MCL - 218-1956-35

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Chapter 500
Act 218 of 1956
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THE INSURANCE CODE OF 1956 (EXCERPT)


Act 218 of 1956

Chapter 35

HEALTH MAINTENANCE ORGANIZATIONS

Document Type Description
Section 500.3501 Section Definitions.
Section 500.3503 Section Applicability of provisions to health maintenance organization.
Section 500.3505 Section Health maintenance contract; use of descriptive words; restrictions.
Section 500.3507 Section Authorizing and regulating health maintenance organization; establishment of system by director.
Section 500.3508 Section Quality assessment program; quality improvement program.
Section 500.3509 Section Certificate of authority; application; form; limitation; change of service area.
Section 500.3511 Section Governing body; election of enrollee board members; requirements; meetings.
Section 500.3513 Section Health maintenance organization operations; regulation by director; incorporation as legal entity.
Section 500.3515 Section Additional health services; deductibles; copayments; "preventive health care services" defined; partial payment from government or private person.
Section 500.3517 Section Healthy lifestyle programs; emergency or out-of-area service; payment of expenses or fees.
Section 500.3519 Section Contract and contract rates; fairness; rate differential; basic health services to large employers required.
Section 500.3521 Section Prepayment rates; filing and approval of methodology; schedule.
Section 500.3523 Section Repealed. 2016, Act 276, Imd. Eff. July 1, 2016.
Section 500.3525 Section Proposal to revise contract or rate; approval of commissioner; approval with modifications; hearing; disposition; exception; notice.
Section 500.3527 Section Repealed. 2016, Act 276, Imd. Eff. July 1, 2016.
Section 500.3528 Section Health maintenance organization; credentialing verification; accreditation by nationally recognized accredited body.
Section 500.3529 Section Affiliated provider contracts; collection of payments from enrollees; contract provisions; waiver of requirement under subsection (2); contract format; evidence of sufficient number of providers.
Section 500.3530 Section Availability of covered services; assurance; establishment and maintenance of proximity.
Section 500.3531 Section Contracts with health care providers to become affiliated providers; requirements; standards; filing; duplicative standards; notice procedures; provider application period; approval or rejection as affiliated provider; termination of contract; providing information to insurer.
Section 500.3533 Section Prudent purchaser contracts; reimbursement for unauthorized services or services by nonaffiliated providers.
Section 500.3535 Section Solicitation or advertising.
Section 500.3537 Section Repealed. 2016, Act 276, Imd. Eff. July 1, 2016.
Section 500.3539 Section Repealed. 2016, Act 276, Imd. Eff. July 1, 2016.
Section 500.3541 Section Repealed. 2016, Act 276, Imd. Eff. July 1, 2016.
Section 500.3542 Section Repealed. 2016, Act 276, Imd. Eff. July 1, 2016.
Section 500.3543 Section Repealed. 2016, Act 276, Imd. Eff. July 1, 2016.
Section 500.3544 Section Noninsured benefit plan; processing and payment of claims.
Section 500.3545 Section Acquisition of obligations from another managed care entity.
Section 500.3547 Section Health care service operations; visitation or examination by director; consultation with enrollees; authority; access to information relating to delivery of services; submission of information regarding proposed contract.
Section 500.3548 Section Maintenance of books, records, files, and financial records; funds and assets.
Section 500.3549 Section Repealed. 2016, Act 276, Imd. Eff. July 1, 2016.
Section 500.3551 Section Health maintenance organization; net worth.
Section 500.3553 Section Certificate of authority; deposit requirements.
Section 500.3555 Section Financial plan.
Section 500.3557 Section Notice of changes in operations.
Section 500.3559 Section Reinsurance contract or plan of self-insurance; purpose; filing; approval; coverage.
Section 500.3561 Section Insolvency; continuation of benefits.
Section 500.3563 Section Insolvency; offer of enrollment by health insurers participating in enrollment process; allocation of group coverage to health maintenance organizations or insurers within service area; nongroup coverage; reassignment of enrollees of insolvent organization contracting with state funded health care program; substitute coverage under American health benefit exchange.
Section 500.3565 Section Repealed. 2016, Act 276, Imd. Eff. July 1, 2016.
Section 500.3567 Section Repealed. 2016, Act 276, Imd. Eff. July 1, 2016.
Section 500.3569 Section Assumption of financial risk.
Section 500.3571 Section State or federal health programs.
Section 500.3573 Section Operation of health care delivery system not meeting requirements of act; permitted conduct; limitations.
Section 500.3580 Section Repealed. 2016, Act 276, Imd. Eff. July 1, 2016.