This bill prohibits insurance companies in Michigan from using price optimization techniques when setting rates. It defines price optimization as adjusting premiums based on factors unrelated to risk, such as a customer's willingness to pay or their likelihood of switching providers. The law also bans insurers from penalizing customers for shopping around, canceling policies early, or complaining about their coverage. By outlawing these practices, the bill aims to ensure that insurance rates are determined solely by the risk of loss or expense rather than a consumer's financial behavior.
HB 4072 requires hospitals and freestanding surgical outpatient facilities to offer patients any unused eye drops or eye ointments after ophthalmic surgical procedures or medical care. This applies when the facility-provided medication was administered to the patient and is required for their ongoing treatment upon discharge. The bill details labeling requirements if a pharmacist dispenses the drug, and assigns the responsibility for patient counseling on its use to the prescribing doctor. This allows patients to take home remaining eye medications for continued care.
SB 415 requires Michigan's medical assistance program to cover group prenatal care services beginning on the bill's effective date. This directly affects pregnant individuals enrolled in Michigan's medical assistance program (like Medicaid) by mandating coverage for a specific type of care. The bill defines "group prenatal care services" as evidence-based, group-based visits that include health assessments, social support, education, and peer interaction in a family-centered setting. These services aim to support pregnant people through shared experiences and structured care, extending into early childhood.
This bill establishes the Commodities and Emergency Services and Supplies Pricing Protection Act to stop businesses from raising prices unfairly during a declared state of emergency. It specifically targets sales of building materials, food, emergency supplies, medical items, and general goods, defining an illegal price hike as an increase of more than 20% compared to pre-emergency rates unless the seller can prove higher costs. The law prohibits charging or offering these items at excessively high prices and grants prosecutors the power to investigate violations by demanding documents and testimony from suspected violators.
SB 1011 creates a new state-regulated program called a small business health pool to offer health coverage to Michigan employers with fewer than 500 employees and eligible self-employed individuals. This initiative requires these businesses to join a nonprofit sponsoring association that meets specific financial and operational standards, ensuring the group is stable and has a legitimate business purpose beyond just providing insurance. The bill establishes rules for how these pools operate, allowing them to be fully insured, level-funded, or self-funded while mandating that they cover essential health benefits and cannot discriminate based on health status or claims history. Additionally, the legislation creates a state-funded reinsurance program to reimburse 60% of catastrophic claims between $75,000 and $250,000 per person to help stabilize premiums. The Department of Insurance will oversee the program by reviewing financial solvency and compliance, but it will not approve insurance rates except for fully insured products.
This bill amends Michigan's insurance code to require health insurers to provide consumers with a plain English summary of their policies and detailed information upon request. The legislation mandates that these summaries clearly explain coverage benefits, costs, exceptions, and renewal terms, while also ensuring policies are printed in a readable font size without highlighting specific text. Additionally, the bill requires insurers to disclose provider network details, professional credentials, and financial arrangements when asked, and it sets specific deadlines for delivering this information to applicants and policyholders.
SB 978 repeals the requirement that health insurers in Michigan provide emergency refills of prescription medications for up to a 30-day supply. This change directly affects insurance companies and their policyholders by removing the obligation to cover such emergency supplies under specific circumstances. The bill eliminates Section 3406w of the state's insurance code, which previously mandated these emergency coverage provisions. Consequently, insurers will no longer be required to grant these specific emergency refill exceptions, leaving the existing formulary and exception processes in Sections 3406o as the primary framework for drug coverage.
SB 974 updates Michigan's insurance code to align with the state's health insurance exchange by clarifying definitions for roles such as navigators and certified application counselors. The bill establishes strict rules requiring these individuals to be state-certified before they can receive funding or assist consumers with health plan enrollment. It explicitly prohibits them from selling insurance or recommending specific plans, ensuring they provide only impartial information about available coverage options. Additionally, the legislation mandates that the state director implement a certification program including background checks and privacy training to protect consumer data.
This bill directs the state insurance director to work with the Michigan health insurance exchange to officially certify qualified health and dental plans. It requires the director to create specific rules for this certification process while maintaining the authority to regulate insurance businesses and exempt these plans from certain laws. The legislation defines qualified plans using existing terms from the Michigan health insurance exchange act and includes a provision that it only takes effect if a related companion bill is also passed.
This bill directs Michigan's department of insurance to request federal permission to create a state-run reinsurance program that helps stabilize health insurance markets. If approved, the program would allow insurers to recover some costs for high-risk patients, potentially lowering premiums and expanding coverage options. The legislation requires the department to share draft plans with the public and lawmakers before submitting a final application to the federal government. Implementation of the program depends on the successful approval of a companion bill, SB 0973, which must also be enacted for this measure to take effect.
