October 27, 2005, Introduced by Senators GEORGE, JOHNSON, TOY, CROPSEY, JELINEK, KUIPERS, McMANUS, HARDIMAN, VAN WOERKOM, GILBERT, BROWN, CASSIS, PATTERSON, BIRKHOLZ, SIKKEMA, SANBORN, BISHOP, STAMAS, ALLEN, GOSCHKA, GARCIA and HAMMERSTROM and referred to the Committee on Health Policy.
A bill to amend 1956 PA 218, entitled
"The insurance code of 1956,"
(MCL 500.100 to 500.8302) by adding section 3426.
THE PEOPLE OF THE STATE OF MICHIGAN ENACT:
Sec. 3426. (1) Each insurer providing a group expense-incurred
hospital, medical, or surgical certificate delivered, issued for
delivery, or renewed in this state and each health maintenance
organization shall offer group wellness coverage that provides for
an appropriate rebate of premiums paid in the last calendar year
for the wellness coverage if the majority of insureds or enrollees
in the wellness coverage plan have enrolled and maintained
participation in any health wellness, maintenance, or improvement
program offered by the employer. The employer shall provide
evidence of demonstrative maintenance or improvement of the
insureds' or enrollees' health status as determined by assessments
of agreed-upon health status indicators between the employer and
the health insurer or health maintenance organization. Any rebate
provided by the health insurer or health maintenance organization
is presumed to be appropriate unless credible data demonstrate
otherwise, but shall not exceed 10% of paid premiums.
(2) Each insurer providing an individual or family expense-
incurred hospital, medical, or surgical policy delivered, issued
for delivery, or renewed in this state and each health maintenance
organization shall offer individual and family wellness coverage
that provides for an appropriate rebate of premiums paid in the
last calendar year if the individual or family is enrolled in and
maintains participation in any health wellness, maintenance, or
improvement program approved by the insurer or health maintenance
organization. The insured or enrollee shall provide evidence of
demonstrative maintenance or improvement of the individual's or
family's health status as determined by assessments of agreed-upon
health status indicators between the insured or enrollee and the
health insurer or health maintenance organization. Any rebate
provided by the health insurer or health maintenance organization
is presumed to be appropriate unless credible data demonstrate
otherwise, but shall not exceed 10% of paid premiums.
(3) The premium rebate authorized by subsection (1) shall be
provided each year that subsection (1) is satisfied.
(4) The premium rebate authorized by subsection (2) shall be
provided each year that subsection (2) is satisfied.
Enacting section 1. This amendatory act takes effect January
1, 2006.