THE INSURANCE CODE OF 1956 (EXCERPT)
Act 218 of 1956
CHAPTER 31A
MANAGED CARE


500.3181 "Managed care option" defined.

Sec. 3181.

    As used in this chapter, "managed care option" means an optional coverage selected by an insured at the time a policy is issued that includes, but is not limited to, the monitoring and adjudication of an injured person's care, the use of a preferred provider program or other network, or other similar option.


History: Add. 2019, Act 21, Imd. Eff. June 11, 2019
Popular Name: Act 218





500.3182 Applicability of chapter.

Sec. 3182.

    This chapter applies to all automobile insurance whether written on an individual or group basis.


History: Add. 2019, Act 21, Imd. Eff. June 11, 2019
Popular Name: Act 218





500.3183 Automobile insurer; offering of managed care option; requirements.

Sec. 3183.

    An automobile insurer may offer a managed care option that provides for allowable expenses consisting of all reasonable charges incurred for reasonably necessary products, services, and accommodations for an injured person's care, recovery, or rehabilitation. This managed care option is subject to all of the following:
    (a) It must be uniformly offered in all areas where the managed care option is available.
    (b) It must provide a discount that reflects reasonably anticipated reductions in losses or expenses or both.
    (c) It must not apply to emergency care. Emergency care includes, but is not limited to, all care necessary to the point where no material deterioration of a condition is likely, within reasonable medical probability, to result from or occur during transfer of the patient.


History: Add. 2019, Act 21, Imd. Eff. June 11, 2019
Compiler's Notes: Act 218





500.3184 Offer of personal protection insurance benefits required for certain managed care options.

Sec. 3184.

    An automobile insurer that offers a managed care option under this chapter shall also offer personal protection insurance benefits under section 3107(1)(a) that are not subject to the managed care option.


History: Add. 2019, Act 21, Imd. Eff. June 11, 2019
Popular Name: Act 218





500.3185 Application of managed care option.

Sec. 3185.

    The managed care option must apply to the insured who selects the managed care option and any person who resides in an area where the managed care option is available and who is claiming personal protection insurance benefits under the policy with the managed care option.


History: Add. 2019, Act 21, Imd. Eff. June 11, 2019
Popular Name: Act 218





500.3186 Managed care option; deductibles and co-pays.

Sec. 3186.

    A managed care option may provide for deductibles, co-pays, or both deductibles and co-pays.


History: Add. 2019, Act 21, Imd. Eff. June 11, 2019
Popular Name: Act 218





500.3187 Managed care option; requirements.

Sec. 3187.

    A managed care option must provide for all of the following:
    (a) That personal protection insurance benefits are primary and will not be coordinated with other health and accident coverage on the individual claiming personal protection insurance benefits under the policy with the managed care option.
    (b) That personal protection insurance benefits must be exhausted by the individual claiming those benefits under the policy with the managed care option before the individual may seek benefits from another health or accident coverage provider.
    (c) That deductibles, co-pays, or other similar sanctions will not be assessed or collected from other health and accident coverage providers for the individual claiming personal protection insurance benefits under the policy with the managed care option.


History: Add. 2019, Act 21, Imd. Eff. June 11, 2019
Popular Name: Act 218





500.3188 Selection of managed care option; written disclosure statement; requirements.

Sec. 3188.

    At the time of the initial selection of the managed care option by the insured, an automobile insurer shall obtain a signed acknowledgment that the insured received a written disclosure statement approved by the director or a written disclosure statement that includes all of the following:
    (a) A summary of the provisions of the managed care option.
    (b) The estimated range of the percentage of the discount provided by the managed care option.
    (c) A general description of the differences between a managed care option under this chapter and personal protection insurance benefits under section 3107(1)(a) that are not subject to the managed care option, including any procedural differences in seeking treatment and filing a claim.
    (d) The consequences for violating any provisions of the managed care option, including the possibility of a claim denial, the payment of a deductible and the amount of that deductible, and any additional out-of-pocket expenses that may be incurred.
    (e) An explanation of whether the insurer offers an opt-out provision that would enable the insured to change his or her policy from a managed care option to personal protection insurance benefits under section 3107(1)(a) that are not subject to the managed care option and any restrictions placed upon the insured in regard to opting out of the managed care option.


History: Add. 2019, Act 21, Imd. Eff. June 11, 2019
Popular Name: Act 218





500.3189 Managed care disclosure statement; additional requirements.

Sec. 3189.

    The disclosure statement under section 3188 must include a postal mailing address and either a toll-free telephone number or an internet website address that insureds or applicants for insurance may write, call, or otherwise access for information on the managed care option.


History: Add. 2019, Act 21, Imd. Eff. June 11, 2019
Popular Name: Act 218



Rendered 8/15/2025 3:24 PM
Michigan Compiled Laws Complete Through PA 5 of 2025
Courtesy of legislature.mi.gov