Michigan Compiled Laws
Act 218 of 1984 - Third Party Administrator Act (550.901 - 550.962)
Section 550.950 - Violation; Probable Cause; Notice; Conference; Disposition of Matter Upon Agreement of Parties; Action for Damages; Hearing; Findings and Decision; Cease and Desist Order; Additional Order.

Sec. 50.
(1) When the commissioner has probable cause to believe that a TPA or manager is violating, or has violated section 40, indicating a persistent tendency to engage in conduct prohibited by that section, or has probable cause to believe that a TPA or manager is violating, or has violated other provisions of this act, he or she shall give written notice to the TPA or manager, pursuant to the administrative procedures act, Act No. 306 of the Public Acts of 1969, being sections 24.201 to 24.315 of the Michigan Compiled Laws, setting forth the general nature of the complaint against the TPA or manager and the proceedings contemplated under this section. Before the issuance of a notice of hearing, the staff of the bureau of insurance responsible for the matters which would be at issue in the hearing shall give the TPA or manager an opportunity to confer and discuss the possible complaint and proceedings in person with the commissioner or a representative of the commissioner, and the matter may be disposed of summarily upon agreement of the parties. This subsection shall not be construed to create or diminish any right of a person to bring an action for damages under this section.
(2) A hearing held pursuant to subsection (1) shall be held pursuant to the administrative procedures act, Act No. 306 of the Public Acts of 1969. If, after the hearing, the commissioner determines that the TPA or manager is violating, or has violated section 40, indicating a persistent tendency to engage in conduct prohibited by that section, or has violated or is violating other provisions of this act, the commissioner shall reduce his or her findings and decision to writing, and shall issue and cause to be served upon the TPA or manager a copy of the findings and an order requiring the TPA or manager to cease and desist from engaging in the prohibited activity, and the commissioner may order any of the following:
(a) Payment of a monetary penalty of not more than $500.00 for each violation but not to exceed an aggregate penalty of $5,000.00, unless the TPA or manager knew or reasonably should have known it was in violation of this act, in which case the penalty shall not be more than $2,500.00 for each violation and shall not exceed an aggregate penalty of $25,000.00 for all violations committed in a 6-month period.
(b) Suspension or revocation of the TPA's certificate of authority or the manager's license if the TPA or manager knowingly and persistently violated this act.
(c) Restitution or refund to an aggrieved person.
History: 1984, Act 218, Eff. Jan. 1, 1985

Structure Michigan Compiled Laws

Michigan Compiled Laws

Chapter 550 - General Insurance Laws

Act 218 of 1984 - Third Party Administrator Act (550.901 - 550.962)

Section 550.901 - Short Title.

Section 550.902 - Definitions.

Section 550.910 - Third Party Administrator; Certificate Required; Requirements; Instances in Which Tpa Subject to Act; Name.

Section 550.912 - Application for Certificate of Authority; Form, Verification, and Contents; Filing Notice of Modification.

Section 550.914 - Certificate of Authority; Issuance; Notice of Disapproval; Continued Compliance With Subsection (1).

Section 550.916 - Repealed. 2002, Act 74, Imd. Eff. Mar. 15, 2002.

Section 550.918 - Fees; Payment; Collection; and Designation.

Section 550.919 - Tpa Advisory Board; Creation; Appointment, Qualifications, and Terms of Members; Expenses; Duty of Board; Report.

Section 550.920 - Authority of Commissioner.

Section 550.922 - Hearings.

Section 550.924 - Destruction or Disposal of Records, Books, Papers, and Other Data.

Section 550.926 - 340b Program Entities; Reimbursement, Co-Pay, and Discrimination Prohibitions; Definitions.

Section 550.927 - Disclosure of Current Selling Prices; Prohibited Contract Provisions.

Section 550.930 - Provision of Administrative Services Pursuant to Written Service Contract; Maintenance of Books and Records; Tpa and Manager as Fiduciary.

Section 550.932 - Benefit Plan; Notice; Plan Covering Less Than 500 Individuals; Service Contract Between Tpa and Governmental Entity Not Subject to Erisa; Construction of Act.

Section 550.934 - Confidentiality.

Section 550.936 - Annual Statement; Report.

Section 550.940 - Prohibited Conduct Generally.

Section 550.942 - Additional Prohibited Conduct.

Section 550.944 - Additional Prohibited Conduct.

Section 550.950 - Violation; Probable Cause; Notice; Conference; Disposition of Matter Upon Agreement of Parties; Action for Damages; Hearing; Findings and Decision; Cease and Desist Order; Additional Order.

Section 550.952 - Civil Fine; Suspension or Revocation of Certificate or License; Refusal to Issue; Grounds for Denial, Suspension, Revocation, or Cease and Desist Order; Definition.

Section 550.954 - Alteration, Modification, or Setting Aside of Order.

Section 550.956 - Judicial Review; Petition for Review; Transcript of Record and Copy of Order or Decision; Hearing Cause as Civil Case in Equity; Evidence; Duty of Court; Incomplete Record; Stay of Order or Decision; Jurisdiction.

Section 550.958 - Self-Incrimination; False Oath or Affirmation.

Section 550.960 - Rules.

Section 550.962 - Repealed. 2002, Act 74, Imd. Eff. Mar. 15, 2002.