SENATE BILL No. 418

 

 

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.