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Michigan Statutes, Title 550

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Michigan/Statutes

← All Michigan coverage

Title 550, GENERAL INSURANCE LAWS

32 chapters · 358 sections in this title.

All chapters in Title 550358 Ch 350-of-1980, THE NONPROFIT HEALTH CARE CORPORATIO…145 Ch 125-of-1963, NONPROFIT DENTAL CARE CORPORATIONS26 Ch 218-of-1984, THIRD PARTY ADMINISTRATOR ACT25 Ch 173-of-1958, CREDIT INSURANCE ACT24 Ch 11-of-2022, PHARMACY BENEFIT MANAGER LICENSURE A…18 Ch 251-of-2000, PATIENT'S RIGHT TO INDEPENDENT REVIE…15 Ch 252-of-1986, THE HEALTH BENEFIT AGENT ACT15 Ch 233-of-1984, PRUDENT PURCHASER ACT13 Ch 175-of-2018, INSURANCE PROVIDER ASSESSMENT ACT9 Ch 386-of-1996, VIATICAL SETTLEMENT CONTRACTS9 Ch 499-of-2000, ELDER PRESCRIPTION INSURANCE COVERAG…9 Ch 66-of-1933, EMERGENCY INSURANCE LEGISLATION8 Ch 101-of-2012, AUTISM COVERAGE REIMBURSEMENT ACT7 Ch 239-of-1995, GROUP HEALTH PLAN ACT6

145 sections·Filtered byTitle 550✕Ch 350-of-1980✕

Mich. Comp. Laws § 550.1101 Short title.
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Sec. 101. This act shall be known and may be cited as "the nonprofit health care corporation reform act".
Mich. Comp. Laws § 550.1102 Legislative intent and policy.
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Sec. 102. (1) It is the purpose of and intent of this act, and the policy of the legislature, to promote an appropriate distribution of health care services for all residents of this state, to promote the progress of the science and art of health care in this state, and to assure…
Mich. Comp. Laws § 550.1103 Meanings of words and phrases.
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Sec. 103. For the purposes of this act, the words and phrases defined in sections 104 to 108 shall have the meanings ascribed to them in those sections.
Mich. Comp. Laws § 550.1104 Definitions; A to C.
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Sec. 104. (1) "Administrative procedures act" means the administrative procedures act of 1969, Act No. 306 of the Public Acts of 1969, as amended, being sections 24.201 to 24.328 of the Michigan Compiled Laws, or a successor act. (2) "Bargaining representative" means a representa…

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Mich. Comp. Laws § 550.1105 Definitions; H.

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Sec. 105. (1) "Health care benefit" means the right under a certificate to have payment made by a health care corporation for a specified health care service, regardless of whether or not the payment is made pursuant to an administrative services only or cost-plus arrangement. (2…

Mich. Comp. Laws § 550.1106 Definitions; L to O.

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Sec. 106. (1) "Large subscriber group" means a group of 10,000 or more subscribers. (2) "Medium subscriber group" means a group of 150 or more subscribers, but less than 10,000 subscribers. (3) "Member", except as used in parts 2 and 3, means a subscriber, a dependent of a subscr…

Mich. Comp. Laws § 550.1107 Definitions; P.

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Sec. 107. (1) "Participating provider" means a provider that has entered into a participating contract with a health care corporation and that meets the standards set by the corporation for that class of providers. (2) "Participating contract" means an agreement, contract, or oth…

Mich. Comp. Laws § 550.1108 Definitions; R, S.

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Sec. 108. (1) "Reimbursement arrangement" means policies, practices, and methods by which a health care corporation makes payments to a provider to implement the provider class plan. (2) "Small subscriber group" means a group of less than 150 subscribers. (3) "Subscriber" means a…

Mich. Comp. Laws § 550.1201 Health care corporation; incorporation; number of persons; payment of cash or other material benefit to subscriber; applicable laws; charitable and benevolent institution; exemption from taxation; certificate of authority; health care benefits and certificates.

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Sec. 201. (1) A health care corporation shall not be incorporated in this state except under this act. (2) Not less than 7 persons, all of whom shall be residents of this state, may form a health care corporation under this act for the purpose of providing 1 or more health care b…

Mich. Comp. Laws § 550.1201a Formation of health care corporation after January 1, 2014; prohibition.

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Sec. 201a. Notwithstanding section 201, a health care corporation shall not be formed in this state on or after January 1, 2014.

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

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Sec. 202. (1) Persons associating to form a health care corporation under this act shall subscribe to articles of incorporation that shall contain all of the following: (a) The names and addresses of the incorporators. (b) The location of the principal office of the corporation f…

Mich. Comp. Laws § 550.1203 Amendment or restatement of articles; review; approval.

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Sec. 203. By action of its board of directors, a health care corporation may integrate into a single instrument the provisions of its articles of incorporation which are then in effect and operative, as theretofore amended. If the restated articles restate and integrate and also …

Mich. Comp. Laws § 550.1204 Filing of statements and documents; examination; investigation; additional information; conditions; duties of commissioner.

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Sec. 204. (1) Before entering into contracts or securing applications of subscribers, the persons incorporating a health care corporation shall file all of the following in the office of the commissioner: (a) Three copies of the articles of incorporation, with the certificate of …

Mich. Comp. Laws § 550.1204a Unimpaired surplus.

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Sec. 204a. (1) A health care corporation shall possess and maintain unimpaired surplus in an amount determined adequate by the commissioner to comply with section 403 of the insurance code of 1956, 1956 PA 218, MCL 500.403. The commissioner shall follow the risk-based capital req…

Mich. Comp. Laws § 550.1205a Actuarial practices and accounting principles; financial report.

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Sec. 205a. A health care corporation shall report financial information in conformity with sound actuarial practices and statutory accounting principles in the same manner as designated by the commissioner for other carriers pursuant to section 438(2) of the insurance code of 195…

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

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Sec. 206. (1) The funds and property of a health care corporation shall be acquired, held, and disposed of only for the lawful purposes of the corporation and for the benefit of the subscribers of the corporation as a whole. A health care corporation shall only transact business,…

Mich. Comp. Laws § 550.1207 Powers of health care corporation; interests of senior citizens; validity of corporate acts.

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Sec. 207. (1) A health care corporation, subject to any limitation provided in this act, in any other statute of this state, or in its articles of incorporation, may do any or all of the following: (a) Contract to provide computer services and other administrative consulting serv…

Mich. Comp. Laws § 550.1208 Action by member; complaint.

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Sec. 208. (1) An action may be brought in the right of a health care corporation to procure a judgment in its favor, by a member of the corporate body. (2) In such an action, the complaint shall allege: (a) That the plaintiff is a member of the corporate body at the time of bring…

Mich. Comp. Laws § 550.1209 Action by member; discontinuance, compromise, or settlement; notice; expense.

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Sec. 209. An action authorized by section 208 shall not be discontinued, compromised, or settled without approval by the court having jurisdiction of the action. If the court determines that the interest of the members of the corporate body or of any component thereof will be sub…

Mich. Comp. Laws § 550.1210 Action by member; reasonable expenses; attorney's fees.

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Sec. 210. (1) If an action brought in the right of the corporation is successful, in whole or in part, or if anything is received by the plaintiff or a claimant as a result of a judgment, compromise, or settlement of an action or claim, the court may award the plaintiff or claima…

Mich. Comp. Laws § 550.1211 Administrative services only and cost-plus arrangements; service contracts; fees; administrative costs; marketing policy; notice; coverage, rights, and obligations under collective bargaining agreement; liability of individual; report; “noninsured benefit plan” defined.

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Sec. 211. (1) Pursuant to section 207(1)(g), a health care corporation may enter into service contracts containing an administrative services only or cost-plus arrangement. Except as otherwise provided in this section, a corporation shall not enter into a service contract contain…

Mich. Comp. Laws § 550.1211a Definitions; prohibited acts by corporation; processing claims for benefits on timely basis; claim form; notice to covered individuals; notice to corporation of complaint and proceedings contemplated; hearing; findings; order; violation of order; penalty; action and award of actual monetary damages; review; stay of enforcement.

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Sec. 211a. (1) As used in this section: (a) "Noninsured benefit plan" means a health benefit plan without coverage by a health care corporation, health maintenance organization, or insurer or the portion of a health benefit plan without coverage by a health care corporation, heal…

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

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Sec. 212. When, under this act or the articles of incorporation or bylaws of a health care corporation or by the terms of an agreement or instrument, a health care corporation or the board of directors of the health care corporation or any committee of the board may take action a…

Mich. Comp. Laws § 550.1213 Indemnification.

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Sec. 213. (1) A health care corporation may indemnify any person who was or is a party to, or is threatened to be made a party to, any threatened, pending, or completed action, suit, or proceeding, whether civil, criminal, administrative, or investigative, other than an action by…

Mich. Comp. Laws § 550.1214 Rate of interest.

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Sec. 214. A health care corporation may by agreement in writing, and not otherwise, agree to pay a rate of interest in excess of the legal rate, and in that case, the defense of usury is prohibited.

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

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Sec. 215. When a health care corporation, consistent with the purposes of the corporation prescribed in this act, is a shareholder in any other nonprofit corporation, its president and other officers or any of its directors may hold the office of director of the other nonprofit c…

Mich. Comp. Laws § 550.1218 Health care corporation; prohibited actions.

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Sec. 218. A health care corporation shall not do any of the following: (a) Take any action to change its nonprofit status. (b) Except as otherwise provided in section 220, dissolve, merge, consolidate, mutualize, or take any other action that results in a change in direct or indi…

Mich. Comp. Laws § 550.1219 Provisions superseded.

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Sec. 219. A nonprofit health care corporation is subject to chapter 37 of the insurance code of 1956, 1956 PA 218, MCL 500.3701 to 500.3723. To the extent that a provision of this act concerning health coverage, including, but not limited to, premiums, rates, filings, and coverag…

Mich. Comp. Laws § 550.1220 Merger of health care corporation with nonprofit mutual disability insurer.

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Sec. 220. (1) Notwithstanding any provision of this act to the contrary, a health care corporation may establish, own, operate, and merge with a nonprofit mutual disability insurer formed under chapter 58 of the insurance code of 1956, 1956 PA 218, MCL 500.5800 to 500.5840. The s…

Mich. Comp. Laws § 550.1301 Board of directors; powers and duties generally; appointment, qualifications, and terms of members; vacancy; officer or employee as voting or nonvoting director; method of selection; definitions; prohibition.

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Sec. 301. (1) The property and lawful business of a health care corporation existing and authorized to do business under this act shall be held and managed by a board of directors to consist of not more than 35 members. The board shall exercise the powers and authority necessary …

Mich. Comp. Laws § 550.1302 Bylaws generally.

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Sec. 302. (1) The board of directors shall adopt initial bylaws and may amend or repeal those bylaws or adopt new bylaws, subject to the prior approval or certification by the attorney general. The bylaws may contain any provision for the regulation and management of the affairs …

Mich. Comp. Laws § 550.1303 Meetings; required provisions in bylaws; notice; waiver; participation by conference telephone or similar communications equipment; quorum; action by board; actions requiring majority vote; record roll call vote; recording vote in minutes.

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Sec. 303. (1) Regular or special meetings of the board or a committee of the board shall be held within this state. With respect to regular or special meetings of the board or a committee of the board, the bylaws shall include provisions regarding all of the following: (a) The mi…

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

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Sec. 304. (1) A health care corporation shall keep accurate books and records of account and minutes of the proceedings of the board of directors of the health care corporation, committees of the board, and the corporate body. The books, records, and minutes may be in written for…

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

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Sec. 305. (1) A health care corporation may establish a corporate body. The corporate body shall consist of individuals selected in the same manner as individuals are selected to serve as nonpublic members on the board of directors. The size of the corporate body shall be such th…

Mich. Comp. Laws § 550.1306 Effect of common directorship, officership, or interest on validity of contract or other transaction; burden of establishing validity of contract; exclusion of common or interested directors in determination of quorum; compensation of directors; bylaws regarding conflict of interest.

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Sec. 306. (1) A contract or other transaction between a health care corporation and 1 or more of its directors or officers, or between a health care corporation and any other corporation, firm, or association of any type or kind in which 1 or more of its directors or officers are…

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

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Sec. 307. The board of directors may establish those advisory councils and, unless otherwise provided in the articles of incorporation or bylaws, those committees it considers necessary to perform its duties. Members of the corporate body may serve on committees of the board of d…

Mich. Comp. Laws § 550.1308 Committees of board of directors; powers and authority; prohibited activities; emergency actions.

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Sec. 308. (1) To the extent provided by resolution of the board or in the bylaws or articles, a committee established pursuant to section 307 may exercise the powers and authority of the board in management of the business and affairs of the health care corporation. The board sha…

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

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Sec. 309. (1) The board of directors shall select the officers of the health care corporation and a chairperson, vice-chairperson, and other board officers and assistants as the board considers necessary. However, an officer shall not execute, acknowledge, or verify an instrument…

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

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Sec. 310. (1) With respect to management of the affairs and property of the health care corporations, and in the selection, supervision, and control of committees of the board, employees of the health care corporation, and officers, each director and officer, and the composite bo…

Mich. Comp. Laws § 550.1311 Liability for misapplication or misuse of corporate money or property.

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Sec. 311. Each director or officer of a health care corporation shall be individually liable for the misapplication or misuse of corporate money or property caused through the neglect or failure of that director or officer to discharge his or her duties in compliance with the sta…

Mich. Comp. Laws § 550.1312 Action for failure to perform duties; commencement.

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Sec. 312. An action against a director or officer for failure to perform the duties imposed by this act shall be commenced within 3 years after the cause of action has accrued, or within 2 years after the time when the cause of action is discovered, or should reasonably have been…

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

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Sec. 313. (1) Except with respect to statements which are subject to prosecution for perjury, as defined in section 423 of Act No. 328 of the Public Acts of 1931, being section 750.423 of the Michigan Compiled Laws, a person, or an agent, director, or officer of a health care cor…

Mich. Comp. Laws § 550.1400 Use of most favored nation clause in provider contract.

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Sec. 400. (1) Notwithstanding any provision of this act to the contrary, this section applies to the use of a most favored nation clause in a provider contract on and after February 1, 2013. (2) Subject to subsection (3), beginning February 1, 2013, a health care corporation shal…

Mich. Comp. Laws § 550.1401 Offering of health care benefits; limiting benefits; division of benefits into classes or kinds; prohibited conduct; grounds for denial of coverage; coordination of benefits, subrogation, and nonduplication of benefits; health care corporation as party in interest; limiting or denying coverage or participation status; requirements for participation and reimbursement; determination by commissioner; definitions.

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Sec. 401. (1) A health care corporation established, maintained, or operating in this state shall offer health care benefits to all residents of this state, and may offer other health care benefits as the corporation specifies with the approval of the commissioner. (2) A health c…

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

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Sec. 401a. (1) If a group or nongroup certificate of a health care corporation provides for health care benefits for a health care service, those benefits or reimbursement for the provision of the service shall not be denied because the service was rendered by a dentist, provided…

Mich. Comp. Laws § 550.1401b Certificate providing benefits for mental health services; requirements.

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Sec. 401b. A certificate issued by a corporation which provides benefits for mental health services shall provide benefits for mental health services provided to an individual by a mental health care provider operated by or under contract with the department of mental health or a…

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

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Sec. 401c. (1) If existing group disability coverage is replaced by a group certificate with a preexisting condition limitation and insuring 10 or more members, coverage in the replacement certificate applicable to the preexisting condition limitation for an individual who had be…

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

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Sec. 401d. (1) Subject to subsections (2) and (3), if a health care corporation group or nongroup certificate provides for health care benefits for services performed by a physician's assistant, those benefits or reimbursement for those benefits at the prevailing rate shall not b…

Mich. Comp. Laws § 550.1401e Group certificate issued by health care corporation; renewal or continuation; guaranteed renewal; discontinuing plan, product, or coverage in nongroup or group market; conditions.

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Sec. 401e. (1) Except as otherwise provided in this section, a health care corporation that has issued a nongroup certificate shall renew or continue in force the certificate at the option of the individual. (2) Except as otherwise provided in this section, a health care corporat…

Mich. Comp. Laws § 550.1401f Health care corporation; access to obstetrician-gynecologist.

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Sec. 401f. (1) A health care corporation certificate that requires a member to designate a participating primary care provider and provides for annual well-woman examinations and routine obstetrical and gynecologic services shall permit a female member to access an obstetrician-g…