Michigan Compiled Laws
350-1980-4 - Part 4 (550.1400...550.1439)
Section 550.1401e - Group Certificate Issued by Health Care Corporation; Renewal or Continuation; Guaranteed Renewal; Discontinuing Plan, Product, or Coverage in Nongroup or Group Market; Conditions.

Sec. 401e.
(1) Except as otherwise provided in this section, a health care corporation that has issued a nongroup certificate shall renew or continue in force the certificate at the option of the individual.
(2) Except as otherwise provided in this section, a health care corporation that has issued a group certificate shall renew or continue in force the certificate at the option of the sponsor of the plan.
(3) Guaranteed renewal is not required in cases of fraud, intentional misrepresentation of material fact, lack of payment, if the health care corporation no longer offers that particular type of coverage in the market, or if the individual or group moves outside the service area.
(4) A health care corporation shall not discontinue offering a particular plan or product in the nongroup or group market unless the health care corporation does all of the following:
(a) Provides notice to the commissioner and to each covered individual or group, as applicable, provided coverage under the plan or product of the discontinuation at least 90 days before the date of the discontinuation.
(b) Offers to each covered individual or group, as applicable, provided coverage under the plan or product the option to purchase any other plan or product currently being offered in the nongroup market or group market, as applicable, by that health care corporation without excluding or limiting coverage for a preexisting condition or providing a waiting period.
(c) Acts uniformly without regard to any health status factor of enrolled individuals or individuals who may become eligible for coverage in making the determination to discontinue coverage and in offering other plans or products.
(5) A health care corporation shall not discontinue offering all coverage in the nongroup or group market unless the health care corporation does all of the following:
(a) Provides notice to the commissioner and to each covered individual or group, as applicable, of the discontinuation at least 180 days before the date of the expiration of coverage.
(b) Discontinues all health benefit plans issued in the nongroup or group market from which the health care corporation withdrew and, except as allowed under subsection (6), does not renew coverage under those plans.
(6) If a health care corporation discontinues coverage under subsection (5), the health care corporation shall not provide for the issuance of any health benefit plans in the nongroup or group market from which the health care corporation withdrew during the 5-year period beginning on the date of the discontinuation of the last plan not renewed under that subsection.
History: Add. 1996, Act 516, Eff. Oct. 1, 1997 ;-- Am. 2013, Act 4, Imd. Eff. Mar. 18, 2013 Popular Name: Blue Cross-Blue ShieldPopular Name: Act 350

Structure Michigan Compiled Laws

Michigan Compiled Laws

Chapter 550 - General Insurance Laws

Act 350 of 1980 - The Nonprofit Health Care Corporation Reform Act (550.1101 - 550.1704)

350-1980-4 - Part 4 (550.1400...550.1439)

Section 550.1400 - Use of Most Favored Nation Clause in Provider Contract.

Section 550.1401 - Offering of Health Care Benefits; Limiting Benefits; Division of Benefits Into Classes or Kinds; Prohibited Conduct; Grounds for Denial of Coverage; Coordination of Benefits, Subrogation, and Nonduplication of Benefits; Health Care...

Section 550.1401a - Health Care Service Rendered by Dentist; Benefits or Reimbursement; “Dentist” Defined; Certificates to Which Section Applicable.

Section 550.1401b - Certificate Providing Benefits for Mental Health Services; Requirements.

Section 550.1401c - Replacement Group Certificate With Preexisting Condition Limitation; Elimination, Reduction, or Limitation of Benefits; “Disability Coverage” Defined.

Section 550.1401d - Services Performed by Physician's Assistant; Reimbursement; Conditions; Applicability of Section; Supervision by Physician; Definitions.

Section 550.1401e - Group Certificate Issued by Health Care Corporation; Renewal or Continuation; Guaranteed Renewal; Discontinuing Plan, Product, or Coverage in Nongroup or Group Market; Conditions.

Section 550.1401f - Health Care Corporation; Access to Obstetrician-Gynecologist.

Section 550.1401g - Health Care Corporation; Access to Pediatric Care Services.

Section 550.1401h - Health Care Corporation Providing Prescription Drug Coverage; Formulary Restrictions.

Section 550.1401i - Prescription Drug Coverage; Pilot Project; Provisions; Interim Report; Determination; Evaluation.

Section 550.1401j - Prescription Drug Coverage; Rate Differentials; Filing.

Section 550.1401k - Telemedicine Services; Provisions; Definition; Applicability.

Section 550.1401m - Offer of Health Care Benefits to All Residents Regardless of Health Status.

Section 550.1402 - Health Care Corporation; Prohibited Conduct; Commission or Compensation; New Preexisting Condition Limitation Waiting Period; Readjusting Rates; Participation in Trade Practice Conference for Disability Insurers; Provider Class Pla...

Section 550.1402a - Terms and Conditions of Certificate; Form; Description; Requested Information; Written Request; “Board Certified” Defined.

Section 550.1402b - Preexisting Condition Limitation or Exclusion; Prohibition; Exception; “Group” Defined.

Section 550.1402c - Termination of Participation Between Primary Care Physician and Health Care Corporation; Notice to Member; Effect of Termination; Definitions.

Section 550.1402d - Applicability of MCL 500.2212c to Health Care Corporation.

Section 550.1403 - Payment of Benefits; Interest; Claim Form; Exception.

Section 550.1403a - Benefits Paid by Check or Written Instrument; Escheat.

Section 550.1403b - Advertising Material Prohibited.

Section 550.1404 - Violation of MCL 550.1402 or MCL 550.1403; Private Informal Managerial-Level Conference; Review by Commissioner; Internal Procedures; Determination by Commissioner; Expedited Grievance Procedure; Procedural Rules; Hearing Matter as...

Section 550.1405 - Single Billing Form; Development; Explanation of Total Bill for Services.

Section 550.1406 - Confidentiality of Records; Disclosures; Consent; Policy Regarding Protection of Privacy and Confidentiality of Personal Data; Violation as Misdemeanor; Penalty; Civil Action for Damages; Effect of Section on Governmental Agencies;...

Section 550.1407 - Complaint System; Procedures; Response to Complaint; Access to Complaints and Responses; Record of Complaints; Annual Report; Other Legal Remedies.

Section 550.1408 - False, Dishonest, or Fraudulent Claim for Payment as Misdemeanor; Penalty; Civil Action; Prosecution.

Section 550.1409 - Civil Action for Negligence.

Section 550.1409a - Coverage for Children Who Are Full-Time or Part-Time Students; Continuing Coverage if Dependent Student Takes Leave of Absence Due to Illness or Injury; Eligibility; Requirements.

Section 550.1410 - Certificate Providing Coverage of Dependent Terminating at Specified Age; Exceptions.

Section 550.1410a - Provisions of Group Certificate; Electing Coverage Under Group Conversion Certificate; Notice of Conversion Privilege; Requirements of Group Conversion Certificate; Premium; Issuance; Compliance.

Section 550.1410b - Premium for Group Conversion Certificate After January 1, 2014; Determination; Rating Factors.

Section 550.1411-550.1413a - Repealed. 1994, Act 40, Imd. Eff. Mar. 14, 1994.

Section 550.1414 - Expired. 1980, Act 430, Eff. Jan. 1, 1982.

Section 550.1414a - Treatment of Substance Abuse; Contracts; Qualifications of Provider; Coverage for Intermediate and Outpatient Care for Substance Abuse Required; Demonstration Projects; Substance Abuse Advisory Committee; Report; Contracts Based o...

Section 550.1414b - Offer of Wellness Coverage by Health Care Corporation.

Section 550.1415 - Benefits for Prosthetic Devices.

Section 550.1416 - Coverage for Breast Cancer Diagnostic Services, Breast Cancer Outpatient Services, and Breast Cancer Rehabilitative Services; Coverage for Breast Cancer Screening Mammography; Definitions; Effective Date of Section.

Section 550.1416a - Coverage for Drug Used in Antineoplastic Therapy and Cost of Its Administration; Conditions.

Section 550.1416b - Establishment of Program to Prevent Onset of Clinical Diabetes Required; Report; Coverages; “Diabetes” Defined.

Section 550.1416c - Off-Label Use of Approved Drug; Coverage; Conditions; Compliance; Use of Copayment, Deductible, Sanction, or Utilization Control; Limitation; Definitions.

Section 550.1416d - Coverage for Obstetrical and Gynecological Services by Physician or Nurse Midwife.

Section 550.1416e - 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; Prescription...

Section 550.1417 - Hospice Care; Contracts With Health Care Corporation; Description of Benefit.

Section 550.1418 - Emergency Health Services; Medical Coverage Required; “Stabilization” Defined.

Section 550.1419 - Certificate Offering Dependent Coverage to Child; Denial of Enrollment on Certain Grounds Prohibited.

Section 550.1419a - Eligibility of Parent for Dependent Coverage; Health Coverage of Child Through Noncustodial Parent; Court or Administrative Order and Notice Required.

Section 550.1419b - Individual Eligible Under Title XIX of Social Security Act; Assignment of Rights of Subscriber to Department of Social Services.

Section 550.1420-550.1430 - Repealed. 2006, Act 441, Imd. Eff. Oct. 19, 2006.

Section 550.1435 - “Program” Defined.

Section 550.1436 - Michigan Caring Programs for Children; Creation; Contribution Requirements; Rating Methodologies; Supersedure of Inconsistent Provisions.

Section 550.1437 - Eligibility of Child for Enrollment in Program.

Section 550.1438 - Limitation of Benefits; Provision of Other Health Care Benefits.

Section 550.1439 - Fees Prohibited; Exception; Funding; Enrollment of Children.