Section 550.1925 – Description of Internal Grievance and External Review Procedures; Inclusion With Materials Provided to Covered Persons.
550.1925 Description of internal grievance and external review procedures; inclusion with materials provided to covered persons. Sec. 25. (1) A health carrier shall include a description of the internal grievance and external review procedures in or attached to the policy, certificate, membership booklet, outline of coverage, or other evidence of coverage it provides to covered […]
Section 550.1927 – Rules.
550.1927 Rules. Sec. 27. The director may promulgate rules under the administrative procedures act of 1969, 1969 PA 306, MCL 24.201 to 24.328, necessary to carry out this act. History: 2000, Act 251, Eff. Oct. 1, 2000 ;– Am. 2016, Act 274, Eff. Sept. 29, 2016
Section 550.1929 – Cease and Desist Order; Additional Orders; Fines; Hearing; Injunction; Creation of Cancer Clinical Trials; Disposition of Funds.
550.1929 Cease and desist order; additional orders; fines; hearing; injunction; creation of cancer clinical trials; disposition of funds. Sec. 29. (1) If the commissioner finds that a violation of this act has occurred, the commissioner shall reduce the findings and decision to writing and shall issue and cause to be served upon the person charged […]
Section 550.1951 – “Local Unit of Government” Defined.
550.1951 “Local unit of government” defined. Sec. 1. As used in this act, “local unit of government” means any political subdivision of this state, including, but not limited to, school districts, community and junior colleges, state universities, cities, villages, townships, charter townships, counties, charter counties, authorities created by the state, and authorities created by other […]
Section 550.1952 – Entities Contracting With State or Local Government for Costs of Health Care Services Under Self-Funded Plan; Duties.
550.1952 Entities contracting with state or local government for costs of health care services under self-funded plan; duties. Sec. 2. (1) An entity that contracts with a state or local unit of government to provide, deliver, arrange for, pay for, or reimburse any of the costs of health care services provided under a self-funded plan […]
Section 550.1953 – Exceptions.
550.1953 Exceptions. Sec. 3. This act does not apply to a self-funded plan that provides coverage only for dental, vision care, or any other limited supplemental benefit. History: 2006, Act 495, Imd. Eff. Dec. 29, 2006
Section 550.1905 – Scope.
550.1905 Scope. Sec. 5. (1) Except as otherwise provided in subsection (2), this act applies to all health carriers. (2) This act does not apply to a policy or certificate that provides coverage only for specified accident or accident-only coverage, credit, disability income, hospital indemnity, long-term care insurance, as that term is defined in section […]
Section 550.1907 – Right to Request External Review for Adverse Determination; Written Notice.
550.1907 Right to request external review for adverse determination; written notice. Sec. 7. (1) A health carrier shall provide written notice to a covered person of the internal grievance and external review processes at the time the health carrier sends written notice of an adverse determination. (2) Except as provided in subsection (3)(a), a request […]
Section 550.1909 – Written Request to Director; Manner; Electronic Communication.
550.1909 Written request to director; manner; electronic communication. Sec. 9. (1) Except for a request for an expedited external review under section 13, all requests for external review must be made in writing to the director. (2) A written notice required to be provided under this act must be provided in a culturally and linguistically […]
Section 550.1911 – Request for External Review; Commencement; Preliminary Review; Notice of Acceptance; Duties of Director; Incomplete Request; Nonacceptance; Assignment of Independent Review Organization; Duty of Health Carrier to Provide Documents; Reconsideration by Health Carrier of Its Adverse Determination; Recommendation; Considerations; Review by Director; Notice of Decision.
550.1911 Request for external review; commencement; preliminary review; notice of acceptance; duties of director; incomplete request; nonacceptance; assignment of independent review organization; duty of health carrier to provide documents; reconsideration by health carrier of its adverse determination; recommendation; considerations; review by director; notice of decision. Sec. 11. (1) Not later than 60 days or, after […]