April 19, 2007, Introduced by Senators JANSEN, BIRKHOLZ, BROWN, KUIPERS, GILBERT, HARDIMAN, GEORGE, CROPSEY, VAN WOERKOM, GARCIA, PAPPAGEORGE and BISHOP and referred to the Committee on Local, Urban and State Affairs.
A bill to provide for a catastrophic stop loss fund and
catastrophic stop loss benefit plans; to create a board of
directors of the catastrophic stop loss fund; to prescribe the
conditions upon which public employers may provide certain
benefits; to require the compilation and release of certain
information and data; to provide certain powers and duties to
certain state officials, departments, agencies, and authorities;
and to provide for appropriations.
THE PEOPLE OF THE STATE OF MICHIGAN ENACT:
Sec. 1. This act shall be known and may be cited as the
"public employees health benefit act".
Sec. 3. As used in this act:
(a) "Board" means the board of directors created under section
5.
(b) "Carrier" means a health, dental, or vision insurance
company authorized to do business in this state under, and a health
maintenance organization or multiple employer welfare arrangement
operating under, the insurance code of 1956, 1956 PA 218, MCL
500.100 to 500.8302; a system of health care delivery and financing
as defined in section 3573 of the insurance code of 1956, 1956 PA
218, MCL 500.3573; a nonprofit dental care corporation operating
under 1963 PA 125, MCL 550.351 to 550.373; a nonprofit health care
corporation operating under the nonprofit health care corporation
reform act, 1980 PA 350, MCL 550.1101 to 550.1704; a voluntary
employees' beneficiary association described in section 501(c)(9)
of the internal revenue code, 26 USC 501(c)(9); a pharmacy benefits
manager; and any other person providing a plan of health benefits,
coverage, or insurance in this state.
(c) "Commissioner" means the commissioner of the office of
financial and insurance services.
(d) "Consumer price index" means the percentage of change in
the consumer price index for all urban consumers in the United
States city average for all items for the calendar year ending
prior to the June 1 effective date of the adjustment under section
7 as reported by the United States department of labor, bureau of
labor statistics, and as certified by the commissioner.
(e) "Medical benefit plan" means a plan established and
maintained by a carrier or 1 or more public employers that provides
for the payment of medical, optical, or dental benefits, including,
but not limited to, hospital and physician services, prescription
drugs, and related benefits, to public employees.
(f) "Public employer" means a city, village, township, county,
or other political subdivision of this state; any
intergovernmental, metropolitan, or local department, agency, or
authority, or other local political subdivision; a school district,
a public school academy, or an intermediate school district, as
those terms are defined in the revised school code, 1976 PA 451,
MCL 380.1 to 380.1852; or a community college or junior college
described in section 7 of article VIII of the state constitution of
1963. Public employer includes the following:
(i) A public university that elects to come under the
provisions of this act.
(ii) This state through the civil service commission that
elects to come under the provisions of this act or any other state
employer on behalf of its state employees that elects to come under
the provisions of this act.
(g) "Public employer pooled plan" or "pooled plan" means a
public employer pooled plan established pursuant to section
11(1)(b).
(h) "Public university" means a public university described in
section 4, 5, or 6 of article VIII of the state constitution of
1963.
(i) "Public employee" means an employee of a public employer.
Sec. 5. (1) There is created a board of directors to
administer the catastrophic stop loss fund. The board shall consist
of 10 directors as follows:
(a) The following 9 directors appointed by the governor with
the advice and consent of the senate with not more than 1 director
representing the same agency:
(i) Until July 1, 2008, 2 directors with some background in
insurance issues representing public employers, and, effective July
1, 2008, 2 directors with some background in insurance issues
representing public employers that have selected a catastrophic
stop loss benefit plan and participate in the catastrophic stop
loss fund.
(ii) Until July 1, 2008, 2 directors with some background in
insurance issues representing collective bargaining organizations
that represent public employees, at least 1 of whom is recommended
by the Michigan state AFL-CIO, and, effective July 1, 2008, 2
directors representing collective bargaining organizations that
represent public employees of public employers that have selected a
catastrophic stop loss benefit plan and participate in the
catastrophic stop loss fund, at least 1 of whom is recommended by
the Michigan state AFL-CIO.
(iii) One director representing the general public.
(iv) One director representing the general public with
expertise in health promotion and chronic care management programs
that include, at a minimum, promoting nutrition and physical
exercise and compliance with disease management programs and
preventive service guidelines that are supported by evidence-based
medical practice.
(v) One director representing the house of representatives
with some background in insurance issues as recommended by the
speaker of the house of representatives.
(vi) One director with some background in insurance issues
representing the senate as recommended by the senate majority
leader.
(vii) One director who is an actuary in good standing with the
American academy of actuaries or the society of actuaries, who
shall serve ex officio and without vote.
(b) The commissioner or his or her designee, who shall serve
ex officio and without vote.
(2) The directors first appointed to the board shall be
appointed within 60 days after the effective date of this act.
(3) The board shall adopt rules providing for the composition
and term of successor boards to the initial board, consistent with
subsection (1). Terms of the board directors shall be staggered so
that the terms of all directors do not expire at the same time. The
appointment of a successor director or to fill a vacancy shall be
made in the same manner as the original appointment.
(4) Except as otherwise provided, each board director shall
have 1 vote on any matter coming before the board.
(5) The first meeting of the board shall be called by the
commissioner. At the first meeting, the board shall elect from
among the directors a chairperson and other officers as it
considers necessary or appropriate. After the first meeting, the
board shall meet at least quarterly, or more frequently at the call
of the chairperson or if requested by 3 or more directors.
(6) A majority of the directors of the board constitute a
quorum for the transaction of business at a meeting of the board. A
majority of the directors present and serving are required for
official action of the board.
(7) Directors of the board shall serve without compensation.
However, board directors may be reimbursed for their actual and
necessary expenses incurred in the performance of their official
duties as board directors.
(8) The board is not a state board or agency and the
catastrophic stop loss fund administered by the board is not a
state fund.
Sec. 7. (1) Beginning July 1, 2007, the board shall implement
and administer a catastrophic stop loss fund that provides 2 or
more catastrophic stop loss benefit plans. The catastrophic stop
loss fund shall reimburse a participating medical benefit plan for
a claim that exceeds the dollar threshold of the catastrophic stop
loss benefit plan chosen by that participating medical benefit
plan. The board shall adopt a plan of operation for the
catastrophic stop loss fund that shall provide for the management
and nonprofit operation of the catastrophic stop loss fund and each
catastrophic stop loss benefit plan consistent with this act.
(2) The board shall establish the catastrophic stop loss fund
and 1 or more catastrophic stop loss benefit plans. The board shall
do all of the following:
(a) Provide for reimbursement to a participating medical
benefit plan for the portion of a covered medical benefit claim
that exceeds a dollar threshold established by the board in the
catastrophic stop loss benefit plan selected by the medical benefit
plan. The minimum dollar threshold to be provided under a
catastrophic stop loss benefit plan shall not be less than
$50,000.00 per individual claim. The board may provide for
additional catastrophic stop loss benefit plans that provide dollar
threshold levels above $50,000.00 per individual claim. A dollar
threshold level established under this subdivision in a
catastrophic stop loss benefit plan shall be adjusted to reflect
changes in the consumer price index by June 1 of each year.
(b) Provide that each catastrophic stop loss benefit plan is
subject to the following:
(i) Does not require any changes in the participating medical
benefit plan for payment from the catastrophic stop loss fund.
(ii) Provides for continuity of health care treatment and
providers for individuals covered under the participating medical
benefit plan.
(c) Maintain relevant and accurate loss and expense data
relative to all liabilities of each catastrophic stop loss benefit
plan.
(d) Require each participating medical benefit plan to furnish
claims data at the times and in the form and detail as may be
required by the catastrophic stop loss fund.
(e) Determine a premium for each catastrophic stop loss
benefit plan that is sufficient to cover expected losses and
expenses that the catastrophic stop loss fund will likely incur
during the period for which the premium is applicable. The premium
shall include an amount to cover incurred but not reported losses
for the period and may be adjusted for any excess or deficient
premiums from previous periods. Excesses or deficiencies from
previous periods may be fully adjusted in a single period or may be
adjusted over several periods.
(f) Receive and distribute all sums required for the operation
of the catastrophic stop loss fund.
(g) Adopt an investment policy for investing and reinvesting
the assets of the catastrophic stop loss fund that complies with
investment limitations governing the investment of assets of public
employee retirement systems under the public employee retirement
system investment act, 1965 PA 314, MCL 38.1132 to 38.1140m.
(h) Provide a comprehensive program of case management
services that shall be offered to a participating medical benefit
plan for a covered individual whose claim is covered under, or is
likely to become covered under, the catastrophic stop loss fund.
(i) Provide 1 or more incentives to participating medical
benefit plans to provide health promotion, case management, and
chronic care management programs to covered individuals of a
participating medical benefit plan for the purpose of improving or
maintaining the health of covered individuals and reducing
unnecessary or excessive medical expenses. Incentives may include
an appropriate rebate of contributions paid for a demonstrated
maintenance or improvement of members' health status as determined
by assessments of agreed upon health status indicators. Health
promotion and chronic care management programs shall meet, if
applicable, nationally recognized accreditation standards. If
nationally recognized accreditation standards are not applicable,
health promotion and chronic care management programs shall meet
standards established by the board which shall include, at a
minimum, complete health risk assessments.
(3) All medical benefit plans in this state shall be offered
the opportunity to select a catastrophic stop loss benefit plan and
participate in the catastrophic stop loss fund. A medical benefit
plan shall provide to the catastrophic stop loss fund all
information necessary for the catastrophic stop loss fund to price
coverage under the catastrophic stop loss benefit plan chosen by
the medical benefit plan, including, but not limited to, medical
benefit plan coverage limits. A public university and a state
employer shall be offered the opportunity to select a catastrophic
stop loss benefit plan and participate in the catastrophic stop
loss fund.
(4) The catastrophic stop loss fund shall do all of the
following:
(a) Assume 100% of all liability for any covered claim
exceeding the dollar threshold under the applicable catastrophic
stop loss benefit plan.
(b) Maintain relevant and accurate loss and expense data
relative to all liabilities of the catastrophic stop loss fund.
(c) Maintain reserves as are required by the commissioner as
being necessary in the exercise of sound and prudent actuarial
judgment for the preservation, maintenance, and operation of the
catastrophic stop loss fund.
Sec. 9. (1) The board may do any of the following:
(a) Sue and be sued in the name of the catastrophic stop loss
fund. A judgment against the board shall not create any direct
liability against the participating medical benefit plans or public
employers.
(b) Purchase coverage to cede all or any portion of its
potential liability with an insurer licensed to transact insurance
in this state or otherwise approved by the commissioner.
(c) Provide for appropriate housing, equipment, and personnel
as may be necessary to assure the efficient operation of the
catastrophic stop loss fund.
(d) Adopt reasonable rules for the administration of the
catastrophic stop loss fund, enforce those rules, and delegate
authority, as the board considers necessary to assure proper
administration and operation.
(e) Contract for goods and services, including independent
claims management and actuarial, investment, and legal services to
assure the efficient operation of the catastrophic stop loss fund.
(f) Perform other acts that are necessary or proper to
accomplish the purposes of the catastrophic stop loss fund.
(2) The board shall hear and determine complaints concerning
the operation of the catastrophic stop loss fund.
Sec. 11. (1) Subject to collective bargaining requirements, a
public employer may provide medical, optical, or dental benefits to
public employees and their dependents by any of the following
methods:
(a) By establishing and maintaining a plan on a self-insured
basis. A plan under this subdivision does not constitute doing the
business of insurance in this state and is not subject to the
insurance laws of this state.
(b) By joining with other public employers and establishing
and maintaining a public employer pooled plan to provide medical,
optical, or dental benefits to not fewer than 250 public employees
on a self-insured basis as provided in this act. A pooled plan
shall accept any public employer that applies to become a member of
the pooled plan, agrees to make the required payments, and
satisfies the other reasonable provisions of the pooled plan. A
pooled plan under this subdivision does not constitute doing the
business of insurance in this state and is not subject to the
insurance laws of this state. A pooled plan under this subdivision
may enter into contracts and sue or be sued in its own name.
(c) By entering into an agreement under which contributions
are made to a trust fund for the purpose of providing medical,
dental, or optical benefits to public employees and their
dependents under a plan agreed to by the public employer. A trust
fund under this subdivision may receive contributions from 1 or
more public employers and may provide medical, dental, and optical
benefits to public employees of 1 or more public employers. A plan
under this subdivision does not constitute doing the business of
insurance in this state and is not subject to the insurance laws of
this state.
(d) By procuring coverage or benefits from 1 or more carriers,
either on an individual basis or with 1 or more other public
employers. Public employers may pool risks with other public
employers under this subdivision to the extent permitted under a
written agreement.
(2) A pooled plan procuring coverage or benefits from 1 or
more carriers shall solicit 4 or more bids when establishing,
renewing, or continuing a medical benefit plan, including at least
1 bid from a voluntary employees' beneficiary association described
in section 501(c)(9) of the internal revenue code, 26 USC
501(c)(9). A pooled plan that provides for administration of a
medical benefit plan using an authorized third party administrator,
an insurer, a nonprofit health care corporation, or other entity
authorized to provide services in connection with a noninsured
medical benefit plan shall solicit 4 or more bids for those
administrative services when establishing, renewing, or continuing
a medical benefit plan.
(3) This act does not prohibit a public employer from
participating, for the payment of medical benefits and claims, in a
purchasing pool or coalition to procure insurance, benefits, or
coverage, or health care plan services or administrative services.
(4) A medical benefit plan participating in a catastrophic
stop loss benefit plan that elects not to participate in a program
of case management under section 7(2)(h) shall provide to covered
individuals case management services that meet the case management
accreditation standards established by the national committee on
quality assurance, the joint commission on health care
organizations, or the utilization review accreditation commission.
(5) A public university and a state employer may establish a
medical benefit plan to provide medical, dental, or optical
benefits to its employees and their dependents by any of the
methods set forth in this section.
Sec. 12. (1) A person shall not establish or maintain a public
employer pooled plan in this state unless the pooled plan obtains
and maintains a certificate of authority pursuant to this act.
(2) A person wishing to establish a pooled plan shall apply
for a certificate of authority on a form prescribed by the
commissioner. The application shall be completed and submitted to
the commissioner along with all of the following:
(a) Copies of all articles, bylaws, agreements, or other
documents or instruments describing the rights and obligations of
employers, employees, and beneficiaries with respect to the pooled
plan and the expected number of public employees to be covered for
medical benefits under the pooled plan.
(b) Current financial statements, if any, of the pooled plan.
(c) A statement showing in full detail the plan upon which the
pooled plan proposes to transact business and a copy of all
contracts or other instruments that it proposes to make with or
sell to its members, together with a copy of its plan description.
(3) The commissioner shall promptly examine the application
and documents submitted by the applicant and may conduct any
investigation that the commissioner considers necessary and examine
under oath any person interested in or connected with the pooled
plan.
(4) The commissioner shall issue a certificate of authority to
the pooled plan if the commissioner is satisfied that the pooled
plan is in a stable and unimpaired financial condition and that the
pooled plan is qualified to maintain a medical benefit plan in
compliance with this act. Failure of the commissioner to act within
30 days after the application and documents required under
subsection (2) have been filed with the commissioner constitutes
approval, and a temporary certificate of authority under subsection
(5) shall be issued. The commissioner shall deny a certificate of
authority to an applicant who fails to meet the requirements of
this act. Notice of denial shall be in writing and shall set forth
the basis for the denial. If the applicant submits a written
request within 30 days after mailing of the notice of denial, the
commissioner shall conduct a hearing within 7 days of receiving the
written request pursuant to the administrative procedures act of
1969, 1969 PA 306, MCL 24.201 to 24.328, in which the applicant
shall be given an opportunity to show compliance with the
requirements of this act.
(5) The pooled plan, upon receipt of its initial certificate
of authority, which shall be a temporary certificate, shall proceed
to the completion of organization of the proposed pooled plan.
(6) A pooled plan shall open its books to the commissioner,
and a final certificate of authority shall not be issued by the
commissioner to a pooled plan until the pooled plan has collected
cash reserves as provided in section 13.
Sec. 13. (1) In addition to other requirements as provided in
this act, a public employer pooled plan established on or after the
effective date of this act shall do all of the following:
(a) Establish and maintain minimum cash reserves of not less
than 25% of the aggregate contributions in the current fiscal year
or in the case of new applicants, 25% of the aggregate
contributions projected to be collected during its first 12 months
of operation, as applicable. Reserves established pursuant to this
section shall be maintained in a separate, identifiable account and
shall not be commingled with other funds of the pooled plan. The
pooled plan shall invest the required reserve in the types of
investments allowed under section 910, 912, or 914 of the insurance
code of 1956, 1956 PA 218, MCL 500.910, 500.912, and 500.914. The
pooled plan may satisfy the reserve requirement through an
irrevocable and unconditional letter of credit. As used in this
subdivision, "letter of credit" means a letter of credit that meets
all of the following requirements:
(i) Is issued by a federally insured financial institution.
(ii) Is subject to draw by the commissioner, upon giving 5
business days' written notice to the pooled plan, or by the pooled
plan for the member's benefit if the pooled plan is unable to pay
claims as they come due.
(b) Within 90 days after the end of each fiscal year, file
with the commissioner financial statements audited by a certified
public accountant. An actuarial opinion regarding reserves for
known claims and associated expenses and incurred but not reported
claims and associated expenses, in accordance with subdivision (d),
shall be included in the audited financial statement. The opinion
shall be rendered by an actuary approved by the commissioner or who
has 5 or more years of experience in this field.
(c) Within 60 days after the end of each fiscal quarter, file
with the commissioner unaudited financial statements, affirmed by
an appropriate officer or agent of the pooled plan.
(d) Within 60 days after the end of each fiscal quarter, file
with the commissioner a report certifying that the pooled plan
maintains reserves that are sufficient to meet its contractual
obligations, and that it maintains coverage for excess loss as
required in this act.
(e) File with the commissioner a schedule of premium
contributions, rates, and renewal projections.
(f) Possess a written commitment, binder, or policy for excess
loss insurance issued by an insurer authorized to do business in
this state or from the catastrophic stop loss fund under this act,
in an amount determined to be actuarially sound by an actuary
approved by the commissioner or who has 5 or more years of
experience in this field. The binder or policy shall provide not
less than 30 days' notice of cancellation to the commissioner.
(g) Establish a procedure, to the satisfaction of the
commissioner, for handling claims for benefits in the event of
dissolution of the pooled plan.
(h) Provide for administration of the plan using personnel of
the pooled plan, provided that the pooled plan has within its own
organization adequate facilities and competent personnel to service
the medical benefit plan, or by awarding a competitively bid
contract, to an authorized third party administrator, an insurer, a
nonprofit health care corporation, or other entity authorized to
provide services in connection with a noninsured medical benefit
plan.
(2) If the commissioner finds that a pooled plan's reserves
are not sufficient to meet the requirements of subsection (1)(a),
the commissioner shall order the pooled plan to immediately collect
from any public employer that is or has been a member of the pooled
plan appropriately proportionate contributions sufficient to
restore reserves to the required level. The commissioner may take
such action as he or she considers necessary, including, but not
limited to, ordering the suspension or dissolution of a pooled
plan, if the pooled plan is consistently failing to maintain
reserves as required in this section, is using methods and
practices that render further transaction of business hazardous or
injurious to its members, employees, beneficiaries, or to the
public, has failed, after written request by the commissioner, to
remove or discharge an officer, director, trustee, or employee who
has been convicted of any crime involving fraud, dishonesty, or
moral turpitude, has failed or refused to furnish any report or
statement required under this act, or if the commissioner, upon
investigation, determines that it is conducting business
fraudulently or is not meeting its contractual obligations in good
faith. Any proceedings by the commissioner under this subsection
shall be governed by the requirements and procedures of sections
7074 to 7078 of the insurance code of 1956, 1956 PA 218, MCL
500.7074 to 500.7078.
Sec. 14. The commissioner, or any person appointed by the
commissioner, may examine the affairs of any pooled plan, and for
such purposes shall have free access to all the books, records, and
documents that relate to the business of the plan, and may examine
under oath its trustees, officers, agents, and employees in
relation to the affairs, transactions, and condition of the pooled
plan. Each authorized pooled plan shall pay an assessment annually
to the commissioner in an amount equal to 1/4 of 1% of the annual
self-funded contributions made to the self-insured medical benefit
plan for that year. The assessments paid under this section shall
be appropriated to the office of financial and insurance services
to cover the additional costs incurred by the office of financial
and insurance services in the examination and regulation of pooled
plans under this act.
Sec. 15. (1) The articles, bylaws, and trust agreement of the
pooled plan and all amendments thereto shall be filed with and
presumed approved by the commissioner if not disapproved by the
commissioner within 30 days after the filing. The trust agreement
shall be filed on a form prescribed by the commissioner.
(2) Each member employer of a pooled plan shall be given
notice of every meeting of the members and shall be entitled to an
equal vote, either in person or by proxy in writing by such member.
(3) The powers of a pooled plan, except as otherwise provided,
shall be exercised by the board of trustees chosen to carry out the
purposes of the trust agreement. Not less than 50% of the trustees
shall be persons who are covered under the pooled plan or the
collective bargaining representatives of those persons.
Sec. 16. (1) Beginning on the effective date of this act, a
carrier that provides 1 or more medical benefit plans to a public
employer, which plans cover in the aggregate 100 or more of that
public employer's employees, shall provide to that public employer
complete and accurate claims utilization and cost information as
provided in subsection (2) for that public employer's claims and
benefits under those medical benefit plans so long as the public
employer has 100 or more public employees entered into a pooled
plan or has signed a letter of intent to enter 100 or more public
employees into a pooled plan.
(2) Beginning on the effective date of this act, all medical
benefit plans in this state shall compile, and shall make available
as provided in subsection (1), complete and accurate claims
utilization and cost information for the medical benefit plan in
the aggregate and for each public employer as follows:
(a) The number of persons covered under the medical benefit
plan.
(b) If applicable, the number of persons covered under a
policy, certificate, or contract issued by a carrier.
(c) The number of claims paid.
(d) The dollar amount of claims paid and the dollar amount of
claims incurred but not reported.
(e) The number of claims paid over $100,000.00 and the total
dollar amount of those claims.
(f) The claims experience, by coverage component and by
provider.
(g) The dollar amount of premiums or fees paid, if any.
(h) The dollar amount of administrative expenses incurred or
paid.
(i) The dollar amount of retentions.
(j) The dollar amount for each of the following fees:
provider; network; case management; and precertification, and other
service fees paid.
(k) The dollar amount of any fees or commissions paid to
agents or brokers by the medical benefit plan or by any public
employer or carrier participating in or providing services to the
medical benefit plan.
(l) Other information as may be required by the commissioner.
(3) The claims utilization and cost information required to be
compiled under this section shall be compiled on an annual basis
and shall cover a relevant period. For purposes of this subsection,
the term "relevant period" means the 36-month period ending no more
than 120 days prior to the effective date or renewal date of the
medical benefit plan under consideration. However, if the medical
benefit plan has been in effect for a period of less than 36
months, the relevant period shall be that shorter period.
(4) A public employer or combination of public employers shall
disclose the claims utilization and cost information required to be
provided under subsection (1) to any carrier or administrator it
solicits to provide benefits or administrative services for its
medical benefit plan, and to the employee representative of
employees covered under the medical benefit plan, and upon request
to any person who requests the opportunity to submit a proposal to
provide benefits or administrative services for the medical benefit
plan. The public employer shall make the claims utilization and
cost information required under this section available at cost and
within a reasonable period of time.
(5) The claims utilization and cost information required under
this section shall include only de-identified health information as
permitted under the health insurance portability and accountability
act of 1996, Public Law 104-191, or regulations promulgated under
that act, 45 CFR parts 160 and 164, and shall not include any
protected health information as defined in the health insurance
portability and accountability act of 1996, Public Law 104-191, or
regulations promulgated under that act, 45 CFR parts 160 and 164.
Sec. 17. To encourage and facilitate informed decisions
concerning medical benefit plan design, the administration of
medical benefit plans, the selection of medical service providers,
and the planning of medical care, the commissioner shall do all of
the following:
(a) Gather data that evaluate and compare the cost,
efficiency, and performance of administrative services provided to
medical benefit plans, including claims payment timeliness and
accuracy, and make available easily accessible comparative ratings
and descriptions of those plan administrators on a regular basis.
(b) Working with other state departments and agencies, ensure
access on a regular basis for public employers, medical benefit
plans, and covered public employees to all of the following
information:
(i) Information concerning cost and performance of Michigan
hospitals, medical clinics, and other health care facilities,
including, but not limited to, licensure, accreditation, and
performance measures for those facilities as recommended by
national organizations such as the national quality forum.
(ii) Information concerning cost and performance of Michigan
physicians and other health care providers, including, but not
limited to, medical training, years in practice, board
certification, verified licensure information, patient experience,
and the results of at least 2 clinical performance measures of
physicians and other health care providers recommended by national
organizations such as the national quality forum.
(c) At least annually, prepare and make available for
distribution to public employers and other interested persons a
buyer's guide for public employers that provides information
necessary to make informed decisions concerning medical benefit
plan design, the administration of medical benefit plans, the
selection of medical service providers, and the planning of medical
care similar to information provided to assist buyers in making
informed decisions in the buyer's guide to auto insurance in
Michigan, the buyer's guide to home and renter's insurance in
Michigan, and the HMO consumer's guide.
Enacting section 1. This act does not take effect unless all
of the following bills of the 94th Legislature are enacted into
law:
(a) Senate Bill No. 419.
(b) Senate Bill No. 420.
(c) Senate Bill No. 421.