HOUSE BILL No. 5242 October 8, 1997, Introduced by Rep. Gustafson and referred to the Committee on Insurance. A bill to amend 1956 PA 218, entitled "The insurance code of 1956," (MCL 500.100 to 500.8302) by adding sections 3406j and 3406k. THE PEOPLE OF THE STATE OF MICHIGAN ENACT: 1 SEC. 3406J. (1) EFFECTIVE JANUARY 1, 1998, AN INSURER THAT 2 DELIVERS, ISSUES FOR DELIVERY, OR RENEWS IN THIS STATE AN 3 EXPENSE-INCURRED HOSPITAL, MEDICAL, OR SURGICAL POLICY OR CERTIF- 4 ICATE THAT OFFERS DEPENDENT COVERAGE SHALL PROVIDE OR OFFER TO 5 PROVIDE THAT THE DEPENDENT COVERAGE APPLICABLE TO CHILDREN 6 INCLUDE COVERAGE FOR VACCINES TO IMMUNIZE AGAINST THE DISEASES 7 AND INFECTIONS LISTED IN SUBSECTION (2) AND SHALL PROVIDE OR 8 OFFER TO PROVIDE FOR COVERAGE FOR THE ADMINISTRATION OF THE VAC- 9 CINES FROM THE MOMENT OF BIRTH OR PLACEMENT FOR ADOPTION THROUGH 10 THE AGE OF 7 YEARS. 03412'97 DKH 2 1 (2) COVERAGE UNDER SUBSECTION (1) APPLIES TO VACCINATIONS TO 2 IMMUNIZE CHILDREN AGAINST EACH OF THE FOLLOWING DISEASES OR 3 INFECTIONS: 4 (A) DIPHTHERIA. 5 (B) HAEMOPHILUS INFLUENZAE TYPE B. 6 (C) HEPATITIS B. 7 (D) MEASLES. 8 (E) MUMPS. 9 (F) PERTUSSIS. 10 (G) POLIO. 11 (H) RUBELLA. 12 (I) TETANUS. 13 (J) VARICELLA. 14 (3) COVERAGE UNDER SUBSECTION (1) IS NOT SUBJECT TO ANY 15 COPAYMENTS, COINSURANCE PROVISIONS, DEDUCTIBLES, OR DOLLAR 16 LIMITS, AND THIS EXEMPTION SHALL BE EXPLICITLY PROVIDED FOR IN 17 THE POLICY OR CERTIFICATE. 18 (4) THIS SECTION DOES NOT APPLY TO LIMITED CLASSIFICATION 19 POLICIES. 20 (5) AS USED IN THIS SECTION, "LIMITED CLASSIFICATION 21 POLICIES" MEANS AN ACCIDENT ONLY POLICY OR CERTIFICATE, A LIMITED 22 ACCIDENT POLICY OR CERTIFICATE, OR A SPECIFIED DISEASE POLICY OR 23 CERTIFICATE. 24 SEC. 3406K. (1) EFFECTIVE JANUARY 1, 1998, AN INSURER THAT 25 DELIVERS, ISSUES FOR DELIVERY, OR RENEWS IN THIS STATE AN 26 EXPENSE-INCURRED HOSPITAL, MEDICAL, OR SURGICAL POLICY OR 27 CERTIFICATE THAT OFFERS DEPENDENT COVERAGE SHALL PROVIDE OR OFFER 03412'97 3 1 TO PROVIDE THAT THE DEPENDENT COVERAGE APPLICABLE TO CHILDREN 2 INCLUDE COVERAGE FOR WELL-CHILD EXAMINATIONS FROM THE MOMENT OF 3 BIRTH UNTIL 18 YEARS OF AGE OR GRADUATION FROM HIGH SCHOOL, 4 WHICHEVER COMES LATER. EACH SUCH POLICY OR CERTIFICATE SHALL 5 PROVIDE COVERAGE, AT A MINIMUM, FOR WELL-CHILD EXAMINATIONS AT 6 APPROXIMATELY THE FOLLOWING AGE INTERVALS: FIRST WEEK, 1 MONTH, 7 2 MONTHS, 4 MONTHS, 6 MONTHS, 9 MONTHS, 12 MONTHS, 15 MONTHS, 8 18 MONTHS, 24 MONTHS, 3 YEARS, 4 YEARS, 5 YEARS, 6 YEARS, 7 9 YEARS, 8 YEARS, 10 YEARS, 12 YEARS, 14 YEARS, 16 YEARS, AND 18 10 YEARS OR GRADUATION FROM HIGH SCHOOL, WHICHEVER COMES LATER. A 11 POLICY OR CERTIFICATE MAY PROVIDE THAT WELL-CHILD EXAMINATIONS 12 THAT ARE RENDERED DURING A PERIODIC REVIEW ARE ONLY COVERED TO 13 THE EXTENT THAT THOSE SERVICES ARE PROVIDED BY OR UNDER THE 14 SUPERVISION OF A SINGLE PHYSICIAN DURING THE COURSE OF 1 VISIT. 15 (2) AS USED IN THIS SECTION, "WELL-CHILD EXAMINATIONS" MEANS 16 THE PERIODIC REVIEW OF A CHILD'S MEDICAL STATUS BY A PHYSICIAN OR 17 PURSUANT TO A PHYSICIAN'S SUPERVISION. A REVIEW INCLUDES A HIS- 18 TORY, COMPLETE PHYSICAL EXAMINATION, GROWTH AND DEVELOPMENT 19 ASSESSMENT, DIET AND NUTRITION GUIDANCE, APPROPRIATE IMMUNIZA- 20 TIONS, AND LABORATORY TESTS IN KEEPING WITH PREVAILING MEDICAL 21 STANDARDS. 22 (3) COVERAGE UNDER SUBSECTION (1) IS NOT SUBJECT TO ANY 23 COPAYMENTS, COINSURANCE PROVISIONS, DEDUCTIBLES, OR DOLLAR 24 LIMITS, AND THIS EXEMPTION SHALL BE EXPLICITLY PROVIDED FOR IN 25 THE POLICY OR CERTIFICATE. 26 (4) THIS SECTION DOES NOT APPLY TO LIMITED CLASSIFICATION 27 POLICIES. 03412'97 4 1 (5) AS USED IN THIS SECTION, "LIMITED CLASSIFICATION 2 POLICIES" MEANS AN ACCIDENT ONLY POLICY OR CERTIFICATE, A LIMITED 3 ACCIDENT POLICY OR CERTIFICATE, OR A SPECIFIED DISEASE POLICY OR 4 CERTIFICATE. 03412'97 Final page. DKH