Michigan

550.1 Declaration of emergency.

550.2 Insurance company disbursement limitations.

550.3 Insurance commissioner regulatory powers.

550.4 Foreign insurance companies; other states' regulations, application.

550.5 Purposes of act.

550.6 Suits against insurance companies; statute of limitations, extension.

550.7 Duration of emergency; proclamations.

550.8 Violation of act; misdemeanor; license revocation, grounds.

550.51 Short title.

550.52 Definitions.

550.53 Prudent purchaser agreement; number; location of health care provider; membership on provider panel; written standards; notice procedures; provider application per

550.53a Disclosure of financial relationships between organization and participating health care providers, health care facilities, or other entities.

550.53b Prudent purchaser agreement services; providing requested information to insurer.

550.54 Discrimination prohibited; complaint of violation; hearing; penalty.

550.55 Notice of membership in provider panels; display.

550.56 Reporting certain information on standard forms required; availability of information to appropriate state agencies; confidentiality.

550.57 Agreements between health care providers and purchasers of health care services.

550.58 Organization subject to enabling act; financial records.

550.59 Report on competition in retail pharmacy industry.

550.60 Repealed.

550.61 Repealed.

550.62 Provisions inapplicable to certain contracts and renewal thereof.

550.63 Conditional effective date.

550.231 Office agent of insurance company taken over by insurance commissioner or receiver; off-set for damages.

550.232 Applicability of act.

550.233 Construction of act.

550.251 Short title.

550.252 Definitions.

550.253 Coverage by 2 or more plans; order of benefit payments; length of time covered under plan; inability to agree on order of benefits; amount to be paid by insurer i

550.253a Contract issued before effective date of amendatory act; compliance with changes; transition period.

550.254 Rules.

550.255 Repealed.

550.281 Definitions.

550.283 Determination that health coverage recipient is also medical assistance recipient; information to be provided by health insurer.

550.285 Determination that health coverage recipient is also medical assistance recipient; actions by department.

550.287 Violation of act; administrative fine; notice; right to hearing.

550.289 Rules.

550.351 Nonprofit dental care corporation; formation; purpose; types of dental care plans; services in other states; corporation subject to nonprofit corporation act.

550.352 Subscriber contract payment regulations; prohibited provisions.

550.353 Supervision by insurance commissioner; incorporation procedures.

550.354 Articles of incorporation; contents.

550.355 Articles of incorporation; execution, filing, fee, approval, amendment.

550.356 Contracts; statement to insurance commissioner; contents, examination.

550.357 Certificate of authority to commence business and issue contracts; requirements.

550.358 Certificate of authority; revocation; liquidation.

550.359 Corporation examination by insurance commissioner; expenses.

550.359a Nonprofit dental care corporation subject to MCL 500.224 and 500.225; costs and expenses.

550.360 Annual statement; filing.

550.361 Providing dental services outside state.

550.362 Dental care service contracts; preliminary requirements; payments.

550.363 Dental care corporation; board of directors; membership, consideration of candidates recommended by Michigan Dental Association; composition of board; hearing to

550.364 Contract limitations; service classes; county residents.

550.365 Dentists; eligibility; agreements with corporation.

550.366 Subscriber-dentist relationship; choice of dentist; refusal to place name of dentist on register; removal of name from register.

550.366a Prudent purchaser agreements; rates; provisions inapplicable to certain contracts and renewal thereof.

550.367 Reserve funds; maintenance; investment.

550.368 Dental care to be in accordance with accepted dental practice.

550.369 Dental care for needy and other persons; payments; contracts.

550.369a Coordination of benefits.

550.370 Dentist-patient relationship; civil actions.

550.371 Previously existing corporations merger; agreement, approval.

550.372 Dental care corporations; tax exemption.

550.373 False statement; penalty.

550.521 Definitions.

550.522 Records; production; maintenance; availability for inspection; payment of expenses.

550.523 Disclosure of information.

550.524 Documents to be obtained by provider; right to avoid or rescind contract.

550.524a Agreement to commit suicide; payment prohibited.

550.525 Disposition of contract consideration.

550.526 Double or additional indemnity.

550.527 Offer to purchase policy or certificate; notice to insurer.

550.528 Order prohibiting provider from entering viatical settlement contract; additional orders.

550.601 Credit insurance act; short title.

550.602 Scope of act.

550.603 Credit insurance act; definitions.

550.604 Credit life insurance, credit accident and health insurance; forms.

550.605 Credit life insurance; amount.

550.606 Periodic indemnity payable.

550.607 Term; refund on termination prior to expiration.

550.608 Evidence of insurance; policy or certificate delivery.

550.609 Policy or certificate; contents.

550.610 Policy or certificate; delivery to debtor.

550.611 Policy or certificate; application, contents.

550.612 Papers filed with commissioner of issuing state.

550.613 Papers filed with commissioner of issuing state; disapproval.

550.614 Papers filed with commissioner of issuing state; use, hearing, prior written approval.

550.615 Papers filed with commissioner of issuing state; withdrawal of approval.

550.616 Papers filed with commissioner of issuing state; use after withdrawal of approval.

550.617 Papers filed with commissioner of issuing state; judicial review.

550.618 Schedule of premium rates; refunds; nonissuance credit.

550.619 Policies issuable only by authorized insurers.

550.620 Payment of claims; claim files; group insurance claims.

550.621 Procurement of insurance by debtor.

550.622 Rules; violation, notice of hearing, finding, order.

550.623 Violation; penalty; license or authority, suspension or revocation.

550.624 Effect of act; scope of act.

550.701 Insurance of state property; determination; approval; bids; purchase of deductible or catastrophe insurance; payment of premiums.

550.702, 550.703 Repealed.

550.704 Loss in case of damage; fixing amount.

550.705 Loss in case of damage; payment, release of additional amounts necessary to rebuild or restore.

550.706 Repealed.

550.707, 550.708 Repealed.

550.709 Self-liquidation projects exempted; applicability of act.

550.710 Election of coverage.

550.711 State insurance fund abolished; reversion of funds.

550.811 Short title.

550.815 Definitions; A to I.

550.817 Definitions; M to P.

550.819 Definitions; R to W.

550.821 Pharmacy benefit manager; licensure; application requirements; modification notice; grounds for refusal, revocation, denial, or suspension; fines; notice and hear

550.823 Promulgation of rules.

550.825 Contractual responsibilities; conflict of interest; exception for certain audits.

550.827 Pharmacy benefit manager network; report; waiver; prohibition on spread pricing and fees for electronic processing.

550.829 Prohibited conduct.

550.831 Contractual restrictions and limitations with pharmacists or pharmacies; disclosure of costs; payment at point of sale.

550.833 Transparency report; requirements; exempt from freedom of information act; report to legislature; inapplicable to Medicaid contracts.

550.837 Maximum allowable costs; pharmacy benefit manager duties.

550.838 Authorization to conduct audit; process and duties; written report; extrapolation audit prohibition; inapplicable to certain investigations; carrier pharmacy audi

550.839 Retail pharmacies; contractual restrictions and limitations; use of untrue, deceptive, or misleading advertisements; reversal and resubmission of claims; terminat

550.840 Enforcement of act; examination and audit.

550.841 Contract compliance; license requirement.

550.843 Retention schedule; records, books, papers, and other data; destruction or disposal of certain documents prohibited.

550.845 Scope of act.

550.901 Short title.

550.902 Definitions.

550.910 Third party administrator; certificate required; requirements; instances in which TPA subject to act; name.

550.912 Application for certificate of authority; form, verification, and contents; filing notice of modification.

550.914 Certificate of authority; issuance; notice of disapproval; continued compliance with subsection (1).

550.916 Repealed.

550.918 Fees; payment; collection; and designation.

550.919 TPA advisory board; creation; appointment, qualifications, and terms of members; expenses; duty of board; report.

550.920 Authority of commissioner.

550.922 Hearings.

550.924 Destruction or disposal of records, books, papers, and other data.

550.926 340B Program entities; reimbursement, co-pay, and discrimination prohibitions; definitions.

550.927 Disclosure of current selling prices; prohibited contract provisions.

550.930 Provision of administrative services pursuant to written service contract; maintenance of books and records; TPA and manager as fiduciary.

550.932 Benefit plan; notice; plan covering less than 500 individuals; service contract between TPA and governmental entity not subject to ERISA; construction of act.

550.934 Confidentiality.

550.936 Annual statement; report.

550.940 Prohibited conduct generally.

550.942 Additional prohibited conduct.

550.944 Additional prohibited conduct.

550.950 Violation; probable cause; notice; conference; disposition of matter upon agreement of parties; action for damages; hearing; findings and decision; cease and desi

550.952 Civil fine; suspension or revocation of certificate or license; refusal to issue; grounds for denial, suspension, revocation, or cease and desist order; definitio

550.954 Alteration, modification, or setting aside of order.

550.956 Judicial review; petition for review; transcript of record and copy of order or decision; hearing cause as civil case in equity; evidence; duty of court; incomple

550.958 Self-incrimination; false oath or affirmation.

550.960 Rules.

550.962 Repealed.

550.1001 Short title.

550.1002 Definitions.

550.1003 Persons authorized to sell health benefits; packaging health benefits with insurance; notify agent of record; annual appointment fee; "agent of record" defined.

550.1004 Influencing agent prohibited.

550.1004a Applicability of certain statutory provisions.

550.1005 Compensation of health benefit agents.

550.1006 Authorized agents; requirements, duties, and restrictions; powers of commissioner.

550.1008 Contracts or other arrangements for packaging of health benefits with insurance; policy supplementing health benefits of health maintenance organization.

550.1009 Licensing affiliate of health benefit corporation as insurance agent prohibited.

550.1010 Health benefit agent as fiduciary; evidence of violation of fiduciary responsibility; use of reasonable accounting methods; records required; examination of reco

550.1012 Notice of termination of agent's authority; liability; duration of agent's responsibility; cancellation or refusal to renew certificate of subscriber; certain re

550.1014 Suspension, revocation, refusal to grant, or refusal to renew accident and health insurance license; grounds; notice; hearing; summary suspension; subpoenas.

550.1016 Violation of act; orders; penalties for violation of cease and desist order; injunction.

550.1018 Construction of act.

550.1020 Conditional effective date.

550.1101 Short title.

550.1102 Legislative intent and policy.

550.1103 Meanings of words and phrases.

550.1104 Definitions; A to C.

550.1105 Definitions; H.

550.1106 Definitions; L to O.

550.1107 Definitions; P.

550.1108 Definitions; R, S.

550.1201 Health care corporation; incorporation; number of persons; payment of cash or other material benefit to subscriber; applicable laws; charitable and benevolent in

550.1201a Formation of health care corporation after January 1, 2014; prohibition.

550.1202 Articles of incorporation; contents; number; forms; examination and certification by attorney general; fees.

550.1203 Amendment or restatement of articles; review; approval.

550.1204 Filing of statements and documents; examination; investigation; additional information; conditions; duties of commissioner.

550.1204a Unimpaired surplus.

550.1205 Repealed.

550.1205a Actuarial practices and accounting principles; financial report.

550.1206 Funds, property, and business of health care corporation; investments; insurance; prepaid health care benefits.

550.1207 Powers of health care corporation; interests of senior citizens; validity of corporate acts.

550.1208 Action by member; complaint.

550.1209 Action by member; discontinuance, compromise, or settlement; notice; expense.

550.1210 Action by member; reasonable expenses; attorney's fees.

550.1211 Administrative services only and cost-plus arrangements; service contracts; fees; administrative costs; marketing policy; notice; coverage, rights, and obligatio

550.1211a Definitions; prohibited acts by corporation; processing claims for benefits on timely basis; claim form; notice to covered individuals; notice to corporation of

550.1212 Action without notice or lapse of time periods; waiver; attorney-in-fact.

550.1213 Indemnification.

550.1214 Rate of interest.

550.1215 Health care corporation as shareholder in other nonprofit corporation; rights, powers, privileges, and liabilities.

550.1216, 550.1217 Repealed.

550.1218 Health care corporation; prohibited actions.

550.1219 Provisions superseded.

550.1220 Merger of health care corporation with nonprofit mutual disability insurer.

550.1301 Board of directors; powers and duties generally; appointment, qualifications, and terms of members; vacancy; officer or employee as voting or nonvoting director;

550.1302 Bylaws generally.

550.1303 Meetings; required provisions in bylaws; notice; waiver; participation by conference telephone or similar communications equipment; quorum; action by board; acti

550.1304 Books, records, and minutes; copy of minutes; disclosure, publication, and dissemination of minutes; compelling production of books or records.

550.1305 Establishment and composition of corporate body; service of members on committees; membership on board of directors.

550.1306 Effect of common directorship, officership, or interest on validity of contract or other transaction; burden of establishing validity of contract; exclusion of c

550.1307 Advisory councils; committees of board of directors; bylaws regarding membership and emergency meetings and actions.

550.1308 Committees of board of directors; powers and authority; prohibited activities; emergency actions.

550.1309 Officers and assistants; selection; restriction; authority and duties; removal; contractual rights; bond; vacancies; compensation; pension.

550.1310 Fiduciary duties; scope and manner of discharge; removal of director for breach of fiduciary duty; notice and hearing.

550.1311 Liability for misapplication or misuse of corporate money or property.

550.1312 Action for failure to perform duties; commencement.

550.1313 False statement as misdemeanor; liability for false statement or report; commencement of action for civil liability.

550.1400 Use of most favored nation clause in provider contract.

550.1401 Offering of health care benefits; limiting benefits; division of benefits into classes or kinds; prohibited conduct; grounds for denial of coverage; coordination

550.1401a Health care service rendered by dentist; benefits or reimbursement; “dentist” defined; certificates to which section applicable.

550.1401b Certificate providing benefits for mental health services; requirements.

550.1401c Replacement group certificate with preexisting condition limitation; elimination, reduction, or limitation of benefits; “disability coverage” defined.

550.1401d Services performed by physician's assistant; reimbursement; conditions; applicability of section; supervision by physician; definitions.

550.1401e Group certificate issued by health care corporation; renewal or continuation; guaranteed renewal; discontinuing plan, product, or coverage in nongroup or group

550.1401f Health care corporation; access to obstetrician-gynecologist.

550.1401g Health care corporation; access to pediatric care services.

550.1401h Health care corporation providing prescription drug coverage; formulary restrictions.

550.1401i Prescription drug coverage; pilot project; provisions; interim report; determination; evaluation.

550.1401j Prescription drug coverage; rate differentials; filing.

550.1401k Telemedicine services; provisions; definition; applicability.

550.1401m Offer of health care benefits to all residents regardless of health status.

550.1402 Health care corporation; prohibited conduct; commission or compensation; new preexisting condition limitation waiting period; readjusting rates; participation in

550.1402a Terms and conditions of certificate; form; description; requested information; written request; “board certified” defined.

550.1402b Preexisting condition limitation or exclusion; prohibition; exception; “group” defined.

550.1402c Termination of participation between primary care physician and health care corporation; notice to member; effect of termination; definitions.

550.1402d Applicability of MCL 500.2212c to health care corporation.

550.1403 Payment of benefits; interest; claim form; exception.

550.1403a Benefits paid by check or written instrument; escheat.

550.1403b Advertising material prohibited.

550.1404 Violation of MCL 550.1402 or MCL 550.1403; private informal managerial-level conference; review by commissioner; internal procedures; determination by commission

550.1405 Single billing form; development; explanation of total bill for services.

550.1406 Confidentiality of records; disclosures; consent; policy regarding protection of privacy and confidentiality of personal data; violation as misdemeanor; penalty;

550.1407 Complaint system; procedures; response to complaint; access to complaints and responses; record of complaints; annual report; other legal remedies.

550.1408 False, dishonest, or fraudulent claim for payment as misdemeanor; penalty; civil action; prosecution.

550.1409 Civil action for negligence.

550.1409a Coverage for children who are full-time or part-time students; continuing coverage if dependent student takes leave of absence due to illness or injury; eligibi

550.1410 Certificate providing coverage of dependent terminating at specified age; exceptions.

550.1410a Provisions of group certificate; electing coverage under group conversion certificate; notice of conversion privilege; requirements of group conversion certific

550.1410b Premium for group conversion certificate after January 1, 2014; determination; rating factors.

550.1411-550.1413a Repealed.

550.1414 Expired.

550.1414a Treatment of substance abuse; contracts; qualifications of provider; coverage for intermediate and outpatient care for substance abuse required; demonstration p

550.1414b Offer of wellness coverage by health care corporation.

550.1415 Benefits for prosthetic devices.

550.1416 Coverage for breast cancer diagnostic services, breast cancer outpatient services, and breast cancer rehabilitative services; coverage for breast cancer screenin

550.1416a Coverage for drug used in antineoplastic therapy and cost of its administration; conditions.

550.1416b Establishment of program to prevent onset of clinical diabetes required; report; coverages; “diabetes” defined.

550.1416c Off-label use of approved drug; coverage; conditions; compliance; use of copayment, deductible, sanction, or utilization control; limitation; definitions.

550.1416d Coverage for obstetrical and gynecological services by physician or nurse midwife.

550.1416e Diagnosis and treatment of autism spectrum disorders; coverage; prohibition; availability of other benefits; conditions; qualified health plan offered through A

550.1417 Hospice care; contracts with health care corporation; description of benefit.

550.1418 Emergency health services; medical coverage required; “stabilization” defined.

550.1419 Certificate offering dependent coverage to child; denial of enrollment on certain grounds prohibited.

550.1419a Eligibility of parent for dependent coverage; health coverage of child through noncustodial parent; court or administrative order and notice required.

550.1419b Individual eligible under title XIX of social security act; assignment of rights of subscriber to department of social services.

550.1420-550.1430 Repealed.

550.1435 “Program” defined.

550.1436 Michigan caring programs for children; creation; contribution requirements; rating methodologies; supersedure of inconsistent provisions.

550.1437 Eligibility of child for enrollment in program.

550.1438 Limitation of benefits; provision of other health care benefits.

550.1439 Fees prohibited; exception; funding; enrollment of children.

550.1451-550.1499a Repealed.

550.1501 Contracts with health care facilities.

550.1501a Special participating contracts with health care providers for provision of primary health care benefits to children enrolled in Michigan caring program.

550.1501b Conduct on behalf of or information provided to subscriber by health care provider; prohibition or discouragement by health care corporation.

550.1501c Provider network.

550.1502 Contracts for reimbursement with professional health care providers; private provider-patient relationship; methods of diagnosis or treatment not to be restricte

550.1502a Prudent purchaser agreements; group contracts; option; group contracts under which financial or other advantage realized; additional option; applicability of su

550.1503 Uniform reporting by health care providers.

550.1504 Reimbursement arrangements; goals; definitions; supplemental efforts.

550.1505 Provider class plan; development, modification, implementation, or review; procedures to obtain advice and consultation.

550.1506 Provider class plan; transmitting to commissioner; examination; determination; notice; placing plan into effect; retention of plan for commissioner's records.

550.1507 Provider class plan; inclusion and transmittal of items omitted.

550.1508 Provider class plan; modifications.

550.1509 Achievement of goals and objectives; determinations by commissioner.

550.1510 Additional determinations by commissioner.

550.1511 Provider class plan; transmittal to commissioner; preparation by commissioner.

550.1512 Extension of 6-month period provided in MCL 550.511(1); determination.

550.1513 Provider class plan; examination; automatic retention; placing plan into effect; preparation of plan by commissioner; notice.

550.1514 Appeal; selection and qualifications of hearing officer; consolidation; annual report.

550.1515 Appeal; parties; request; time; relief; transmittal of provider class plan to hearing officer; determinations.

550.1516 Provider class plan; standards.

550.1517 Annual report.

550.1518 Considerations and standards; applicability; appeal.

550.1601 Regulation and supervision of health care corporation; delegation of authority.

550.1602 Statement of condition; statistical, financial, and other reports.

550.1603 Visitation and examination; access to books, papers, and documents; witnesses; expenses; disclosure of information; reporting violation; action by attorney gener

550.1603a Health care corporation subject to MCL 500.224 and 500.225; costs and expenses.

550.1604 Confidentiality; violation as misdemeanor; penalty.

550.1605 Certificate of authority; suspension or limitation; circumstances; order; hearing; notice.

550.1606 Authority of commissioner regarding officers and directors; authority as to dissolution, taking over, or liquidation of corporations; insolvency defined.

550.1607 Submission of new or revised certificate and applicable proposed rates; approval or disapproval; exemption; circumstances and conditions; notice; implementation

550.1608 Rates charged to nongroup subscribers for certificate; methodology and definitions of rating system, formula, component, and factor used to calculate rates for g

550.1609 Excessive rate; administrative expense budget; equitable rate; adequate rate; line of business to be self-sustaining; cost transfers for benefit of senior citize

550.1610 Filing of information and materials relative to proposed rate; notice; approval, approval with modifications, or disapproval; additional information and material

550.1611 Legislative intent.

550.1612 Notice of rate filing; contents of request for hearing; advertisements; limitation on fee for copy of rate filing; waiver or reduction of fee; calculation of cos

550.1613 Request for hearing; standing of person; access to filing; confidentiality; penalty; appointment and qualifications of independent hearing officer; commencement

550.1614 Interim rates; petition; determination; granting interim rate; final rate determination; refunds or adjustments; limitation on order establishing interim rate ad

550.1615 Review of final order or decision.

550.1616 Endorsing, filing, and indexing documents; notice of refusal to file; judicial review; certificate of correction; persons adversely affected by correction; docum

550.1617 Rules.

550.1618 Compliance with new procedures, benefits, or contracts.

550.1619 Injunction; declaratory and equitable relief; enforcement of act or rules.

550.1620 Certificate subject to policy and certificate issuance and rate filing requirements; establishment of reasonable open enrollment periods; frequency and duration;

550.1651 Definitions.

550.1652 Health endowment fund corporation; incorporation; conflict of interest; appointment of board members; vacancy; terms; quorum; vote; business open to public; noti

550.1653 Charitable purpose nonprofit corporation; receipt and administration of funds; articles of incorporation; grants; conflict with other provisions of law; social m

550.1654 Executive director.

550.1655 Disbursement, expenditure, and investment of money by fund; system of financial accounting, controls, audits, and reports; appointment of audit committee; duties

550.1701 Formal reorganization not required; duties of health care corporation; amendments to articles and bylaws; description of board restructuring; review; certificati

550.1702 Discontinuation of certain rules; continuation of certain orders and approvals.

550.1703 Repeal of MCL 550.301 to 550.316 and 550.501 to 550.517.

550.1704 Effective date.

550.1751 Short title.

550.1753 Definitions.

550.1755 Waiver request; notification of member months, rate, and insurance providers by tier.

550.1757 Assessment; levy; rates; payment method.

550.1759 Records; failure to file return or keep proper records; right of department to impose assessment.

550.1761 Administration of assessment; conflicting provisions of law; rules; annual report.

550.1763 Insurance provider fund; establishment; creation; deposit; transfer of money.

550.1765 Appropriation for administration.

550.1767 Failure to pay assessment, interest, or penalty; final determination; written notice to director; suspension or revocation of certificate of authority to transac