HOUSE BILL No. 5761

June 9, 2016, Introduced by Reps. Pagan and Chang 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 3406t.

 

THE PEOPLE OF THE STATE OF MICHIGAN ENACT:

 

     Sec. 3406t. (1) An expense-incurred hospital, medical, or

 

surgical group or individual policy or certificate delivered,

 

issued for delivery, or renewed in this state that provides

 

coverage for prescription drugs and a health maintenance

 

organization group or individual contract that provides coverage

 

for prescription drugs shall include coverage for both of the

 

following:

 

     (a) Prescription contraceptives.

 

     (b) If covered for other prescription drugs under the policy,

 

certificate, or contract, outpatient consultations, examinations,

 

procedures, and medical services that are necessary to prescribe,


 

dispense, deliver, distribute, administer, or remove a prescription

 

contraceptive.

 

     (2) The coverage required under subsection (1) shall provide

 

coverage for the dispensing of prescription contraceptives intended

 

to last for the following time periods:

 

     (a) If the prescription contraceptive is being dispensed for

 

the first time to the insured or enrollee, a 3-month period.

 

     (b) If the prescription contraceptive is being dispensed a

 

second or subsequent time to the insured or enrollee, a 12-month

 

period regardless of whether the insured or enrollee was covered

 

under the policy, plan, or certificate at the time of the first

 

dispensing.

 

     (3) Coverage under subsection (1) may be subject to provisions

 

of the policy, certificate, or contract that apply equally to other

 

prescription drugs covered by the policy, certificate, or contract,

 

including, but not limited to, required copayments, deductibles,

 

and coinsurance.

 

     (4) This section does not apply to a religious employer that

 

provides group health coverage to its employees.

 

     (5) As used in this section:

 

     (a) "Prescription contraceptive" means a drug or device that

 

requires a prescription and is approved by the United States Food

 

and Drug Administration to prevent pregnancy.

 

     (b) "Religious employer" means an employer that meets all of

 

the following:

 

     (i) The employer's purpose is the inculcation of religious

 

values.


 

     (ii) The employer primarily employs persons who share the

 

religious tenets of the employer.

 

     (iii) The employer primarily serves persons who share the

 

religious tenets of the employer.

 

     (iv) The employer is a nonprofit organization that is exempt

 

from filing under section 6033(a)(3)(A)(i) or (iii) of the internal

 

revenue code of 1986, 26 USC 6033.

 

     Enacting section 1. This amendatory act applies to policies,

 

certificates, and contracts delivered, executed, issued, amended,

 

adjusted, or renewed in this state, or outside of this state if

 

covering residents of this state, beginning 90 days after the date

 

this amendatory act is enacted into law.