HOUSE BILL No. 5417

November 9, 2005, Introduced by Reps. Gaffney and Hune and referred to the Committee on Insurance.

 

     A bill to amend 1980 PA 350, entitled

 

"The nonprofit health care corporation reform act,"

 

(MCL 550.1101 to 550.1704) by adding section 416e.

 

THE PEOPLE OF THE STATE OF MICHIGAN ENACT:

 

     Sec. 416e. (1) A health care corporation may offer a limited

 

benefits certificate that excludes mandated health benefits from

 

coverage under the certificate.

 

     (2) Before issuing a limited benefits certificate, a health

 

care corporation shall provide to a prospective subscriber for a

 

nongroup limited benefits certificate or prospective certificate

 

holder for a group limited benefits certificate a written notice

 

that does both of the following:

 

     (a) Discloses that mandated health benefits are not covered by


 

the limited benefits certificate.

 

     (b) Lists and describes each mandated health benefit that is

 

not covered by the limited benefits certificate.

 

     (3) Before issuing a limited benefits certificate, a health

 

care corporation shall obtain from the prospective subscriber for a

 

nongroup limited benefits certificate or from a prospective

 

certificate holder for a group limited benefits certificate a

 

signed written statement that acknowledges both of the following:

 

     (a) That the disclosure statement required under subsection

 

(2) was provided.

 

     (b) That the extent of the coverage under the limited benefits

 

certificate was understood.

 

     (4) Except as provided in this section, all provisions of this

 

act that apply to health care corporation certificates apply to

 

limited benefits certificates.

 

     (5) Notwithstanding any other provision of this act, a limited

 

benefits certificate is not subject to any mandated health benefit

 

requirement of this act.

 

     (6) As used in this section:

 

     (a) "Limited benefits certificate" means a health care

 

corporation certificate that provides benefits under this section.

 

     (b) "Mandated health benefit" means a particular health care

 

service, benefit, coverage, or reimbursement for covered health

 

care services that a health care corporation is required by statute

 

to provide or offer in a certificate that is issued, renewed, or

 

delivered in this state.