HOUSE BILL No. 4758


     June 3, 1999, Introduced by Rep. Hart and referred to the Committee on Family and
Civil Law.


        A bill to amend 1978 PA 368, entitled

   "Public health code,"

   (MCL 333.1101 to 333.25211) by adding section 21046.

               THE PEOPLE OF THE STATE OF MICHIGAN ENACT:

 1         SEC. 21046.  A HEALTH MAINTENANCE ORGANIZATION SHALL FURNISH

 2    TO ANY PERSON PRIMARILY PAYING FOR A GROUP HEALTH MAINTENANCE

 3    CONTRACT, WITHIN 30 DAYS AFTER RECEIVING A WRITTEN REQUEST THERE-

 4    FORE AND UPON PAYMENT OF A REASONABLE CHARGE, ALL OF THE FOLLOW-

 5    ING INFORMATION FOR THE GROUP CONTRACT FOR THE IMMEDIATELY PRE-

 6    CEDING 12-MONTH PERIOD:

 7         (A) TOTAL NUMBER OF INDIVIDUALS COVERED.

 8         (B) TOTAL NUMBER OF CLAIMS PAID OR SERVICES DELIVERED.

 9         (C) TOTAL NUMBER OF CLAIMS OR SERVICES PENDING.

10         (D) TOTAL NUMBER OF CLAIMS OR SERVICES DELIVERED EXCEEDING

11    $50,000.00 AND THE AMOUNT OF EACH OF THOSE CLAIMS OR SERVICES.


   03707'99                                                 DKH
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 1    INFORMATION UNDER THIS SUBDIVISION SHALL NOT DISCLOSE PERSONAL

 2    DATA THAT MAY REVEAL THE IDENTITY OF A COVERED INDIVIDUAL.

 3         (E) UTILIZATION AND COST PER SERVICE DATA BY COVERED

 4    COMPONENT.

 5         (F) ALL PERTINENT INFORMATION THAT IS NECESSARY FOR THE

 6    PERSON TO OBTAIN COMPETITIVE BIDS FOR OTHER HEALTH CARE COVERAGE.












































   03707'99          Final page.                            DKH