SB-0234,As Passed House,Jun 5, 2003                                         

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                           HOUSE SUBSTITUTE FOR                                 

                                                                                

                           SENATE BILL NO. 234                                  

                                                                                

                         (As amended June 5, 2003)                              

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                 [A bill to amend 1980 PA 350, entitled                                             

                                                                                

    "The nonprofit health care corporation reform act,"                         

                                                                                

    by amending sections 107, 204, 206, 207, 211, 502, 602, 606,                

                                                                                

    607, 608, 609, 610, 613, and 619 (MCL 550.1107,                             

                                                                                

    550.1204, 550.1206, 550.1207, 550.1211, 550.1502, 550.1602,                 

                                                                                

    550.1606, 550.1607, 550.1608, 550.1609, 550.1610, 550.1613, and             

                                                                                

    550.1619), section 207 as amended by 1999 PA 210, section 211 as            

                                                                                

    amended by 1993 PA 127, section 502 as amended by 1998 PA 446,              

                                                                                

    section 608 as amended by 1991 PA 73, and section 609 as amended            

                                                                                

    by 1991 PA 61, and by adding sections 204a, 205a, 219, 401j, 403b, and      

                                                                                

    422c; and to repeal acts and parts of acts.]                                

                                                                                

                THE PEOPLE OF THE STATE OF MICHIGAN ENACT:                      

                                                                                

1       Sec. 107.  (1) "Participating provider" means a provider                    

                                                                                

2   that has entered into a participating contract with a health care           

                                                                                

3   corporation and that meets the standards set by the corporation             

                                                                                


                                                                                

1   for that class of providers.                                                

                                                                                

2       (2) "Participating contract" means an agreement, contract, or               

                                                                                

3   other arrangement under which a provider agrees to accept the               

                                                                                

4   payment of the health care corporation as payment in full for               

                                                                                

5   health care services or parts of health care services covered               

                                                                                

6   under a certificate, as provided for in section 502(1).                     

                                                                                

7       (3) "Person" means an individual, corporation, partnership,                 

                                                                                

8   organization, limited liability company, or association.                    

                                                                                

9       (4) "Personal data" means a document incorporating medical or               

                                                                                

10  surgical history, care, treatment, or service; or any similar               

                                                                                

11  record, including an automated or computer accessible record,               

                                                                                

12  relative to a member, which is maintained or stored by a health             

                                                                                

13  care corporation.                                                           

                                                                                

14      (5) "Proposed rate" means any of the following:                             

                                                                                

15      (a) A proposed increase or decrease in the rates to be                      

                                                                                

16  charged to nongroup subscribers.                                            

                                                                                

17      (b) For group subscribers, any proposed changes in the                      

                                                                                

18  methodology or definitions of any rating system, formula,                   

                                                                                

19  component, or factor subject to prior approval by the                       

                                                                                

20  commissioner.                                                               

                                                                                

21      (c) A proposed increase or decrease in deductible amounts or                

                                                                                

22  coinsurance percentages.                                                    

                                                                                

23      (d) A proposed extension of benefits, additional benefits, or               

                                                                                

24  a reduction or limitation in benefits.                                      

                                                                                

25      (e) A review pursuant to section 608(2).                                    

                                                                                

26      (6) "Provider class" means classes of providers, as defined                 

                                                                                

27  in section 105(4), that have a provider contract or a                       


     Senate Bill No. 234 (H-2) as amended June 5, 2003

   

1   reimbursement arrangement with a health care corporation to                 

                                                                                

2   render health care services to subscribers, as those classes are            

                                                                                

3   established by the corporation.                                             

                                                                                

4       (7) "Provider class plan" or "plan" means a document                        

                                                                                

5   containing a reimbursement arrangement and objectives for a                 

                                                                                

6   provider class, and, in the case of those providers with which a            

                                                                                

7   health care corporation contracts, provisions that are included             

                                                                                

8   in that contract.                                                           

                                                                                

9       (8) "Provider contract" or "contract" means an agreement                    

                                                                                

10  between a provider and a health care corporation that contains              

                                                                                

11  provisions to implement the provider class plan.                            

                                                                                

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     Senate Bill No. 234 (H-2) as amended June 5, 2003

   

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21      Sec. 204.  (1) Before entering into contracts or securing                   

                                                                                

22  applications of subscribers, the persons incorporating a health             

                                                                                

23  care corporation shall file all of the following in the office of           

                                                                                

24  the commissioner:                                                           

                                                                                

25      (a) Three copies of the articles of incorporation, with the                 

                                                                                

26  certificate of the attorney general required under section 202(3)           

                                                                                

27  attached.                                                                   


                                                                                

1       (b) A statement showing in full detail the plan upon which                  

                                                                                

2   the corporation proposes to transact business.                              

                                                                                

3       (c) A copy of all certificates to be issued to subscribers.                 

                                                                                

4       (d) A copy of the financial statements of the corporation.                  

                                                                                

5       (e) Proposed advertising to be used in the solicitation of                  

                                                                                

6   certificates for subscribers.                                               

                                                                                

7       (f) A copy of the bylaws.                                                   

                                                                                

8       (g) A copy of all proposed contracts and reimbursement                      

                                                                                

9   methods.                                                                    

                                                                                

10      (2) The commissioner shall examine the statements and                       

                                                                                

11  documents filed under subsection (1), may conduct any                       

                                                                                

12  investigation  which  that he or she considers necessary, may               

                                                                                

13  request additional oral and written information from the                    

                                                                                

14  incorporators, and may examine under oath any persons interested            

                                                                                

15  in or connected with the proposed health care corporation.  The             

                                                                                

16  commissioner shall ascertain whether all of the following                   

                                                                                

17  conditions are met:                                                         

                                                                                

18      (a) The solicitation of certificates will not work a fraud                  

                                                                                

19  upon the persons solicited by the corporation.                              

                                                                                

20      (b) The rates to be charged and the benefits to be provided                 

                                                                                

21  are adequate, equitable, and not excessive, as defined in section           

                                                                                

22  609.                                                                        

                                                                                

23      (c) The amount of money actually available for working                      

                                                                                

24  capital is sufficient to carry all acquisition costs and                    

                                                                                

25  operating expenses for a reasonable period of time from the date            

                                                                                

26  of issuance of the certificate of authority, and is not less than           

                                                                                

27  $500,000.00 or a greater amount, if the commissioner considers it           


                                                                                

1   necessary.                                                                  

                                                                                

2       (d) The amounts contributed as the working capital of the                   

                                                                                

3   corporation are payable only out of amounts in excess of minimum            

                                                                                

4   required reserves of the corporation.                                       

                                                                                

5       (e) Adequate and  reasonable reserves are provided, as                      

                                                                                

6   defined in section 205  unimpaired surplus is provided, as                  

                                                                                

7   determined under section 204a.                                              

                                                                                

8       (3) If the commissioner finds that the conditions prescribed                

                                                                                

9   in subsection (2) are met, the commissioner shall do all of the             

                                                                                

10  following:                                                                  

                                                                                

11      (a) Return to the incorporators 1 copy of the articles of                   

                                                                                

12  incorporation, certified for filing with the  chief officer                 

                                                                                

13  director of the department of  commerce  consumer and industry              

                                                                                

14  services or of any other agency or department authorized by law             

                                                                                

15  to administer  Act No. 284 of the Public Acts of 1972, as                   

                                                                                

16  amended, being sections 450.1101 to 450.2099 of the Michigan                

                                                                                

17  Compiled Laws  the business corporation act, 1972 PA 284,                   

                                                                                

18  MCL 450.1101 to 450.2098, or his or her designated                          

                                                                                

19  representative, and 1 copy of the articles of incorporation                 

                                                                                

20  certified for the records of the corporation itself.                        

                                                                                

21      (b) Retain 1 copy of the articles of incorporation for the                  

                                                                                

22  commissioner's office files.                                                

                                                                                

23      (c) Deliver to the corporation a certificate of authority to                

                                                                                

24  commence business and to issue certificates  which  that have               

                                                                                

25  been approved by the commissioner, or  which  that are exempted             

                                                                                

26  from prior approval pursuant to section 607(2) or  (7)  (8),                

                                                                                

27  entitling subscribers to certain health care benefits.                      


                                                                                

1       Sec. 204a.  (1) A health care corporation shall possess and                 

                                                                                

2   maintain unimpaired surplus in an amount determined adequate by             

                                                                                

3   the commissioner to comply with section 403 of the insurance code           

                                                                                

4   of 1956, 1956 PA 218, MCL 500.403.  The commissioner shall follow           

                                                                                

5   the risk-based capital requirements as developed by the national            

                                                                                

6   association of insurance commissioners in order to determine                

                                                                                

7   whether a health care corporation is in adequate compliance with            

                                                                                

8   section 403 of the insurance code of 1956, 1956 PA 218,                     

                                                                                

9   MCL 500.403.                                                                

                                                                                

10      (2) If a health care corporation files a risk-based capital                 

                                                                                

11  report that indicates that its surplus is less than the amount              

                                                                                

12  determined adequate by the commissioner under subsection (1), the           

                                                                                

13  health care corporation shall prepare and submit a plan for                 

                                                                                

14  remedying the deficiency in accordance with risk-based capital              

                                                                                

15  requirements adopted by the commissioner.  Among the remedies               

                                                                                

16  that a health care corporation may employ are planwide viability            

                                                                                

17  contributions to surplus by subscribers.                                    

                                                                                

18      (3) If contributions for planwide viability under subsection                

                                                                                

19  (2) are employed, those contributions shall be made in accordance           

                                                                                

20  with the following:                                                         

                                                                                

21      (a) If the health care corporation's surplus is less than                   

                                                                                

22  200% but more than 150% of the authorized control level under               

                                                                                

23  risk-based capital requirements, the maximum contribution rate              

                                                                                

24  shall be 0.5% of the rate charged to subscribers for the benefits           

                                                                                

25  provided.                                                                   

                                                                                

26      (b) If the health care corporation's surplus is 150% or less                

                                                                                

27  than the authorized control level under risk-based capital                  


                                                                                

1   requirements, the maximum contribution rate shall be 1% of the              

                                                                                

2   rate charged to subscribers for the benefits provided.                      

                                                                                

3       (c) The actual contribution rate charged is subject to the                  

                                                                                

4   commissioner's approval.                                                    

                                                                                

5       (4) As used in subsection (3), "authorized control level"                   

                                                                                

6   means the number determined under the risk-based capital formula            

                                                                                

7   in accordance with the instructions developed by the national               

                                                                                

8   association of insurance commissioners and adopted by the                   

                                                                                

9   commissioner.                                                               

                                                                                

10      (5) Subject to this subsection, a health care corporation                   

                                                                                

11  shall not maintain surplus in an amount that equals or is greater           

                                                                                

12  than 200% of the authorized control level under risk-based                  

                                                                                

13  capital requirements multiplied by 5.  If a health care                     

                                                                                

14  corporation files a risk-based capital report that indicates that           

                                                                                

15  its surplus is more than the allowable maximum surplus permitted            

                                                                                

16  under this subsection for 2 successive calendar years, the health           

                                                                                

17  care corporation shall file a plan for approval by the                      

                                                                                

18  commissioner to adjust its surplus to a level below the allowable           

                                                                                

19  maximum surplus.  If the commissioner disapproves the health care           

                                                                                

20  corporation's plan, the commissioner shall formulate an alternate           

                                                                                

21  plan and forward the alternate plan to the health care                      

                                                                                

22  corporation.  The health care corporation shall begin                       

                                                                                

23  implementation of the plan immediately upon receipt of approval             

                                                                                

24  of its plan by the commissioner or upon receipt of the                      

                                                                                

25  commissioner's alternate plan.                                              

                                                                                

26      Sec. 205a.  A health care corporation shall report financial                

                                                                                

27  information in conformity with sound actuarial practices and                


     Senate Bill No. 234 (H-2) as amended June 5, 2003

   

1   statutory accounting principles in the same manner as designated            

                                                                                

2   by the commissioner for other carriers pursuant to section 438(2)           

                                                                                

3   of the insurance code of 1956, 1956 PA 218, MCL 500.438.                    

                                                                                

4   Approved permitted practices may be used by a health care                   

                                                                                

5   corporation until [March 1, 2007] to effectuate the transfer to             

                                                                                

6   statutory accounting principles required by this section.                   

                                                                                

7       Sec. 206.  (1) The funds and property of a health care                      

                                                                                

8   corporation shall be acquired, held, and disposed of only for the           

                                                                                

9   lawful purposes of the corporation and for the benefit of the               

                                                                                

10  subscribers of the corporation as a whole.  A health care                   

                                                                                

11  corporation shall only transact  such  business, receive,                   

                                                                                

12  collect, and disburse  such  money, and acquire, hold, protect,             

                                                                                

13  and convey  such  property,  as are  that is properly within the            

                                                                                

14  scope of the purposes of the corporation as specifically set                

                                                                                

15  forth in section 202(1)(d), for the benefit of the subscribers of           

                                                                                

16  the corporation as a whole, and consistent with this act.                   

                                                                                

17      (2) The funds of a health care corporation shall be invested                

                                                                                

18  only in securities permitted by the laws of this state for the              

                                                                                

19  investments of assets of life insurance companies, as described             

                                                                                

20  in chapter 9 of  Act No. 218 of the Public Acts of 1956, as                 

                                                                                

21  amended, being sections 500.901 to 500.947 of the Michigan                  

                                                                                

22  Compiled Laws  the insurance code of 1956, 1956 PA 218,                     

                                                                                

23  MCL 500.901 to 500.947.                                                     

                                                                                

24      (3) Without regard to the limitation in subsection (2), up to               

                                                                                

25  2% of the assets of the health care corporation may be invested             

                                                                                

26  in venture-type investments.  For purposes of calculating  the              

                                                                                

27  contingency reserve pursuant to section 205  adequate and                   


                                                                                

1   unimpaired surplus under section 204a, a venture-type investment            

                                                                                

2   shall be carried on the books of a health care corporation at the           

                                                                                

3   original acquisition cost, and losses may only be realized as an            

                                                                                

4   offset against gains from venture-type investments.  All                    

                                                                                

5   venture-type investments under this subsection shall provide                

                                                                                

6   employment or capital investment primarily within this state.               

                                                                                

7   Each investment under this subsection  shall be  is subject to              

                                                                                

8   prior approval by the board of directors.  As used in this                  

                                                                                

9   subsection, "venture-type investments" include:                             

                                                                                

10      (a) Common stock, preferred stock, limited partnerships, or                 

                                                                                

11  similar equity interests acquired from the issuer subject to a              

                                                                                

12  provision barring resale without consent of the issuer for 5                

                                                                                

13  years from the date of acquisition by the corporation.                      

                                                                                

14      (b) Unsecured debt instruments  which  that are either                      

                                                                                

15  convertible into equity or have equity acquisition rights.  These           

                                                                                

16  debt instruments shall be subordinated by their terms to all                

                                                                                

17  borrowings of the issuer from other institutional lenders and               

                                                                                

18  shall have no part amortized during the first 5 years.                      

                                                                                

19      (4) A health care corporation shall not market or transact,                 

                                                                                

20  as defined in sections 402a and 402b of  Act No. 218 of the                 

                                                                                

21  Public Acts of 1956, being sections 500.402a and 500.402b of the            

                                                                                

22  Michigan Compiled Laws  the insurance code of 1956, 1956 PA 218,            

                                                                                

23  MCL 500.402a and 500.402b, any type of insurance described in               

                                                                                

24  chapter 6 of  Act No. 218 of the Public Acts of 1956, as amended,           

                                                                                

25  being sections 500.600 to 500.644 of the Michigan Compiled Laws             

                                                                                

26  the insurance code of 1956, 1956 PA 218, MCL 500.600 to 500.644.            

                                                                                

27  This subsection shall not be construed to prohibit the provision            


                                                                                

1   of prepaid health care benefits.                                            

                                                                                

2       Sec.  207.  (1) A health care corporation, subject to any                   

                                                                                

3   limitation provided in this act, in any other statute of this               

                                                                                

4   state, or in its articles of incorporation, may do any or all of            

                                                                                

5   the following:                                                              

                                                                                

6       (a) Contract to provide computer services and other                         

                                                                                

7   administrative consulting services to 1 or more providers or                

                                                                                

8   groups of providers, if the services are primarily designed to              

                                                                                

9   result in cost savings to subscribers.                                      

                                                                                

10      (b) Engage in experimental health care projects to explore                  

                                                                                

11  more efficient and economical means of implementing the                     

                                                                                

12  corporation's programs, or the corporation's goals as prescribed            

                                                                                

13  in section 504 and the purposes of this act, to develop                     

                                                                                

14  incentives to promote alternative methods and alternative                   

                                                                                

15  providers, including nurse midwives, nurse anesthetists, and                

                                                                                

16  nurse practitioners, for delivering health care, including                  

                                                                                

17  preventive care and home health care.                                       

                                                                                

18      (c) For the purpose of providing health care services to                    

                                                                                

19  employees of this state, the United States, or an agency,                   

                                                                                

20  instrumentality, or political subdivision of this state or the              

                                                                                

21  United States, or for the purpose of providing all or part of the           

                                                                                

22  costs of health care services to disabled, aged, or needy                   

                                                                                

23  persons, contract with this state, the United States, or an                 

                                                                                

24  agency, instrumentality, or political subdivision of this state             

                                                                                

25  or the United States.                                                       

                                                                                

26      (d) For the purpose of administering any publicly supported                 

                                                                                

27  health benefit plan, accept and administer funds, directly or               


                                                                                

1   indirectly, made available by a contract authorized under                   

                                                                                

2   subdivision (c), or made available by or received from any                  

                                                                                

3   private entity.                                                             

                                                                                

4       (e) For the purpose of administering any publicly supported                 

                                                                                

5   health benefit plan, subcontract with any organization that has             

                                                                                

6   contracted with this state, the United States, or an agency,                

                                                                                

7   instrumentality, or political subdivision of this state or the              

                                                                                

8   United States, for the administration or furnishing of health               

                                                                                

9   services or any publicly supported health benefit plan.                     

                                                                                

10      (f) Provide administrative services only and cost-plus                      

                                                                                

11  arrangements for the federal medicare program established by                

                                                                                

12  parts A and B of title XVIII of the social security act, chapter            

                                                                                

13  531, 49 Stat. 620, 42 U.S.C.  1395 to 1395b, 1395b-2, 1395b-6 to            

                                                                                

14  1395b-7,  1395c to 1395i, 1395i-2 to 1395i-5, 1395j to 1395t,               

                                                                                

15  1395u to 1395w, and 1395w-2 to 1395w-4;  , 1395w-21 to 1395w-28,            

                                                                                

16  1395x to 1395yy, and 1395bbb to 1395ggg;  for the federal                   

                                                                                

17  medicaid program established under title XIX of the social                  

                                                                                

18  security act, chapter 531, 49 Stat. 620, 42 U.S.C. 1396 to                  

                                                                                

19  1396f, 1396g-1 to  1396r-6, and 1396r-8 to 1396v; for title V of           

                                                                                

20  the social security act, chapter 531, 49 Stat. 620, 42 U.S.C. 701           

                                                                                

21  to 704 and 705 to 710; for the program of medical and dental care           

                                                                                

22  established by the military medical benefits amendments of 1966,            

                                                                                

23  Public Law 85-861, 80 Stat. 862; for the Detroit maternity and              

                                                                                

24  infant care--preschool, school, and adolescent project; and for             

                                                                                

25  any other health benefit program established under state or                 

                                                                                

26  federal law.                                                                

                                                                                

27      (g) Provide administrative services only and cost-plus                      


                                                                                

1   arrangements for any noninsured health benefit plan, subject to             

                                                                                

2   the requirements of sections 211 and 211a.                                  

                                                                                

3       (h) Establish, own, and operate a health maintenance                        

                                                                                

4   organization, subject to the requirements of the  public health             

                                                                                

5   code, 1978 PA 368, MCL 333.1101 to 333.25211  insurance code of             

                                                                                

6   1956, 1956 PA 218, MCL 500.100 to 500.8302.                                 

                                                                                

7       (i) Guarantee loans for the education of persons who are                    

                                                                                

8   planning to enter or have entered a profession that is licensed,            

                                                                                

9   certified, or registered under parts 161 to 182 of the public               

                                                                                

10  health code, 1978 PA 368, MCL 333.16101 to 333.18237, and has               

                                                                                

11  been identified by the commissioner, with the consultation of the           

                                                                                

12  office of health and medical affairs in the department of                   

                                                                                

13  management and budget, as a profession whose practitioners are in           

                                                                                

14  insufficient supply in this state or specified areas of this                

                                                                                

15  state and who agree, as a condition of receiving a guarantee of a           

                                                                                

16  loan, to work in this state, or an area of this state specified             

                                                                                

17  in a listing of shortage areas for the profession issued by the             

                                                                                

18  commissioner, for a period of time determined by the                        

                                                                                

19  commissioner.                                                               

                                                                                

20      (j) Receive donations to assist or enable the corporation to                

                                                                                

21  carry out its purposes, as provided in this act.                            

                                                                                

22      (k) Bring an action against an officer or director of the                   

                                                                                

23  corporation.                                                                

                                                                                

24                                                                               (l) Designate and maintain a registered office and a resident                       

                                                                                

25  agent in that office upon whom service of process may be made.              

                                                                                

26      (m) Sue and be sued in all courts and participate in actions                

                                                                                

27  and proceedings, judicial, administrative, arbitrative, or                  


                                                                                

1   otherwise, in the same cases as natural persons.                            

                                                                                

2       (n) Have a corporate seal, alter the seal, and use it by                    

                                                                                

3   causing the seal or a facsimile to be affixed, impressed, or                

                                                                                

4   reproduced in any other manner.                                             

                                                                                

5       (o)  Invest  Subject to chapter 9 of the insurance code of                  

                                                                                

6   1956, 1956 PA 218, MCL 500.901 to 500.947, invest and reinvest              

                                                                                

7   its funds and, for investment purposes only, purchase, take,                

                                                                                

8   receive, subscribe for, or otherwise acquire, own, hold, vote,              

                                                                                

9   employ, sell, lend, lease, exchange, transfer, or otherwise                 

                                                                                

10  dispose of, mortgage, pledge, use, and otherwise deal in and                

                                                                                

11  with, bonds and other obligations, shares, or other securities or           

                                                                                

12  interests issued by entities other than domestic, foreign, or               

                                                                                

13  alien insurers, as defined in sections 106 and 110 of the                   

                                                                                

14  insurance code of 1956, 1956 PA 218, MCL 500.106 and 500.110,               

                                                                                

15  whether engaged in a similar or different business, or                      

                                                                                

16  governmental or other activity, including banking corporations or           

                                                                                

17  trust companies.  However, a health care corporation may                    

                                                                                

18  purchase, take, receive, subscribe for, or otherwise acquire,               

                                                                                

19  own, hold, vote, employ, sell, lend, lease, exchange, transfer,             

                                                                                

20  or otherwise dispose of bonds or other obligations, shares, or              

                                                                                

21  other securities or interests issued by a domestic, foreign, or             

                                                                                

22  alien insurer, so long as the activity meets all of the                     

                                                                                

23  following:                                                                  

                                                                                

24                                                                               (i) Is determined by the attorney general to be lawful under                        

                                                                                

25  section 202.                                                                

                                                                                

26      (ii) Is approved in writing by the commissioner as being in                  

                                                                                

27  the best interests of the health care corporation and its                   


                                                                                

1   subscribers.                                                                

                                                                                

2       (iii)  Will  Except as otherwise provided in subparagraph                    

                                                                                

3   (iv), will not result in the health care corporation owning or               

                                                                                

4   controlling 10% or more of the voting securities of the insurer.            

                                                                                

5   Nothing in this subdivision shall be interpreted as expanding the           

                                                                                

6   lawful purposes of a health care corporation under this act.                

                                                                                

7   Except where expressly authorized by statute, a health care                 

                                                                                

8   corporation shall not indirectly engage in any investment                   

                                                                                

9   activity that it may not engage in directly.  A health care                 

                                                                                

10  corporation shall not guarantee or become surety upon a bond or             

                                                                                

11  other undertaking securing the deposit of public money.  As used            

                                                                                

12  in this subparagraph, subparagraph (iv), and subsection (4),                 

                                                                                

13  "controlled" or "controlling" means that term as defined in                 

                                                                                

14  section 115 of the insurance code of 1956, 1956 PA 218, MCL                 

                                                                                

15  500.115.                                                                    

                                                                                

16      (iv) Beginning on the effective date of the amendatory act                   

                                                                                

17  that added this subparagraph, will not result in the health care            

                                                                                

18  corporation owning or controlling part or all of the insurer                

                                                                                

19  unless the transaction satisfies chapter 13 of the insurance code           

                                                                                

20  of 1956, 1956 PA 218, MCL 500.1301 to 500.1379; the insurer being           

                                                                                

21  acquired is only authorized to sell long-term care insurance; the           

                                                                                

22  insurer being acquired will not be exempt from taxation by this             

                                                                                

23  state or any political subdivision of this state after the                  

                                                                                

24  acquisition; the insurer being acquired has a board of directors            

                                                                                

25  or other governing body that is separate from the health care               

                                                                                

26  corporation's board of directors; and if the insurer being                  

                                                                                

27  acquired is a foreign or alien insurer, the insurer's domicile is           


                                                                                

1   transferred to Michigan as soon as reasonably possible after                

                                                                                

2   acquisition.                                                                

                                                                                

3       (p) Purchase, receive, take by grant, gift, devise, bequest                 

                                                                                

4   or otherwise, lease, or otherwise acquire, own, hold, improve,              

                                                                                

5   employ, use and otherwise deal in and with, real or personal                

                                                                                

6   property, or an interest therein, wherever situated.                        

                                                                                

7       (q) Sell, convey, lease, exchange, transfer or otherwise                    

                                                                                

8   dispose of, or mortgage or pledge, or create a security interest            

                                                                                

9   in, any of its property, or an interest therein, wherever                   

                                                                                

10  situated.                                                                   

                                                                                

11      (r) Borrow money and issue its promissory note or bond for                  

                                                                                

12  the repayment of the borrowed money with interest.                          

                                                                                

13      (s) Make donations for the public welfare, including                        

                                                                                

14  hospital, charitable, or educational contributions that do not              

                                                                                

15  significantly affect rates charged to subscribers.                          

                                                                                

16      (t) Participate with others in any joint venture with respect               

                                                                                

17  to any transaction that the health care corporation would have              

                                                                                

18  the power to conduct by itself.                                             

                                                                                

19      (u) Cease its activities and dissolve, subject to the                       

                                                                                

20  commissioner's authority under section 606(2).                              

                                                                                

21      (v) Make contracts, transact business, carry on its                         

                                                                                

22  operations, have offices, and exercise the powers granted by this           

                                                                                

23  act in any jurisdiction, to the extent necessary to carry out its           

                                                                                

24  purposes under this act.                                                    

                                                                                

25      (w) Have and exercise all powers necessary or convenient to                 

                                                                                

26  effect any purpose for which the corporation was formed.                    

                                                                                

27      (x) Notwithstanding subdivision (o) or any other provision of               


                                                                                

1   this act, establish, own, and operate a domestic stock insurance            

                                                                                

2   company only for the purpose of acquiring, owning, and operating            

                                                                                

3   the state accident fund pursuant to chapter 51 of the insurance             

                                                                                

4   code of 1956, 1956 PA 218, MCL 500.5100 to 500.5114, so long as             

                                                                                

5   all of the following are met:                                               

                                                                                

6                                                                                (i) For insurance products and services the insurer whether                         

                                                                                

7   directly or indirectly only transacts worker's compensation                 

                                                                                

8   insurance and employer's liability insurance, transacts                     

                                                                                

9   disability insurance limited to replacement of loss of earnings,            

                                                                                

10  and acts as an administrative services organization for an                  

                                                                                

11  approved self-insured worker's compensation plan or a disability            

                                                                                

12  insurance plan limited to replacement of loss of earnings and               

                                                                                

13  does not transact any other type of insurance notwithstanding the           

                                                                                

14  authorization in chapter 51 of the insurance code of 1956, 1956             

                                                                                

15  PA 218, MCL 500.5100 to 500.5114.  This subparagraph does not               

                                                                                

16  preclude the insurer from providing either directly or indirectly           

                                                                                

17  noninsurance products and services as otherwise provided by law.            

                                                                                

18      (ii) The activity is determined by the attorney general to be                

                                                                                

19  lawful under section 202.                                                   

                                                                                

20      (iii) The health care corporation does not directly or                       

                                                                                

21  indirectly subsidize the use of any provider or subscriber                  

                                                                                

22  information, loss data, contract, agreement, reimbursement                  

                                                                                

23  mechanism or arrangement, computer system, or health care                   

                                                                                

24  provider discount to the insurer.                                           

                                                                                

25      (iv) Members of the board of directors, employees, and                       

                                                                                

26  officers of the health care corporation are not, directly or                

                                                                                

27  indirectly, employed by the insurer unless the health care                  


                                                                                

1   corporation is fairly and reasonably compensated for the services           

                                                                                

2   rendered to the insurer if those services were paid for by the              

                                                                                

3   health care corporation.                                                    

                                                                                

4       (v) Health care corporation and subscriber funds are used                   

                                                                                

5   only for the acquisition from the state of Michigan of the assets           

                                                                                

6   and liabilities of the state accident fund.                                 

                                                                                

7       (vi) Health care corporation and subscriber funds are not                    

                                                                                

8   used to operate or subsidize in any way the insurer including the           

                                                                                

9   use of such funds to subsidize contracts for goods and services.            

                                                                                

10  This subparagraph does not prohibit joint undertakings between              

                                                                                

11  the health care corporation and the insurer to take advantage of            

                                                                                

12  economies of scale or arm's-length loans or other financial                 

                                                                                

13  transactions between the health care corporation and the                    

                                                                                

14  insurer.                                                                    

                                                                                

15      (2) In order to ascertain the interests of senior citizens                  

                                                                                

16  regarding the provision of medicare supplemental coverage, as               

                                                                                

17  described in section 202(1)(d)(v), and to ascertain the interests           

                                                                                

18  of senior citizens regarding the administration of the federal              

                                                                                

19  medicare program when acting as fiscal intermediary in this                 

                                                                                

20  state, as described in section 202(1)(d)(vi), a health care                  

                                                                                

21  corporation shall consult with the office of services to the                

                                                                                

22  aging and with senior citizens' organizations in this state.                

                                                                                

23      (3) An act of a health care corporation, otherwise lawful, is               

                                                                                

24  not invalid because the corporation was without capacity or power           

                                                                                

25  to do the act.  However, the lack of capacity or power may be               

                                                                                

26  asserted:                                                                   

                                                                                

27      (a) In an action by a director or a member of the corporate                 


                                                                                

1   body against the corporation to enjoin the doing of an act.                 

                                                                                

2       (b) In an action by or in the right of the corporation to                   

                                                                                

3   procure a judgment in its favor against an incumbent or former              

                                                                                

4   officer or director of the corporation for loss or damage due to            

                                                                                

5   an unauthorized act of that officer or director.                            

                                                                                

6       (c) In an action or special proceeding by the attorney                      

                                                                                

7   general to enjoin the corporation from the transacting of                   

                                                                                

8   unauthorized business, to set aside an unauthorized transaction,            

                                                                                

9   or to obtain other equitable relief.                                        

                                                                                

10      (4) A health care corporation shall not condition the sale or               

                                                                                

11  vary the terms or conditions of any product sold by the                     

                                                                                

12  corporation or by a person controlled by the corporation by                 

                                                                                

13  requiring the purchase of any other product from the corporation            

                                                                                

14  or by a person controlled by the corporation.                               

                                                                                

15      Sec. 211.  (1) Pursuant to section 207(1)(g), a health care                 

                                                                                

16  corporation may enter into service contracts containing an                  

                                                                                

17  administrative services only or cost-plus arrangement.  Except as           

                                                                                

18  otherwise provided in this section, a corporation shall not enter           

                                                                                

19  into a service contract containing an administrative services               

                                                                                

20  only or cost-plus arrangement for a noninsured benefit plan                 

                                                                                

21  covering a group of less than 500 individuals, except that a                

                                                                                

22  health care corporation may continue an administrative services             

                                                                                

23  only or cost-plus arrangement with a group of less than 500,                

                                                                                

24  which arrangement is in existence in September of 1980.  A                  

                                                                                

25  corporation may enter into contracts containing an administrative           

                                                                                

26  services only or cost-plus arrangement for a noninsured benefit             

                                                                                

27  plan covering a group of less than 500 individuals if either the            


                                                                                

1   corporation makes arrangements for excess loss coverage or the              

                                                                                

2   sponsor of the plan that covers the individuals is liable for the           

                                                                                

3   plan's liabilities and is a sponsor of 1 or more plans covering a           

                                                                                

4   group of 500 or more individuals in the aggregate.  The                     

                                                                                

5   commissioner, upon obtaining the advice of the corporations                 

                                                                                

6   subject to this act, shall establish the standards for the manner           

                                                                                

7   and amount of the excess loss coverage required by this                     

                                                                                

8   subsection.  It is the intent of the legislature that the excess            

                                                                                

9   loss coverage requirements be uniform as between corporations               

                                                                                

10  subject to this act and other persons authorized to provide                 

                                                                                

11  similar services.  The corporation shall offer in connection with           

                                                                                

12  a noninsured benefit plan a program of specific or aggregate                

                                                                                

13  excess loss coverage.                                                       

                                                                                

14      (2) Relative to actual administrative costs, fees for                       

                                                                                

15  administrative services only and cost-plus arrangements shall be            

                                                                                

16  set in a manner that precludes cost transfers between subscribers           

                                                                                

17  subject to either of these arrangements and other subscribers of            

                                                                                

18  the health care corporation.  Administrative costs for these                

                                                                                

19  arrangements shall be determined in accordance with the                     

                                                                                

20  administrative costs allocation methodology and definitions filed           

                                                                                

21  and approved under part 6, and shall be expressed clearly and               

                                                                                

22  accurately in the contracts establishing the arrangements, as a             

                                                                                

23  percentage of costs rather than charges.  This subsection shall             

                                                                                

24  not be construed to prohibit the inclusion, in fees charged, of             

                                                                                

25  contributions to  the contingency reserve of the corporation,               

                                                                                

26  consistent with section 205  adequate and unimpaired surplus as             

                                                                                

27  provided in section 204a.                                                   


                                                                                

1       (3) Before a health care corporation may enter into contracts               

                                                                                

2   containing administrative services only or cost-plus arrangements           

                                                                                

3   pursuant to section 207(1)(g), the board of directors of the                

                                                                                

4   corporation shall approve a marketing policy  with respect to               

                                                                                

5   such  for these arrangements that is consistent with  the                   

                                                                                

6   provisions of  this section.  The marketing policy may contain              

                                                                                

7   other provisions as the board considers necessary.  The marketing           

                                                                                

8   policy shall be carried out by the corporation consistent with              

                                                                                

9   this act.                                                                   

                                                                                

10      (4) A corporation providing services under a contract                       

                                                                                

11  containing an administrative services only or cost-plus                     

                                                                                

12  arrangement in connection with a noninsured benefit plan shall              

                                                                                

13  provide in its service contract a provision that the person                 

                                                                                

14  contracting for the services in connection with a noninsured                

                                                                                

15  benefit plan shall notify each covered individual of what                   

                                                                                

16  services are being provided; the fact that individuals are not              

                                                                                

17  insured or are not covered by a certificate from the corporation,           

                                                                                

18  or are only partially insured or are only partially covered by a            

                                                                                

19  certificate from the corporation, as the case may be; which party           

                                                                                

20  is liable for payment of benefits; and of future changes in                 

                                                                                

21  benefits.                                                                   

                                                                                

22      (5) A service contract containing an administrative services                

                                                                                

23  only arrangement between a corporation and a governmental entity            

                                                                                

24  not subject to the employee retirement income security act of               

                                                                                

25  1974, Public Law 93-406, 88 Stat. 829, whose plan provides                  

                                                                                

26  coverage under a collective bargaining agreement utilizing a                

                                                                                

27  policy or certificate issued by a carrier before the signing of             


                                                                                

1   the service contract, is void unless the governmental entity has            

                                                                                

2   provided the notice described in subsection (4) to the collective           

                                                                                

3   bargaining agent and to the members of the collective bargaining            

                                                                                

4   unit not less than 30 days before signing the service contract.             

                                                                                

5   The voiding of a service contract under this subsection shall not           

                                                                                

6   relieve the governmental entity of any obligations to the                   

                                                                                

7   corporation under the service contract.                                     

                                                                                

8       (6) Nothing in this section shall be construed to permit an                 

                                                                                

9   actionable interference by a corporation with the rights and                

                                                                                

10  obligations of the parties under a collective bargaining                    

                                                                                

11  agreement.                                                                  

                                                                                

12      (7) An individual covered under a noninsured benefit plan for               

                                                                                

13  which services are provided under a service contract authorized             

                                                                                

14  under subsection (1)  shall  is not  be  liable for that portion            

                                                                                

15  of claims incurred and subject to payment under the plan if the             

                                                                                

16  service contract is entered into between an employer and a                  

                                                                                

17  corporation, unless that portion of the claim has been paid                 

                                                                                

18  directly to the covered individual.                                         

                                                                                

19      (8) A corporation shall report with its annual statement the                

                                                                                

20  amount of business it has conducted as services provided under              

                                                                                

21  subsection (1) that are performed in connection with a noninsured           

                                                                                

22  benefit plan, and the commissioner shall transmit annually this             

                                                                                

23  information to the state  commissioner of revenue  treasurer.               

                                                                                

24  The commissioner shall submit to the legislature on April 1,                

                                                                                

25  1994, a report detailing the impact of this section on employers            

                                                                                

26  and covered individuals, and similar activities under other                 

                                                                                

27  provisions of law, and in consultation with the  revenue                    


     Senate Bill No. 234 (H-2) as amended June 5, 2003

   

1   commissioner  state treasurer the total financial impact on the             

                                                                                

2   state for the preceding legislative biennium.                               

                                                                                

3       (9) As used in this section, "noninsured benefit plan" or                   

                                                                                

4   "plan" means a health benefit plan without coverage by a health             

                                                                                

5   care corporation, health maintenance organization, or insurer or            

                                                                                

6   the portion of a health benefit plan without coverage by a health           

                                                                                

7   care corporation, health maintenance organization, or insurer               

                                                                                

8   that has a specific or aggregate excess loss coverage.                      

                                                                                

9       Sec. 219.  A nonprofit health care corporation is subject to                

                                                                                

10  chapter 37 of the insurance code of 1956, 1956 PA 218,                      

                                                                                

11  MCL 500.3701 to 500.3723.  To the extent that a provision of this           

                                                                                

12  act concerning health coverage, including, but not limited to,              

                                                                                

13  premiums, rates, filings, and coverages, conflicts with chapter             

                                                                                

14  37 of the insurance code of 1956, 1956 PA 218, MCL 500.3701 to              

                                                                                

15  500.3723, chapter 37 of the insurance code of 1956, 1956 PA 218,            

                                                                                

16  MCL 500.3701 to 500.3723, supersedes this act.                              

                                                                                

17      Sec. 401j.  The rates charged to nongroup and group                         

                                                                                

18  conversion subscribers for a certificate that includes                      

                                                                                

19  prescription drug coverage pursuant to section 401i may include             

                                                                                

20  rate differentials based upon age, with not more than 8 separate            

                                                                                

21  age bands.  The health care corporation shall file its rates for            

                                                                                

22  the prescription drug coverage in this section in the same manner           

                                                                                

23  and under the same requirements as contained in section 607.                

          [Sec. 403b.  A health care corporation shall not include in any bill for services or products any advertising material for any other service or product sold by the corporation or by a person controlled by the corporation.]

   

24      Sec. 422c.  A health care corporation may condition the                     

                                                                                

25  granting of long-term care coverage based on answers given on an            

                                                                                

26  application under section 422a and pursuant to underwriting                 

                                                                                

27  standards established by the corporation.                                   


                                                                                

1       Sec. 502.  (1) A health care corporation may enter into                     

                                                                                

2   participating contracts for reimbursement with professional                 

                                                                                

3   health care providers practicing legally in this state for health           

                                                                                

4   care services or with health practitioners practicing legally in            

                                                                                

5   any other jurisdiction for health care services that the                    

                                                                                

6   professional health care providers or practitioners may legally             

                                                                                

7   perform.  However, a health care corporation shall not enter into           

                                                                                

8   participating contracts for reimbursement with health                       

                                                                                

9   practitioners out of state, for the purpose of disadvantaging a             

                                                                                

10  Michigan health care provider or replacing a participating                  

                                                                                

11  contract with a Michigan health care provider. A participating              

                                                                                

12  contract may cover all members or may be a separate and                     

                                                                                

13  individual contract on a per claim basis, as set forth in the               

                                                                                

14  provider class plan, if, in entering into a separate and                    

                                                                                

15  individual contract on a per claim basis, the participating                 

                                                                                

16  provider certifies to the health care corporation:                          

                                                                                

17      (a) That the provider will accept payment from the                          

                                                                                

18  corporation as payment in full for services rendered for the                

                                                                                

19  specified claim for the member indicated.                                   

                                                                                

20      (b) That the provider will accept payment from the                          

                                                                                

21  corporation as payment in full for all cases involving the                  

                                                                                

22  procedure specified, for the duration of the calendar year.  As             

                                                                                

23  used in this subdivision, provider does not include a person                

                                                                                

24  licensed as a dentist under part 166 of the public health code,             

                                                                                

25  1978 PA 368, MCL 333.16601 to 333.16648.                                    

                                                                                

26      (c) That the provider will not determine whether to                         

                                                                                

27  participate on a claim on the basis of the race, color, creed,              


                                                                                

1   marital status, sex, national origin, residence, age, disability,           

                                                                                

2   or lawful occupation of the member entitled to health care                  

                                                                                

3   benefits.                                                                   

                                                                                

4       (2) A contract entered into pursuant to subsection (1) shall                

                                                                                

5   provide that the private provider-patient relationship shall be             

                                                                                

6   maintained to the extent provided for by law.  A health care                

                                                                                

7   corporation shall continue to offer a reimbursement arrangement             

                                                                                

8   to any class of providers with which it has contracted prior to             

                                                                                

9   August 27, 1985 and that continues to meet the standards set by             

                                                                                

10  the corporation for that class of providers.                                

                                                                                

11      (3) A health care corporation shall not restrict the methods                

                                                                                

12  of diagnosis or treatment of professional health care providers             

                                                                                

13  who treat members.  Except as otherwise provided in section 502a,           

                                                                                

14  each member of the health care corporation shall at all times               

                                                                                

15  have a choice of professional health care providers.  This                  

                                                                                

16  subsection does not apply to limitations in benefits contained in           

                                                                                

17  certificates, to the reimbursement provisions of a provider                 

                                                                                

18  contract or reimbursement arrangement, or to standards set by the           

                                                                                

19  corporation for all contracting providers.  A health care                   

                                                                                

20  corporation may refuse to reimburse a health care provider for              

                                                                                

21  health care services that are overutilized, including those                 

                                                                                

22  services rendered, ordered, or prescribed to an extent that is              

                                                                                

23  greater than reasonably necessary.                                          

                                                                                

24      (4) A health care corporation may provide to a member, upon                 

                                                                                

25  request, a list of providers with whom the corporation contracts,           

                                                                                

26  for the purpose of assisting a member in obtaining a type of                

                                                                                

27  health care service.  However, except as otherwise provided in              


                                                                                

1   section 502a, an employee, agent, or officer of the corporation,            

                                                                                

2   or an individual on the board of directors of the corporation,              

                                                                                

3   shall not make recommendations on behalf of the corporation with            

                                                                                

4   respect to the choice of a specific health care provider.  Except           

                                                                                

5   as otherwise provided in section 502a, an employee, agent, or               

                                                                                

6   officer of the corporation, or a person on the board of directors           

                                                                                

7   of the corporation who influences or attempts to influence a                

                                                                                

8   person in the choice or selection of a specific professional                

                                                                                

9   health care provider on behalf of the corporation, is guilty of a           

                                                                                

10  misdemeanor.                                                                

                                                                                

11      (5) A health care corporation shall provide a symbol of                     

                                                                                

12  participation, which can be publicly displayed, to providers who            

                                                                                

13  participate on all claims for covered health care services                  

                                                                                

14  rendered to subscribers.                                                    

                                                                                

15      (6) This section does not impede the lawful operation of, or                

                                                                                

16  lawful promotion of, a health maintenance organization owned by a           

                                                                                

17  health care corporation.                                                    

                                                                                

18      (7) Contracts entered into under this section with                          

                                                                                

19  professional health care providers licensed in this state are               

                                                                                

20  subject to the provisions of sections 504 to 518.                           

                                                                                

21      (8) A health care corporation shall not deny participation to               

                                                                                

22  a freestanding surgical outpatient facility on the basis of                 

                                                                                

23  ownership if the facility meets the reasonable standards set by             

                                                                                

24  the health care corporation for similar facilities, is licensed             

                                                                                

25  under part 208 of the public health code, 1978 PA 368,                      

                                                                                

26  MCL 333.20801 to 333.20821, and complies with part 222 of the               

                                                                                

27  public health code, 1978 PA 368, MCL 333.22201 to 333.22260.                


                                                                                

1       (9) Notwithstanding any other provision of this act, if a                   

                                                                                

2   certificate provides for benefits for services that are within              

                                                                                

3   the scope of practice of optometry, a health care corporation is            

                                                                                

4   not required to provide benefits or reimburse for a practice of             

                                                                                

5   optometric service unless that service was included in the                  

                                                                                

6   definition of practice of optometry under section 17401 of the              

                                                                                

7   public health code, 1978 PA 368, MCL 333.17401, as of May 20,               

                                                                                

8   1992.                                                                       

                                                                                

9       (10) Notwithstanding any other provision of this act, a                     

                                                                                

10  health care corporation is not required to reimburse for services           

                                                                                

11  otherwise covered under a certificate if the services were                  

                                                                                

12  performed by a member of a health care profession, which health             

                                                                                

13  care profession was not licensed or registered by this state on             

                                                                                

14  or before January 1, 1998 but that becomes a health care                    

                                                                                

15  profession licensed or registered by this state after January 1,            

                                                                                

16  1998.  This subsection does not change the status of a health               

                                                                                

17  care profession that was licensed or registered by this state on            

                                                                                

18  or before January 1, 1998.                                                  

                                                                                

19      Sec. 602.  (1) Not later than March 1 each year, subject to                 

                                                                                

20  a 30-day extension  which  that may be granted by the                       

                                                                                

21  commissioner, a health care corporation shall file in the office            

                                                                                

22  of the commissioner a sworn statement verified by at least 2 of             

                                                                                

23  the principal officers of the corporation showing its condition             

                                                                                

24  as of the preceding December 31.  The statement shall be in a               

                                                                                

25  form  ,  and contain those matters  , which  that the                       

                                                                                

26  commissioner prescribes for a health care corporation, including            

                                                                                

27  those matters contained in section  205  204a.  The statement               


                                                                                

1   shall include the number of members and the number of                       

                                                                                

2   subscribers' certificates issued by the corporation and                     

                                                                                

3   outstanding.                                                                

                                                                                

4       (2) The commissioner, by order, may require a health care                   

                                                                                

5   corporation to submit statistical, financial, and other reports             

                                                                                

6   for the purpose of monitoring compliance with this act.                     

                                                                                

7       Sec. 606.  (1) The commissioner shall have the same                         

                                                                                

8   authority regarding the officers and directors of a health care             

                                                                                

9   corporation as the commissioner has with respect to the officers            

                                                                                

10  and directors of insurers under sections 249 and 250 of  Act                

                                                                                

11  No. 218 of the Public Acts of 1956, being sections 500.249 and              

                                                                                

12  500.250 of the Michigan Compiled Laws  the insurance code of                

                                                                                

13  1956, 1956 PA 218, MCL 500.249 and 500.250.                                 

                                                                                

14      (2) The commissioner shall have the same authority with                     

                                                                                

15  respect to the dissolution, taking over, or liquidation of                  

                                                                                

16  corporations formed or doing business under this act as is                  

                                                                                

17  provided in chapter  78 of Act No. 218 of the Public Acts of                

                                                                                

18  1956, as amended, being sections 500.7800 to 500.7868 of the                

                                                                                

19  Michigan Compiled Laws  81 of the insurance code of 1956, 1956              

                                                                                

20  PA 218, MCL 500.8101 to 500.8159.  For purposes of this                     

                                                                                

21  subsection, a health care corporation shall be considered to be             

                                                                                

22  insolvent if its liabilities exceed its assets, unless otherwise            

                                                                                

23  defined in chapter  78 of Act No. 218 of the Public Acts of 1956,           

                                                                                

24  as amended  81 of the insurance code of 1956, 1956 PA 218,                  

                                                                                

25  MCL 500.8101 to 500.8159.                                                   

                                                                                

26      Sec. 607.  (1)  A health care corporation shall submit a                    

                                                                                

27  copy of any new or revised certificate to the commissioner along            


                                                                                

1   with applicable proposed rates and rate rationale.  The                     

                                                                                

2   certificates, and applicable proposed rates, shall be deemed                

                                                                                

3   approved and effective 30 days after filing with the                        

                                                                                

4   commissioner, except as otherwise provided in this section.                 

                                                                                

5   Except as otherwise provided in subsection (2) and section 608,             

                                                                                

6   if a health care corporation wants to offer a new certificate,              

                                                                                

7   change an existing certificate, or change a rate charge, a copy             

                                                                                

8   of the proposed certificate, proposed revised certificate, or               

                                                                                

9   proposed rate shall be filed with the commissioner and shall not            

                                                                                

10  take effect until 60 days after the filing unless the                       

                                                                                

11  commissioner approves the change in writing before the expiration           

                                                                                

12  of the 60 days. The commissioner may subsequently disapprove any            

                                                                                

13  certificate  deemed approved  or rate change.                               

                                                                                

14      (2) The commissioner shall exempt from prior approval                       

                                                                                

15  certificates resulting from a collective bargaining agreement.              

                                                                                

16      (3) The commissioner may disapprove, or approve with                        

                                                                                

17  modifications, a certificate and applicable rates under 1 or more           

                                                                                

18  of the following circumstances:                                             

                                                                                

19      (a) If the rate charged for the benefits provided is not                    

                                                                                

20  equitable, not adequate, or excessive, as defined in section                

                                                                                

21  609.                                                                        

                                                                                

22      (b) If the certificate contains 1 or more provisions  which                 

                                                                                

23  that are unjust, unfair, inequitable, misleading, deceptive, or             

                                                                                

24  which  that encourage misrepresentation of the coverage.                   

                                                                                

25      (c) If a certificate reduces the scope, amount, or duration                 

                                                                                

26  of benefits so as to have the effect of reducing the                        

                                                                                

27  comprehensiveness of existing health care benefits available to             


                                                                                

1   groups or to individuals.  The commissioner may approve a                   

                                                                                

2   certificate  which  that reduces the scope, amount, or duration             

                                                                                

3   of health care benefits if the commissioner determines that the             

                                                                                

4   certificate will be offered as an alternative in addition to an             

                                                                                

5   existing certificate  which  that provides comprehensive health             

                                                                                

6   care benefits and if the commissioner determines that approval of           

                                                                                

7   the alternative certificate will not adversely affect the                   

                                                                                

8   opportunity for groups or individuals to obtain comprehensive               

                                                                                

9   health care benefits.                                                       

                                                                                

10      (4) The commissioner shall approve a certificate and                        

                                                                                

11  applicable proposed rates if all of the following conditions are            

                                                                                

12  met:                                                                        

                                                                                

13      (a) If the rate charged for the benefits provided is                        

                                                                                

14  equitable, adequate, and not excessive, as defined in section               

                                                                                

15  609.                                                                        

                                                                                

16      (b) If the certificate does not contain any provision  which                

                                                                                

17  that is unjust, unfair, inequitable, misleading, deceptive, or              

                                                                                

18  which  that encourages misrepresentation of the coverage.                  

                                                                                

19      (5) If the commissioner disapproves a certificate and any                   

                                                                                

20  applicable proposed rates under this section, he or she shall               

                                                                                

21  issue a written notice of disapproval  which specifies in what              

                                                                                

22  respects  specifying how a filing fails to meet the requirements            

                                                                                

23  of this act.  The notice shall state that the filing shall not              

                                                                                

24  become effective.                                                           

                                                                                

25      (6) If the commissioner approves, or approves with                          

                                                                                

26  modifications, a certificate and any applicable proposed rates              

                                                                                

27  under this section, he or she shall issue a written notice of               


                                                                                

1   approval or approval with modifications.  If the notice is of               

                                                                                

2   approval with modifications, the notice shall specify what                  

                                                                                

3   modifications in the filing are required for approval under this            

                                                                                

4   act, and the reasons for the modifications.  The notice shall               

                                                                                

5   also state that the filing shall become effective after the                 

                                                                                

6   modifications are made and approved by the commissioner.                    

                                                                                

7       (7) The commissioner shall schedule a hearing not more than                 

                                                                                

8   30 days after receipt of a written request from the health care             

                                                                                

9   corporation, and the revised certificate, revised proposed                  

                                                                                

10  certificate, or proposed rate shall not take effect until                   

                                                                                

11  approved by the commissioner after the hearing.  Within 30 days             

                                                                                

12  after the hearing, the commissioner shall notify the health care            

                                                                                

13  corporation in writing of the disposition of the revised                    

                                                                                

14  certificate, revised proposed certificate, or proposed rate,                

                                                                                

15  together with the commissioner's findings of fact and                       

                                                                                

16  conclusions.                                                                

                                                                                

17      (8)  (7)  Upon request by a health care corporation, the                    

                                                                                

18  commissioner may allow certificates and rates to be implemented             

                                                                                

19  prior to filing to allow implementation of a new certificate on             

                                                                                

20  the date requested.                                                         

                                                                                

21      Sec. 608.  (1) The rates charged to nongroup medicare                       

                                                                                

22  supplemental subscribers for each certificate shall be filed in             

                                                                                

23  accordance with section 610 and shall be subject to the prior               

                                                                                

24  approval of the commissioner.  Annually, the commissioner shall             

                                                                                

25  approve, disapprove, or modify and approve the proposed or                  

                                                                                

26  existing rates for each certificate subject to the standard that            

                                                                                

27  the rates must be determined to be equitable, adequate, and not             


                                                                                

1   excessive, as defined in section 609.  The burden of proof that             

                                                                                

2   rates to be charged meet these standards shall be upon the health           

                                                                                

3   care corporation proposing to use the rates.                                

                                                                                

4       (2) The methodology and definitions of each rating system,                  

                                                                                

5   formula, component, and factor used to calculate rates for group            

                                                                                

6   subscribers for each certificate, including the methodology and             

                                                                                

7   definitions used to calculate administrative costs for                      

                                                                                

8   administrative services only and cost-plus arrangements, shall be           

                                                                                

9   filed in accordance with section 610 and shall be subject to the            

                                                                                

10  prior approval of the commissioner.  The definition of a group,             

                                                                                

11  including any clustering principles applied to nongroup                     

                                                                                

12  subscribers or small group subscribers for the purpose of group             

                                                                                

13  formation, shall be subject to the prior approval of the                    

                                                                                

14  commissioner.  However, if a Michigan caring program is created             

                                                                                

15  under section 436, that program shall be defined as a group                 

                                                                                

16  program for the purpose of establishing rates.  The commissioner            

                                                                                

17  shall approve, disapprove, or modify and approve the methodology            

                                                                                

18  and definitions of each rating system, formula, component, and              

                                                                                

19  factor for each certificate subject to the standard that the                

                                                                                

20  resulting rates for group subscribers must be determined to be              

                                                                                

21  equitable, adequate, and not excessive, as defined in section               

                                                                                

22  609.  In addition, the commissioner may from time to time review            

                                                                                

23  the records of the corporation to determine proper application of           

                                                                                

24  a rating system, formula, component, or factor with respect to              

                                                                                

25  any group.  The corporation shall refile for approval under this            

                                                                                

26  subsection, every 3 years, the methodology and definitions of               

                                                                                

27  each rating system, formula, component, and factor used to                  


                                                                                

1   calculate rates for group subscribers, including the methodology            

                                                                                

2   and definitions used to calculate administrative costs for                  

                                                                                

3   administrative services only and cost-plus arrangements.  The               

                                                                                

4   burden of proof that the resulting rates to be charged meet these           

                                                                                

5   standards shall be upon the health care corporation proposing to            

                                                                                

6   use the rating system, formula, component, or factor.                       

                                                                                

7       (2)  (3)  A proposed rate filed under subsection (1) shall                  

                                                                                

8   not take effect until a filing has been made with the                       

                                                                                

9   commissioner and approved under  section 607 or  this section, as           

                                                                                

10  applicable, except as provided in  subsections (4) and (5)                  

                                                                                

11  subsection (3).                                                             

                                                                                

12      (3)  (4)  Upon request by a health care corporation, the                    

                                                                                

13  commissioner may allow rate adjustments to become effective prior           

                                                                                

14  to approval, for federal or state mandated benefit changes.                 

                                                                                

15  However, a filing for these adjustments shall be submitted before           

                                                                                

16  the effective date of the mandated benefit changes.  If the                 

                                                                                

17  commissioner disapproves or modifies and approves the rates, an             

                                                                                

18  adjustment shall be made retroactive to the effective date of the           

                                                                                

19  mandated benefit changes or additions.                                      

                                                                                

20      (5) Implementation prior to approval may be allowed if the                  

                                                                                

21  health care corporation is participating with 1 or more health              

                                                                                

22  care corporations to underwrite a group whose employees are                 

                                                                                

23  located in several states.  Upon request from the commissioner,             

                                                                                

24  the corporation shall file with the commissioner, and the                   

                                                                                

25  commissioner shall examine, the financial arrangement, formulae,            

                                                                                

26  and factors.  If any are determined to be unacceptable, the                 

                                                                                

27  commissioner shall take appropriate action.                                 


                                                                                

1       Sec. 609.  (1) A rate is not excessive if the rate is not                   

                                                                                

2   unreasonably high relative to the following elements,                       

                                                                                

3   individually or collectively; provision for anticipated benefit             

                                                                                

4   costs; provision for administrative expense; provision for cost             

                                                                                

5   transfers, if any; provision for a contribution to or from  the             

                                                                                

6   corporate contingency reserve that is consistent with the                   

                                                                                

7   attainment or maintenance of the target contingency reserve level           

                                                                                

8   prescribed in section 205  surplus that is consistent with the              

                                                                                

9   attainment or maintenance of adequate and unimpaired surplus as             

                                                                                

10  provided in section 204a; and provision for adjustments due to              

                                                                                

11  prior experience of groups, as defined in the group rating                  

                                                                                

12  system.  A determination as to whether a rate is excessive                  

                                                                                

13  relative to  the  these elements,  listed above,  individually or           

                                                                                

14  collectively, shall be based on the following:  reasonable                  

                                                                                

15  evaluations of recent claim experience; projected trends in claim           

                                                                                

16  costs; the allocation of administrative expense budgets; and the            

                                                                                

17  present and anticipated  contingency reserve positions                      

                                                                                

18  unimpaired surplus of the health care corporation.  To the extent           

                                                                                

19  that any of these elements are considered excessive, the                    

                                                                                

20  provision in the rates for these elements shall be modified                 

                                                                                

21  accordingly.                                                                

                                                                                

22      (2) The administrative expense budget must be reasonable, as                

                                                                                

23  determined by the commissioner after examination of material and            

                                                                                

24  substantial administrative and acquisition expense items.                   

                                                                                

25      (3) A rate is equitable if the rate can be compared to any                  

                                                                                

26  other rate offered by the health care corporation to its                    

                                                                                

27  subscribers, and the observed rate differences can be supported             


                                                                                

1   by differences in anticipated benefit costs, administrative                 

                                                                                

2   expense cost, differences in risk, or any identified cost                   

                                                                                

3   transfer provisions.                                                        

                                                                                

4       (4) A rate is adequate if the rate is not unreasonably low                  

                                                                                

5   relative to the elements prescribed in subsection (1),                      

                                                                                

6   individually or collectively, based on reasonable evaluations of            

                                                                                

7   recent claim experience, projected trends in claim costs, the               

                                                                                

8   allocation of administrative expense budgets, and the present and           

                                                                                

9   anticipated  contingency reserve positions  unimpaired surplus of           

                                                                                

10  the health care corporation.                                                

                                                                                

11      (5) Except for identified cost transfers, each line of                      

                                                                                

12  business, over time, shall be self-sustaining.  However, there              

                                                                                

13  may be cost transfers for the benefit of senior citizens and                

                                                                                

14  group conversion subscribers.  Cost transfers for the benefit of            

                                                                                

15  senior citizens, in the aggregate, annually shall not exceed 1%             

                                                                                

16  of the earned subscription income of the health care corporation            

                                                                                

17  as reported in the most recent annual statement of the                      

                                                                                

18  corporation.  Group conversion subscribers are those who have               

                                                                                

19  maintained coverage with the health care corporation on an                  

                                                                                

20  individual basis after leaving a subscriber group.   The Michigan           

                                                                                

21  caring program created in section 436 is not subject to any                 

                                                                                

22  assessment or surcharge for cost transfer under this subsection.            

                                                                                

23      Sec. 610.  (1) Except as provided under section  608(4) or                  

                                                                                

24  (5)  608(3), a filing of information and materials relative to a            

                                                                                

25  proposed nongroup medicare supplemental rate shall be made not              

                                                                                

26  less than 120 days before the proposed effective date of the                

                                                                                

27  proposed rate.  A filing shall not be considered to have been               


                                                                                

1   received until there has been substantial and material compliance           

                                                                                

2   with the requirements prescribed in subsections (6) and (8).                

                                                                                

3       (2) Within 30 days after a filing is made of information and                

                                                                                

4   materials relative to a proposed nongroup medicare supplemental             

                                                                                

5   rate, the commissioner shall do either of the following:                    

                                                                                

6       (a) Give written notice to the corporation, and to each                     

                                                                                

7   person described under section 612(1), that the filing is in                

                                                                                

8   material and substantial compliance with subsections (6) and (8)            

                                                                                

9   and that the filing is complete.  The commissioner shall then               

                                                                                

10  proceed to approve, approve with modifications, or disapprove the           

                                                                                

11  rate filing 60 days after receipt of the filing, based upon                 

                                                                                

12  whether the filing meets the requirements of this act.  However,            

                                                                                

13  if a hearing has been requested under section 613, the                      

                                                                                

14  commissioner shall not approve, approve with modifications, or              

                                                                                

15  disapprove a filing until the hearing has been completed and an             

                                                                                

16  order issued.                                                               

                                                                                

17      (b) Give written notice to the corporation that the                         

                                                                                

18  corporation has not yet complied with subsections (6) and (8).              

                                                                                

19  The notice shall state specifically  in what respects  the                  

                                                                                

20  reasons the filing fails to meet the requirements of subsections            

                                                                                

21  (6) and (8).                                                                

                                                                                

22      (3) Within 10 days after the filing of notice pursuant to                   

                                                                                

23  subsection (2)(b), the corporation shall submit to the                      

                                                                                

24  commissioner  such  additional information and materials  , as              

                                                                                

25  requested by the commissioner.  Within 10 days after receipt of             

                                                                                

26  the additional information and materials, the commissioner shall            

                                                                                

27  determine whether the filing is in material and substantial                 


                                                                                

1   compliance with subsections (6) and (8).  If the commissioner               

                                                                                

2   determines that the filing does not yet materially and                      

                                                                                

3   substantially meet the requirements of subsections (6) and (8),             

                                                                                

4   the commissioner shall give notice to the corporation pursuant to           

                                                                                

5   subsection (2)(b) or use visitation of the corporation's                    

                                                                                

6   facilities and examination of the corporation's records to obtain           

                                                                                

7   the necessary information described in the notice issued pursuant           

                                                                                

8   to subsection (2)(b).  The commissioner shall use either                    

                                                                                

9   procedure previously mentioned, or a combination of both                    

                                                                                

10  procedures, in order to obtain the necessary information as                 

                                                                                

11  expeditiously as possible.  The per diem, traveling,                        

                                                                                

12  reproduction, and other necessary expenses in connection with               

                                                                                

13  visitation and examination shall be paid by the corporation, and            

                                                                                

14  shall be credited to the general fund of the state.                         

                                                                                

15      (4) If a filing is approved, approved with modifications, or                

                                                                                

16  disapproved under subsection (2)(a), the commissioner shall issue           

                                                                                

17  a written order of the approval, approval with modifications, or            

                                                                                

18  disapproval.  If the filing was approved with modifications or              

                                                                                

19  disapproved, the order shall state specifically  in what                    

                                                                                

20  respects  the reasons the filing fails to meet the requirements             

                                                                                

21  of this act and, if applicable, what modifications are required             

                                                                                

22  for approval under this act.  If the filing was approved with               

                                                                                

23  modifications, the order shall state that the filing shall take             

                                                                                

24  effect after the modifications are made and approved by the                 

                                                                                

25  commissioner.  If the filing was disapproved, the order shall               

                                                                                

26  state that the filing shall not take effect.                                

                                                                                

27      (5) The inability to approve 1 or more rating classes of                    


                                                                                

1   business within a line of business because of a requirement to              

                                                                                

2   submit further data or because a request for a hearing under                

                                                                                

3   section 613 has been granted shall not delay the approval of                

                                                                                

4   rates by the commissioner  which  that could otherwise be                   

                                                                                

5   approved or the implementation of rates already approved, unless            

                                                                                

6   the approval or implementation would affect the consideration of            

                                                                                

7   the unapproved classes of business.                                         

                                                                                

8       (6) Information furnished under subsection (1) in support of                

                                                                                

9   a nongroup medicare supplemental rate filing shall include the              

                                                                                

10  following:                                                                  

                                                                                

11      (a) Recent claim experience on the benefits or comparable                   

                                                                                

12  benefits for which the rate filing applies.                                 

                                                                                

13      (b) Actual prior trend experience.                                          

                                                                                

14      (c) Actual prior administrative expenses.                                   

                                                                                

15      (d) Projected trend factors.                                                

                                                                                

16      (e) Projected administrative expenses.                                      

                                                                                

17      (f) Contributions for risk and contingency reserve factors.                 

                                                                                

18      (g) Actual health care corporation contingency reserve                      

                                                                                

19  position.                                                                   

                                                                                

20      (h) Projected health care corporation contingency reserve                   

                                                                                

21  position.                                                                   

                                                                                

22      (i) Other information  which  the corporation considers                     

                                                                                

23  pertinent to evaluating the risks to be rated, or relevant to the           

                                                                                

24  determination to be made under this section.                                

                                                                                

25      (j) Other information  which  the commissioner considers                    

                                                                                

26  pertinent to evaluating the risks to be rated, or relevant to the           

                                                                                

27  determination to be made under this section.                                


                                                                                

1       (7) A copy of the filing, and all supporting information,                   

                                                                                

2   except for the information  which  that may not be disclosed                

                                                                                

3   under section 604, shall be open to public inspection as of the             

                                                                                

4   date filed with the commissioner.                                           

                                                                                

5       (8) The commissioner shall make available forms and                         

                                                                                

6   instructions for filing for proposed rates under  sections                  

                                                                                

7   section 608(1).  and 608(2).  The forms with instructions shall             

                                                                                

8   be available not less than 180 days before the proposed effective           

                                                                                

9   date of the filing.                                                         

                                                                                

10      Sec. 612.  (1) Upon receipt of a nongroup medicare                          

                                                                                

11  supplemental rate filing under section 610, the commissioner                

                                                                                

12  immediately shall notify each person who has requested in writing           

                                                                                

13  notice of those filings within the previous 2 years, specifying             

                                                                                

14  the nature and extent of the proposed rate revision and                     

                                                                                

15  identifying the location, time, and place where the copy of the             

                                                                                

16  rate filing described in section 610(7) shall be open to public             

                                                                                

17  inspection and copying.  The notice shall also state that if the            

                                                                                

18  person has standing, the person shall have, upon making a written           

                                                                                

19  request for a hearing within 60 days after receiving notice of              

                                                                                

20  the rate filing, an opportunity for an evidentiary hearing under            

                                                                                

21  section 613 to determine whether the proposed rates meet the                

                                                                                

22  requirements of this act.  The request shall identify the issues            

                                                                                

23  which  that the requesting party asserts are involved, what                

                                                                                

24  portion of the rate filing is requested to be heard, and how the            

                                                                                

25  party has standing.  The corporation shall place advertisements             

                                                                                

26  giving notice, containing the information specified above, in at            

                                                                                

27  least 1 newspaper  which serves  serving each geographic area in            


                                                                                

1   which significant numbers of subscribers reside.                            

                                                                                

2       (2) Upon receipt of a rate filing under section 607(1), the                 

                                                                                

3   commissioner shall notify the attorney general and provide to the           

                                                                                

4   attorney general a copy of the proposed rate revision.  Upon                

                                                                                

5   making a written request for a hearing within 30 days after                 

                                                                                

6   receiving notice of the rate filing, the attorney general shall             

                                                                                

7   have an opportunity for an evidentiary hearing under section 613            

                                                                                

8   to determine whether the proposed rates meet the requirements of            

                                                                                

9   this act.  The request shall identify the issues that the                   

                                                                                

10  attorney general asserts are involved and what portion of the               

                                                                                

11  rate filing is requested to be heard.  If the attorney general              

                                                                                

12  requests a hearing under section 613, the commissioner shall not            

                                                                                

13  approve, approve with modifications, or disapprove a filing until           

                                                                                

14  the hearing has been completed and an order issued.                         

                                                                                

15      (3)  (2)  The commissioner may charge a fee for providing,                  

                                                                                

16  pursuant to subsection (1), a copy of the rate filing described             

                                                                                

17  in section 610(7).  The commissioner may charge a fee for                   

                                                                                

18  providing a copy of the entire filing to a person whose request             

                                                                                

19  for a hearing has been granted by the commissioner pursuant to              

                                                                                

20  section 613.  The fee shall be limited to actual mailing costs              

                                                                                

21  and to the actual incremental cost of duplication, including                

                                                                                

22  labor and the cost of deletion and separation of information as             

                                                                                

23  provided in section 14 of  Act No. 442 of the Public Acts of                

                                                                                

24  1976, being section 15.244 of the Michigan Compiled Laws  the               

                                                                                

25  freedom of information act, 1976 PA 442, MCL 15.244.  Copies of             

                                                                                

26  the filing may be provided free of charge or at a reduced charge            

                                                                                

27  if the commissioner determines that a waiver or reduction of the            


                                                                                

1   fee is in the public interest because the furnishing of a copy of           

                                                                                

2   the filing will primarily benefit the general public.  In                   

                                                                                

3   calculating the costs under this subsection, the commissioner               

                                                                                

4   shall not attribute more than the hourly wage of the lowest paid,           

                                                                                

5   full-time clerical employee of the  insurance bureau  office of             

                                                                                

6   financial and insurance services to the cost of labor incurred in           

                                                                                

7   duplication and mailing and to the cost of separation and                   

                                                                                

8   deletion.  The commissioner shall use the most economical means             

                                                                                

9   available to provide copies of a rate filing.                               

                                                                                

10      Sec. 613.  (1) If the request for a hearing under this                      

                                                                                

11  section is with regard to a rate filing not yet acted upon under            

                                                                                

12  section 610(2)(a) or section 612(2), no such action shall be                

                                                                                

13  taken by the commissioner until after the hearing has been                  

                                                                                

14  completed.  However, the commissioner shall proceed to act upon             

                                                                                

15  those portions of a rate filing upon which no hearing has been              

                                                                                

16  requested.  Within 15 days after receipt of a request for a                 

                                                                                

17  hearing, the commissioner shall determine if the person has                 

                                                                                

18  standing.  If the commissioner determines that the person has               

                                                                                

19  standing, the person may have access to the entire filing subject           

                                                                                

20  to the same confidentiality requirements as the commissioner                

                                                                                

21  under section 604  ,  and  shall be  is subject to the penalty              

                                                                                

22  provision of section 604(5).  Upon determining that the person              

                                                                                

23  has standing, the commissioner shall immediately appoint an                 

                                                                                

24  independent hearing officer before whom the hearing shall be                

                                                                                

25  held.  In appointing an independent hearing officer, the                    

                                                                                

26  commissioner shall select a person qualified to conduct hearings,           

                                                                                

27  who has experience or education in the area of health care                  


                                                                                

1   corporation or insurance rate determination and finance, and who            

                                                                                

2   is not otherwise associated financially with a health care                  

                                                                                

3   corporation or a health care provider.  The person selected shall           

                                                                                

4   not be currently or actively employed by this state.  For                   

                                                                                

5   purposes of this subsection, an employee of an educational                  

                                                                                

6   institution shall not be considered to be employed by this                  

                                                                                

7   state.  For purposes of this section, a person has "standing" if            

                                                                                

8   any of the following circumstances exist:                                   

                                                                                

9       (a) The person is, or there are reasonable grounds to believe               

                                                                                

10  that the person could be, aggrieved by the proposed rate.                   

                                                                                

11      (b) The person is acting on behalf of 1 or more named persons               

                                                                                

12  described in subdivision (a).                                               

                                                                                

13      (c) The person is the commissioner, the attorney general, or                

                                                                                

14  the health care corporation.                                                

                                                                                

15      (2) Not more than 30 days after receipt of a request for a                  

                                                                                

16  hearing, and upon not less than 15 days' notice to all parties,             

                                                                                

17  the hearing shall be commenced.  Each party to the hearing shall            

                                                                                

18  be given a reasonable opportunity for discovery before and                  

                                                                                

19  throughout the course of the hearing.  However, the hearing                 

                                                                                

20  officer may terminate discovery at any time, for good cause                 

                                                                                

21  shown.  The hearing officer shall conduct the hearing pursuant to           

                                                                                

22  the administrative procedures act.  The hearing shall be                    

                                                                                

23  conducted in an expeditious manner.  At the hearing, the burden             

                                                                                

24  of proving compliance with this act shall be upon the health care           

                                                                                

25  corporation.                                                                

                                                                                

26      (3) In rendering a proposal for a decision, the hearing                     

                                                                                

27  officer shall consider the factors prescribed in section 609.               


                                                                                

1       (4) Within 30 days after receipt of the hearing officer's                   

                                                                                

2   proposal for decision, the commissioner shall by order render a             

                                                                                

3   decision  which shall include  that includes a statement of                 

                                                                                

4   findings.                                                                   

                                                                                

5       (5) The commissioner shall withdraw an order of approval or                 

                                                                                

6   approval with modifications if the commissioner finds that the              

                                                                                

7   filing no longer meets the requirements of this act.                        

                                                                                

8       Sec. 619.  (1) The attorney general may bring an action, or                 

                                                                                

9   apply to the circuit court for a court order, to enjoin a health            

                                                                                

10  care corporation from transacting business, receiving,                      

                                                                                

11  collecting, or disbursing money, or acquiring, holding,                     

                                                                                

12  protecting, or conveying property if that corporate activity is             

                                                                                

13  not authorized under this act or chapter 37 of the insurance code           

                                                                                

14  of 1956, 1956 PA 218, MCL 500.3701 to 500.3723.                             

                                                                                

15      (2) The attorney general may apply to the circuit court for a               

                                                                                

16  court order enjoining an alleged violation of this act or chapter           

                                                                                

17  37 of the insurance code of 1956, 1956 PA 218, MCL 500.3701 to              

                                                                                

18  500.3723, or other equitable or extraordinary relief to enforce             

                                                                                

19  this act or chapter 37 of the insurance code of 1956, 1956 PA               

                                                                                

20  218, MCL 500.3701 to 500.3723.                                              

                                                                                

21      (3) A political subdivision of this state, an agency of this                

                                                                                

22  state, or any person may bring an action in the circuit court for           

                                                                                

23  Ingham county for declaratory and equitable relief against the              

                                                                                

24  commissioner or to compel the commissioner to enforce this act or           

                                                                                

25  chapter 37 of the insurance code of 1956, 1956 PA 218, MCL                  

                                                                                

26  500.3701 to 500.3723, or rules promulgated under this act.                  

                                                                                

27      Enacting section 1.  This amendatory act does not take                      


                                                                                

1   effect unless Senate Bill No. 460 of the 92nd Legislature is                

                                                                                

2   enacted into law.                                                           

                                                                                

3       Enacting section 2.  Section 205 of the nonprofit health                    

                                                                                

4   care corporation reform act, 1980 PA 350, MCL 550.1205, is                  

                                                                                

5   repealed.