; Applicability of MCL 500.2038 to 500.2040; Violation; Penalty.

Sec. 3861.
(1) If the commissioner has probable cause to believe that an insurer or agent has violated or is violating this chapter and that a hearing by the commissioner would be in the public interest, the commissioner shall give notice in writing to the person involved pursuant to the administrative procedures act of 1969, Act No. 306 of the Public Acts of 1969, being sections 24.201 to 24.328 of the Michigan Compiled Laws, setting forth the general nature of the complaint against him or her, and the proceedings contemplated. Before the issuance of a notice of hearing, the commissioner shall give the person an opportunity to confer and discuss the possible complaint and proceedings in person with the commissioner or his or her representative, and the matter may be disposed of summarily upon agreement of the parties.
(2) The provisions of section 2030 shall apply with respect to a hearing held pursuant to subsection (1), except that the use of an independent hearing officer shall not be allowed.
(3) If, after opportunity for a hearing held pursuant to Act No. 306 of the Public Acts of 1969, the commissioner determines that the insurer or agent has violated this chapter, the provisions of sections 2038 to 2040 shall apply. Each medicare supplement policy issued or delivered in violation of any of the provisions contained in this chapter shall constitute a separate violation for purposes of assessing a civil fine.
(4) In addition to any other applicable penalties for violations of this act, the commissioner may require insurers violating this chapter to cease marketing any medicare supplement policy or certificate in this state that is related directly or indirectly to a violation or may require the insurer to take such actions as are necessary to comply with this chapter.
History: Add. 1992, Act 84, Imd. Eff. June 2, 1992 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)

218-1956-38 - Chapter 38 Medicare Supplement Policies and Certificates (500.3801...500.3861)

Section 500.3801 - Chapter; Definitions.

Section 500.3803 - Applicability of Chapter.

Section 500.3804 - Repealed. 2018, Act 429, Eff. Mar. 20, 2019.

Section 500.3805 - Medicare Supplement Policy; Definitions.

Section 500.3807 - Basic Core Package of Benefits; Standards for Plans K and L; Applicability of Section.

Section 500.3807a - Medicare Supplement Policies or Certificates With Effective Date for Coverage on or After June 1, 2010; Basic Core Package of Benefits.

Section 500.3808 - Repealed. 2018, Act 429, Eff. Mar. 20, 2019.

Section 500.3809 - Additional Benefits; Reimbursement for Preventive Screening Tests and Services; Definitions; Applicability of Section.

Section 500.3809a - Medicare Supplement Policies or Certificates With Effective Date for Coverage on or After June 1, 2010; Additional Benefits.

Section 500.3811 - Basic Core Benefits; Availability; Sale of Certain Benefits Prohibited; Designations, Structure, Language, and Format; Other Designations; Requirements; Applicability of Section.

Section 500.3811a - Medicare Supplement Policies or Certificates With Effective Date for Coverage on or After June 1, 2010; Basic Core Benefits; Availability; Sale of Certain Benefits Prohibited; Structure, Language, Designation, and Format; Other De...

Section 500.3811b - Medicare Supplement Policies or Certificates for Newly Eligible Individuals After December 31, 2019; Exceptions to Standards and Requirements.

Section 500.3813 - Disability Coverage; Medicare Supplement Buyer's Guide; Applicability of Section.

Section 500.3815 - Outline of Coverage; Acknowledgment of Receipt; Compliance With Notice Requirements; Substitute; Language, Written or Electronic Format, and Required Items.

Section 500.3817 - Medicare Select Policies and Certificates; Definitions; Requirements for Issuance; Plan of Operation; Filing, Format, and Contents; Proposed Changes; Updated List of Network Providers; Payment for Covered Services Not Available Thr...

Section 500.3819 - Minimum Standards; Suspension of Benefits and Premiums; Notice; Reinstitution; Offer to Exchange 1990 Standardized Plan to 2010 Plan.

Section 500.3819a - Medicare Supplement Policies or Certificates With Effective Date for Coverage on or After June 1, 2010; Minimum Standards.

Section 500.3821 - Issuance of Policy to Person Not Enrolled in Medicare Parts a and B Prohibited; Refund; Interest.

Section 500.3823 - Covered Benefits More Restrictive Than Benefits Under Medicare and Required Under State Law Prohibited; Benefits for Outpatient Prescription Drugs.

Section 500.3825 - Preexisting Diseases or Conditions; Waiver Prohibited.

Section 500.3827 - Duplicate Benefits Prohibited; Application; Statements and Questions Whether Another Policy in Force; List of Policies Sold to Applicant; Notice Regarding Replacement Coverage.

Section 500.3829 - Denying or Conditioning Issuance Based on Health Status, Claims Experience, Receipt of Health Care, or Medical Condition of Applicant Prohibited; Condition; Exclusion of Benefits Based on Preexisting Conditions; Reduction; Creditab...

Section 500.3829a - Medicare Supplement Policies or Certificates Delivered, Issued for Delivery, or Renewed on or After May 21, 2009; Genetic Test; Definitions.

Section 500.3830 - Eligible Person; Requirements.

Section 500.3830a - Termination of Contract or Agreement; Notice to Individual.

Section 500.3831 - Individual or Group Expense Incurred Hospital, Medical, or Surgical Policies; Right of Continuation or Conversion to Medicare Supplemental Plan; Request for Coverage; Exclusion From Preexisting Conditions; Notice of Availability of...

Section 500.3833 - Replacement Policy; Waiver of Certain Time Periods.

Section 500.3835 - Marketing Procedures; Determining Appropriateness of Recommended Purchase or Replacement; More Than 1 Policy Prohibited; Individual Enrolled in Medicare Advantage; "Notice to Buyer" Displayed.

Section 500.3837 - Repealed. 2002, Act 304, Imd. Eff. May 10, 2002.

Section 500.3839 - Renewal or Continuation Provision; Effect of Termination or Replacement; Elimination of Outpatient Prescription Drug Benefit.

Section 500.3841 - Riders or Endorsements; Signed Acceptance or Agreement; Additional Premium; Use of Certain Standards, Terms, and Words; Filing of Changes in Medicare Benefits; Elimination of Duplicate Benefits; Notice of Modifications; Notice Requ...

Section 500.3843 - Health Insurance; Notice; Contents; Applicability of Subsection (1).

Section 500.3847 - Advertising; Filing Copy With Director.

Section 500.3849 - Filing and Approval Requirements; Deletion of Outpatient Prescription Drug Benefits; Issuance of Policy; Use and Change in Premium Rates; Additional Forms; Availability; Conditions and Effect of Discontinuance; Combining Forms for...

Section 500.3851 - Aggregate Benefits; Rates, Rating Schedules, and Rate Revisions.

Section 500.3852 - Benchmark Ratio.

Section 500.3853 - Refund or Credit Calculation; Form; Interest; Due Date.

Section 500.3855 - Annual Filing of Rates, Rating Schedule, and Supporting Documentation; Premium Adjustments; Public Hearing for Rate Increase; Failure to Make Premium Adjustments.

Section 500.3857 - Duties of Insurer; Certification of Compliance With Subsection (1)(a).

Section 500.3859 - Prohibited Conduct; Violation as Misdemeanor; Penalty.

Section 500.3861 - Probable Cause of Violation; Notice of Hearing; Opportunity to Confer and Discuss; Hearing; Applicability of MCL 500.2038 to 500.2040; Violation; Penalty.