April 30, 2013, Introduced by Senator KAHN and referred to the Committee on Appropriations.
A bill to amend 2011 PA 142, entitled
"Health insurance claims assessment act,"
by amending section 3 (MCL 550.1733); and to repeal acts and parts
of acts.
THE PEOPLE OF THE STATE OF MICHIGAN ENACT:
Sec. 3. (1) For dates of service beginning on or after January
1, 2012, subject to this subsection and subsections (2), (3), and
(4), there is levied upon and there shall be collected from every
carrier and third party administrator an assessment of 1% on that
carrier's or third party administrator's paid claims. Beginning
January 1, 2017 and on January 1 of every third year after 2017,
the department shall adjust the assessment rate under this
subsection by the medical inflation rate for the preceding 3-year
period.
(2) A carrier with a suspension or exemption under section
3717 of the insurance code of 1956, 1956 PA 218, MCL 500.3717, on
the
effective date of this act September
20, 2011 is subject to an
assessment of 0.1%.
(3) All of the following apply to a group health plan that
uses the services of a third party administrator or excess loss or
stop loss insurer:
(a)
A group health plan sponsor shall is not be responsible
for
an assessment under this subsection for a paid claim where if
the assessment on that claim has been paid by a third party
administrator or excess loss or stop loss insurer, except as
otherwise provided in section 3a(2).
(b) Except as otherwise provided in subdivision (d), the third
party
administrator shall be is responsible for all assessments on
paid claims paid by the third party administrator.
(c) Except as otherwise provided in subdivision (d), the
excess
loss or stop loss insurer shall be is responsible for all
assessments on paid claims paid by the excess loss or stop loss
insurer.
(d) If there is both a third party administrator and an excess
loss or stop loss insurer servicing the group health plan, the
third
party administrator shall be is
responsible for all
assessments for paid claims that are not reimbursed by the excess
loss or stop loss insurer and the excess loss or stop loss insurer
shall
be is responsible for all assessments for paid claims that
are reimbursable to the excess loss or stop loss insurer.
(4) The assessment under this section shall not exceed
$10,000.00 per insured individual or covered life annually.
(5) To the extent an assessment paid under this section for
paid claims for a group plan or individual subscriber is inaccurate
due to subsequent claim adjustments or recoveries, subsequent
filings shall be adjusted to accurately reflect the correct
assessment based on actual claims paid.
(6) If the assessment under this section collects revenue in
an amount greater than $400,000,000.00, adjusted annually by the
medical inflation rate, each carrier and third party administrator
that paid the assessment shall receive a proportional credit
against the carrier's or third party administrator's assessment in
the immediately succeeding year. The department shall send a notice
of credit to each carrier or third party administrator entitled to
a credit under this subsection not later than July 1. A carrier or
third party administrator entitled to a credit under this
subsection shall apply that credit to the July 30 payment. Any
unused credit shall be carried forward and applied to subsequent
payments. If a carrier or third party administrator entitled to a
credit under this subsection has no liability under this act in the
immediately succeeding year or if this act is no longer in effect,
the department shall issue that carrier or third party
administrator a refund in the amount of any unused credit. If a
third party administrator receives a credit or refund under this
subsection, the third party administrator shall apply that credit
or refund to the benefit of the entity for which it processed the
claims under a service contract.
Enacting section 1. Enacting section 2 of 2011 PA 142 is
repealed.