Michigan Laws 500.3544 – Noninsured benefit plan; processing and payment of claims
Current as of: 2023 | Check for updates
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Terms Used In Michigan Laws 500.3544
- Health maintenance organization: means a person that, among other things, does the following:
(i) Delivers health services that are medically necessary to enrollees under the terms of its health maintenance contract, directly or through contracts with affiliated providers, in exchange for a fixed prepaid sum or per capita prepayment, without regard to the frequency, extent, or kind of health services. See Michigan Laws 500.3501
(1) A health maintenance organization may process and pay claims on behalf of a noninsured benefit plan only after the health maintenance organization has received adequate money from the noninsured benefit plan sponsor to fully cover the claim payments.
(2) As used in this section, “noninsured benefit plan” means that term as defined in section 5208.