November 12, 2013, Introduced by Senators HOPGOOD, HUNTER, HOOD and SMITH 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 2213e.
THE PEOPLE OF THE STATE OF MICHIGAN ENACT:
Sec. 2213e. (1) An insurer or health maintenance organization
that offers a health benefit plan or the person that administers a
health benefit plan, which health benefit plan provides coverage
for prescription drugs or devices, shall do all of the following:
(a) Establish a subscription service for the purpose of
conveying information about the cost of prescription drugs or
devices under the health benefit plan at no cost to individuals who
subscribe to the service.
(b) Allow enrollees, members, subscribers, and other
beneficiaries of the health benefit plan to subscribe and
unsubscribe from the service at any time. The insurer, health
maintenance organization, or person shall allow an individual to
subscribe and unsubscribe to the service in person, in writing,
through the internet, by telephone, by electronic mail, or by any
other method approved by the department.
(c) Allow subscribers to the service a choice of the manner in
which they will receive notices about the cost of prescription
drugs or devices under the health benefit plan as follows:
(i) By mail through the United States postal service.
(ii) Through text messaging.
(iii) By electronic mail.
(iv) Through any other electronic method made available to and
chosen by the subscriber.
(d) Advertise and promote the availability of the subscription
service to enrollees, members, subscribers, and other beneficiaries
of the health benefit plan.
(e) Allow a subscriber to choose to receive all notices about
the cost of prescription drugs or devices under the health benefit
plan or to receive notices about the cost of the specific drugs or
devices of his or her choosing.
(f) Provide notice to subscribers when the cost of a
prescription drug or device under the health benefit plan will
increase by more than 50%.
(g) Provide notice to subscribers if a prescription drug or
device that was on the health benefit plan's maximum allowable cost
list is being removed from that list.
(2) As used in this section, "health benefit plan" means all
of the following but does not include a department of community
health pharmacy program:
(a) An expense-incurred hospital, medical, or surgical policy
or certificate provided by an insurer, not including any of the
following:
(i) Any policy or certificate that provides coverage only for
any of the following:
(A) Vision.
(B) Dental.
(C) Specific diseases.
(D) Accidents.
(E) Credit.
(ii) Hospital indemnity policy or certificate.
(iii) Disability income policy or certificate.
(iv) Coverage issued as a supplement to liability insurance.
(v) Medical payments under automobile, homeowners, or worker's
compensation insurance.
(b) A benefit plan that provides hospital, medical, or
surgical benefits through a multiple employer welfare arrangement
regulated under chapter 70.
(c) A health maintenance contract issued by a health
maintenance organization licensed or issued a certificate of
authority in this state.
(d) Any policy, contract, or certificate of health benefits
administered by a third party administrator licensed under the
third party administrator act, 1984 PA 218, MCL 550.901 to 550.960.