November 1, 2005, Introduced by Reps. Dillon, Alma Smith, Gleason, Tobocman, Zelenko, Vagnozzi, Adamini, Gaffney, Condino, Leland, Bieda, Meisner, Gillard, Ball, Clemente and Kolb and referred to the Committee on Insurance.
A bill to amend 1956 PA 218, entitled
"The insurance code of 1956,"
(MCL 500.100 to 500.8302) by adding section 255.
THE PEOPLE OF THE STATE OF MICHIGAN ENACT:
Sec. 255. (1) The catastrophic medical coverage task force is
created within the office of financial and insurance services.
(2) The catastrophic medical coverage task force shall consist
of the commissioner of the office of financial and insurance
services, 1 member of the senate appointed by the senate majority
leader, 1 member of the senate appointed by the senate minority
leader, 1 member of the house of representatives appointed by the
speaker of the house of representatives, 1 member of the house of
representatives appointed by the minority leader of the house of
representatives, and the following 9 members, appointed by the
governor:
(a) One member representing the general public.
(b) One member representing employers with more than 50
employees.
(c) One member representing employers with 50 or fewer
employees.
(d) One member representing a nonprofit health care
corporation operating pursuant to the nonprofit health care
corporation reform act, 1980 PA 350, MCL 550.1101 to 550.1704.
(e) One member representing health maintenance organizations
regulated under chapter 35.
(f) One member representing insurers providing expense-
incurred hospital, surgical, and medical policies and certificates
regulated under chapters 34 and 36.
(g) One member representing labor.
(h) One member representing public employees of this state.
(i) One member representing health care providers in this
state.
(3) The members appointed to the catastrophic medical coverage
task force shall be appointed within 14 days after the effective
date of this section.
(4) If a vacancy occurs on the catastrophic medical coverage
task force, an appointment for the unexpired term shall be made in
the same manner as the original appointment.
(5) The governor may remove a member of the catastrophic
medical coverage task force for incompetency, dereliction of duty,
malfeasance, misfeasance, or nonfeasance in office, or any other
good cause.
(6) The first meeting of the catastrophic medical coverage
task force shall be called not later than 24 days after the
effective date of this section. At the first meeting, the members
of the catastrophic medical coverage task force shall elect from
among its members a chairperson and other officers as they consider
necessary or appropriate. After the first meeting, the catastrophic
medical coverage task force shall meet at least monthly, or more
frequently at the call of the chairperson or if requested by 7 or
more members.
(7) A majority of the members of the catastrophic medical
coverage task force constitute a quorum for the transaction of
business at a meeting of the catastrophic medical coverage task
force. A majority of the members present and serving are required
for official action of the catastrophic medical coverage task
force.
(8) The business that the catastrophic medical coverage task
force may perform shall be conducted at a public meeting of the
catastrophic medical coverage task force held in compliance with
the open meetings act, 1976 PA 267, MCL 15.261 to 15.275.
(9) A writing prepared, owned, used, in the possession of, or
retained by the catastrophic medical coverage task force in the
performance of an official function is subject to the freedom of
information act, 1976 PA 442, MCL 15.231 to 15.246.
(10) Members of the catastrophic medical coverage task force
shall serve without compensation. However, members of the
catastrophic medical coverage task force may be reimbursed for
their actual and necessary expenses incurred in the performance of
their official duties as members of the catastrophic medical
coverage task force.
(11) The catastrophic medical coverage task force shall
conduct a study to determine whether a statewide catastrophic
health care coverage pool is an appropriate mechanism for providing
health coverage for catastrophic health claims to all residents of
this state. In conducting the study, the office of financial and
insurance services shall provide to the catastrophic medical
coverage task force whatever technical assistance is necessary,
including, but not limited to, actuarial services.
(12) In conducting the study under subsection (11), the
catastrophic medical coverage task force shall examine all of the
following:
(a) Different levels of loss, including, but not limited to,
loss levels of $50,000.00, $75,000.00, and $100,000.00, that need
to occur before coverage under the catastrophic health care
coverage pool occurs, and the level of premiums needed at the
different levels of loss.
(b) How coverage under the catastrophic health care coverage
pool is to be funded. In making this determination, the
catastrophic medical coverage task force shall examine a broad mix
of funding sources in order to make the funding burden less
detrimental, including, but not limited to, premium percentages to
be paid by individuals and by employers through taxes or payroll
deductions; general fund or other state appropriation; carrier
assessments; hospital-based assessment; and whether any federal or
other revenue is available.
(c) Benefit structures, including, but not limited to, annual
deductibles and copayments and lifetime benefit maximums.
(d) Eligibility criteria and enrollment estimates.
(e) Supervision of the catastrophic health care coverage pool
by a board of directors with members as necessary to have balanced
representation of consumers, employers, regulators, insurers, and
medical personnel, the term of office of board members, and the
method of selection of board members.
(f) Administration of the catastrophic health care coverage
pool, including, but not limited to, determinations of eligibility;
payment of claims; premium billing; case management; and salaries,
expenses, and fees.
(g) Methods for controlling costs, including, but not limited
to, health promotion and chronic care management.
(h) Impact of coverage under the catastrophic health care
coverage pool on health insurance and coverage rates, on medicaid
rates, on the state's uninsured population, and on the health care
system with the reduction in uncompensated care.
(13) In conducting the study under subsection (11), the
catastrophic medical coverage task force shall also examine the use
of regional purchasing pools and methods for gathering and
providing comparative health care provider performance information.
(14) The catastrophic medical coverage task force shall report
to the senate and house of representatives standing committees on
health and insurance issues on the study conducted pursuant to this
section and shall make findings and recommendations based on that
study by not later than 1 year after the effective date of this
section.