February 23, 2010, Introduced by Reps. Segal, Stanley, Gregory, Rick Jones, Scripps, McDowell, Roy Schmidt, Lindberg, Slavens, Hildenbrand, Marleau, Walsh, Kowall, Green, Calley, Ball and Paul Scott and referred to the Committee on Insurance.
A bill to amend 1956 PA 218, entitled
"The insurance code of 1956,"
by amending section 3525 (MCL 500.3525), as added by 2000 PA 252.
THE PEOPLE OF THE STATE OF MICHIGAN ENACT:
Sec. 3525. (1) Except as otherwise provided in subsection (2),
if a health maintenance organization desires to change a contract
it offers to enrollees or desires to change a rate charged, a copy
of the proposed revised contract or rate shall be filed with the
commissioner and shall not take effect until 60 days after the
filing, unless the commissioner approves the change in writing
before the expiration of 60 days after the filing. If the
commissioner considers that the proposed revised contract or rate
is illegal or unreasonable in relation to the services provided,
the commissioner, not more than 60 days after the proposed revised
contract or rate is filed, shall notify the organization in
writing, specifying the reasons for disapproval or for approval
with modifications. For an approval with modifications, the notice
shall specify what modifications in the filing are required for
approval, the reasons for the modifications, and that the filing
becomes effective after the modifications are made and approved by
the commissioner. The commissioner shall schedule a hearing not
more than 30 days after receipt of a written request from the
health maintenance organization, and the revised contract or rate
shall not take effect until approved by the commissioner after the
hearing. Within 30 days after the hearing, the commissioner shall
notify the organization in writing of the disposition of the
proposed revised contract or rate, together with the commissioner's
findings of fact and conclusions.
(2) If the revised contract or rate is the result of
collective bargaining and affects only the members of the groups
engaged in the collective bargaining, subsection (1) does not apply
but the revised contract or rate shall be immediately filed with
the commissioner.
(3)
Not Except as provided in
this subsection with respect to
health maintenance contracts issued in connection with state and
federal health programs under section 3571, not less than 30 days
before the effective date of a proposed change in a health
maintenance contract or the rate charged, the health maintenance
organization shall issue to each subscriber or group of subscribers
who will be affected by the proposed change a clear written
statement stating the extent and nature of the proposed change.
With respect to health maintenance contracts issued in connection
with state and federal health programs under section 3571, advance
notice shall not be required if the change in a health maintenance
contract or rate arises from a change in the law, a state or
federal administrative order, or an executive order. In that case,
the health maintenance organization shall provide notice not less
than 30 days after the effective date of the change. If the
commissioner has approved a proposed change in a contract or rate
in writing before the expiration of 60 days after the date of
filing, the organization immediately shall notify each subscriber
or group of subscribers who will be affected by the proposed
change.