HOUSE BILL No. 5454

 

November 8, 2007, Introduced by Reps. Sak, Bennett, Miller, Hammel, LeBlanc, Young, Byrnes, Simpson, Cushingberry, Kathleen Law, Hammon, Bauer, Lindberg, Corriveau, Lemmons, McDowell, Ebli, Virgil Smith, Dean, Melton, Byrum, Clack, Meadows, Cheeks, Gillard, Alma Smith and Scott and referred to the Committee on Education.

 

     A bill to amend 2007 PA 106, entitled

 

"Public employees health benefit act,"

 

by amending sections 5 and 15 (MCL 124.75 and 124.85).

 

THE PEOPLE OF THE STATE OF MICHIGAN ENACT:

 

     Sec. 5. (1) Subject to collective bargaining requirements, a

 

public employer may provide medical, optical, or dental benefits to

 

public employees and their dependents by any of the following

 

methods:

 

     (a) By establishing and maintaining a plan on a self-insured

 

basis. A plan under this subdivision does not constitute doing the

 

business of insurance in this state and is not subject to the

 

insurance laws of this state.

 

     (b) By joining with other public employers and establishing


 

and maintaining a public employer pooled plan to provide medical,

 

optical, or dental benefits to not fewer than 250 public employees

 

on a self-insured basis as provided in this act. A pooled plan

 

shall accept any public employer that applies to become a member of

 

the pooled plan, agrees to make the required payments, agrees to

 

remain in the pool for a 3-year period, and satisfies the other

 

reasonable provisions of the pooled plan. A public employer that

 

leaves a pooled plan may not rejoin the pooled plan for 2 years

 

after leaving the plan. A pooled plan under this subdivision does

 

not constitute doing the business of insurance in this state and,

 

except as provided in this act, is not subject to the insurance

 

laws of this state. A pooled plan under this subdivision may enter

 

into contracts and sue or be sued in its own name.

 

     (c) By procuring coverage or benefits from 1 or more carriers,

 

either on an individual basis or with 1 or more other public

 

employers.

 

     (2) A public employer or pooled plan procuring coverage or

 

benefits from 1 or more carriers shall solicit 4 or more bids when

 

establishing a medical benefit plan, including at least 1 bid from

 

a voluntary employees' beneficiary association described in section

 

501(c)(9) of the internal revenue code, 26 USC 501(c)(9). A public

 

employer or pooled plan procuring coverage or benefits from 1 or

 

more carriers shall solicit 4 or more bids every 3 years when

 

renewing or continuing a medical benefit plan, including at least 1

 

bid from a voluntary employees' beneficiary association described

 

in section 501(c)(9) of the internal revenue code, 26 USC

 

501(c)(9). A public employer or pooled plan that provides for


 

administration of a medical benefit plan using an authorized third

 

party administrator, an insurer, a nonprofit health care

 

corporation, or other entity authorized to provide services in

 

connection with a noninsured medical benefit plan shall solicit 4

 

or more bids for those administrative services when establishing a

 

medical benefit plan. A public employer or pooled plan that

 

provides for administration of a medical benefit plan using an

 

authorized third party administrator, an insurer, a nonprofit

 

health care corporation, or other entity authorized to provide

 

services in connection with a noninsured medical benefit plan shall

 

solicit 4 or more bids for those administrative services every 3

 

years when renewing or continuing a medical benefit plan.

 

     (2) (3) This act does not prohibit a public employer from

 

participating, for the payment of medical benefits and claims, in a

 

purchasing pool or coalition to procure insurance, benefits, or

 

coverage, or health care plan services or administrative services.

 

     (3) (4) A public university may establish a medical benefit

 

plan to provide medical, dental, or optical benefits to its

 

employees and their dependents by any of the methods set forth in

 

this section.

 

     (4) (5) A medical benefit plan that provides medical benefits

 

shall provide to covered individuals case management services that

 

meet the case management accreditation standards established by the

 

national committee on quality assurance, the joint commission on

 

health care organizations, or the utilization review accreditation

 

commission.

 

     Sec. 15. (1) Notwithstanding subsection (2), a A public


 

employer that has 100 or more employees in a medical benefit plan

 

shall be provided with claims utilization and cost information as

 

provided in subsection (3) (2).

 

     (2) A public employer who is in an arrangement with 1 or more

 

other public employers, and together have 100 or more employees in

 

a medical benefit plan or have signed a letter of intent to enter

 

together 100 or more public employees into a medical benefit plan,

 

shall be provided with claims utilization and cost information as

 

provided in subsection (3) that is aggregated for all the public

 

employees together of those public employers, and, except as

 

otherwise permitted under subsection (1), shall not be separated

 

out for any of those public employers.

 

     (2) (3) All medical benefit plans in this state shall compile,

 

and shall make available electronically as provided in subsections

 

(1) and (2) subsection (1), complete and accurate claims

 

utilization and cost information for the medical benefit plan in

 

the aggregate and for each public employer as follows for the most

 

recent rate renewal period and under the same basis by which the

 

public employer has been pooled or rated, including:

 

     (a) For persons covered under the medical benefit plan, census

 

information, including date of birth, gender, zip code, and medical

 

tier, such as single, dependent, or family.

 

     (b) Monthly claims by provider type and service category

 

reported by the total number and dollar amounts of claims paid and

 

reported separately for in-network and out-of-network providers.

 

     (c) The number of claims paid over $50,000.00 and the total

 

dollar amount of those claims.


 

     (d) The dollar amounts paid for specific and aggregate stop-

 

loss insurance.

 

     (e) The dollar amount of administrative expenses incurred or

 

paid, reported separately for medical, pharmacy, dental, and

 

vision.

 

     (f) The total dollar amount of retentions and other expenses.

 

     (g) The dollar amount for all service fees paid.

 

     (h) The dollar amount of any fees or commissions paid to

 

agents, consultants, or brokers by the medical benefit plan or by

 

any public employer or carrier participating in or providing

 

services to the medical benefit plan, reported separately for

 

medical, pharmacy, stop-loss, dental, and vision.

 

     (i) Other information as may be required by the commissioner.

 

     (3) (4) The claims utilization and cost information required

 

to be compiled under this section shall be compiled on an annual

 

basis and shall cover a relevant the most recent rate renewal

 

period. For purposes of this subsection, the term "relevant period"

 

means the 36-month period ending no more than 120 days prior to the

 

effective date or renewal date of the medical benefit plan under

 

consideration. However, if the medical benefit plan has been in

 

effect for a period of less than 36 months, the relevant period

 

shall be that shorter period.

 

     (5) A public employer or combination of public employers shall

 

disclose the claims utilization and cost information required to be

 

provided under subsections (1) and (2) to any carrier or

 

administrator it solicits to provide benefits or administrative

 

services for its medical benefit plan, and to the employee


 

representative of employees covered under the medical benefit plan,

 

and upon request to any carrier or administrator who requests the

 

opportunity to submit a proposal to provide benefits or

 

administrative services for the medical benefit plan at the time of

 

the request for bids. The public employer shall make the claims

 

utilization and cost information required under this section

 

available at cost and within a reasonable period of time.

 

     (4) (6) The claims utilization and cost information required

 

under this section shall include only de-identified health

 

information as permitted under the health insurance portability and

 

accountability act of 1996, Public Law 104-191, or regulations

 

promulgated under that act, 45 CFR parts 160 and 164, and shall not

 

include any protected health information as defined in the health

 

insurance portability and accountability act of 1996, Public Law

 

104-191, or regulations promulgated under that act, 45 CFR parts

 

160 and 164.

 

     (5) (7) All claims utilization and cost information described

 

in this section is required to be compiled beginning 60 days after

 

the effective date of this act. However, claims utilization and

 

cost information already being compiled on the effective date of

 

this act is subject to this section on the effective date of this

 

act.