HOUSE BILL No. 5243 October 8, 1997, Introduced by Rep. Gustafson and referred to the Committee on Insurance. A bill to amend 1980 PA 350, entitled "The nonprofit health care corporation reform act," (MCL 550.1101 to 550.1704) by adding sections 418 and 418a. THE PEOPLE OF THE STATE OF MICHIGAN ENACT: 1 SEC. 418. (1) EFFECTIVE JANUARY 1, 1998, A HEALTH CARE COR- 2 PORATION GROUP OR NONGROUP CERTIFICATE THAT OFFERS DEPENDENT BEN- 3 EFITS SHALL PROVIDE OR OFFER TO PROVIDE THAT THE DEPENDENT BENE- 4 FITS APPLICABLE TO CHILDREN INCLUDE BENEFITS FOR VACCINES TO 5 IMMUNIZE AGAINST THE DISEASES AND INFECTIONS LISTED IN SUBSECTION 6 (2) AND SHALL PROVIDE OR OFFER TO PROVIDE FOR COVERAGE FOR THE 7 ADMINISTRATION OF THE VACCINES FROM THE MOMENT OF BIRTH OR PLACE- 8 MENT FOR ADOPTION THROUGH THE AGE OF 7 YEARS. 9 (2) COVERAGE UNDER SUBSECTION (1) APPLIES TO VACCINATIONS TO 10 IMMUNIZE CHILDREN AGAINST EACH OF THE FOLLOWING DISEASES OR 11 INFECTIONS: 03413'97 DKH 2 1 (A) DIPHTHERIA. 2 (B) HAEMOPHILUS INFLUENZAE TYPE B. 3 (C) HEPATITIS B. 4 (D) MEASLES. 5 (E) MUMPS. 6 (F) PERTUSSIS. 7 (G) POLIO. 8 (H) RUBELLA. 9 (I) TETANUS. 10 (J) VARICELLA. 11 (3) BENEFITS UNDER SUBSECTION (1) ARE NOT SUBJECT TO ANY 12 COPAYMENTS, COINSURANCE PROVISIONS, DEDUCTIBLES, OR DOLLAR 13 LIMITS, AND THIS EXEMPTION SHALL BE EXPLICITLY PROVIDED FOR IN 14 THE CERTIFICATE. 15 SEC. 418A. (1) EFFECTIVE JANUARY 1, 1998, A HEALTH CARE 16 CORPORATION GROUP OR NONGROUP CERTIFICATE THAT OFFERS DEPENDENT 17 BENEFITS SHALL PROVIDE OR OFFER TO PROVIDE THAT THE DEPENDENT 18 BENEFITS APPLICABLE TO CHILDREN INCLUDE BENEFITS FOR WELL-CHILD 19 EXAMINATIONS FROM THE MOMENT OF BIRTH UNTIL 18 YEARS OF AGE OR 20 GRADUATION FROM HIGH SCHOOL, WHICHEVER COMES LATER. EACH SUCH 21 CERTIFICATE SHALL PROVIDE BENEFITS, AT A MINIMUM, FOR WELL-CHILD 22 EXAMINATIONS AT APPROXIMATELY THE FOLLOWING AGE INTERVALS: FIRST 23 WEEK, 1 MONTH, 2 MONTHS, 4 MONTHS, 6 MONTHS, 9 MONTHS, 12 MONTHS, 24 15 MONTHS, 18 MONTHS, 24 MONTHS, 3 YEARS, 4 YEARS, 5 YEARS, 6 25 YEARS, 7 YEARS, 8 YEARS, 10 YEARS, 12 YEARS, 14 YEARS, 16 YEARS, 26 AND 18 YEARS OF AGE OR GRADUATION FROM HIGH SCHOOL, WHICHEVER 27 COMES LATER. A CERTIFICATE MAY PROVIDE THAT WELL-CHILD 03413'97 3 1 EXAMINATIONS THAT ARE RENDERED DURING A PERIODIC REVIEW ARE ONLY 2 COVERED TO THE EXTENT THAT THOSE SERVICES ARE PROVIDED BY OR 3 UNDER THE SUPERVISION OF A SINGLE PHYSICIAN DURING THE COURSE OF 4 1 VISIT. 5 (2) AS USED IN THIS SECTION, "WELL-CHILD EXAMINATIONS" MEANS 6 THE PERIODIC REVIEW OF A CHILD'S MEDICAL STATUS BY A PHYSICIAN OR 7 PURSUANT TO A PHYSICIAN'S SUPERVISION. A REVIEW INCLUDES A HIS- 8 TORY, COMPLETE PHYSICAL EXAMINATION, GROWTH AND DEVELOPMENT 9 ASSESSMENT, DIET AND NUTRITION GUIDANCE, APPROPRIATE IMMUNIZA- 10 TIONS, AND LABORATORY TESTS IN KEEPING WITH PREVAILING MEDICAL 11 STANDARDS. 12 (3) BENEFITS UNDER SUBSECTION (1) ARE NOT SUBJECT TO ANY 13 COPAYMENTS, COINSURANCE PROVISIONS, DEDUCTIBLES, OR DOLLAR 14 LIMITS, AND THIS EXEMPTION SHALL BE EXPLICITLY PROVIDED FOR IN 15 THE CERTIFICATE. 03413'97 Final page. DKH