Sub HB 5282 - Independent Health Benefit Plans - Michigan Key Vote

Stage Details

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Title: Independent Health Benefit Plans

Vote Smart's Synopsis:

Vote to pass a bill to modify the Michigan insurance code to regulate individual health care plans.

Highlights:

-Requires health insurance carriers that offer short-term plans to file annual reports with the gross premium of the policies (Sec. 2213). -Requires health insurance carriers to issue refunds to individuals if its actual losses are lower than its predicted losses, provided that each refund would be at least $25 (Sec. 3763). -Requires health insurance carriers to issue written notice of rejection of coverage (Sec. 3766). -Prohibits health insurance providers to refuse coverage to an individual because of pre-existing conditions within six months of when the policy starts (Sec. 3767). -Ensures that health care carriers will not cancel plans unless they provide notice at least 90 days in advance and offer individuals covered by the canceled plan the option to purchase another offered plan (Sec. 3769).

NOTE: THIS IS A SUBSTITUTE BILL, MEANING THE LANGUAGE OF THE ORIGINAL BILL HAS BEEN REPLACED. THE DEGREE TO WHICH THE SUBSTITUTE BILL TEXT DIFFERS FROM THE PREVIOUS VERSION OF THE TEXT CAN VARY GREATLY.

See How Your Politicians Voted

Title: Independent Health Benefit Plans

Vote Smart's Synopsis:

Vote to pass a bill that regulates individual health coverage plans.

Highlights:

- Allows providers to refuse coverage based on an individual's responses to an initial health questionnaire. Requires the provider to notify the applicant in writing if they fail to meet the criteria for coverage (sec. 3755). - Prohibits providers from denying or limiting coverage based on a medical condition only if the individual received medical treatment or advice for the condition within six months of enrollment (sec. 3757). - Prohibits the limitation or denial of coverage is the individual was previously covered by the provider under a group health plan, was previously covered by the provider for at least 18 months, or did not lose eligibility due to a failure to pay or fraud (sec. 3757). - Requires providers to continue coverage once it has been issued as long as that plan is still offered and the individual is in good standing (sec. 3759). - Allows providers to charge varying premiums based on age and existing conditions only if they can be justified by credible loss statistics. Rates may not vary more than 80 percent from the index rate (sec. 3765). - Limits premium increases to ten percent (sec. 3767). - Prohibits providers from discouraging individuals to apply for coverage or encouraging an individual to apply with another carrier instead based on an existing health condition (sec. 3771). - Applies to Medicare supplement plans but prohibits premium rate variations based on age to be used with Medicare supplement plans (sec. 3735). - Assures individuals who do not meet coverage criteria a guaranteed access health benefit plan from Blue Cross Blue Shield (sec. 3755).

NOTE: THIS IS A SUBSTITUTE BILL, MEANING THE LANGUAGE OF THE ORIGINAL BILL HAS BEEN REPLACED. THE DEGREE TO WHICH THE SUBSTITUTE BILL TEXT DIFFERS FROM THE PREVIOUS VERSION OF THE TEXT CAN VARY GREATLY.

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