§ 500.3400 Definitions; scope of chapter, exemptions, exceptions
§ 500.3401a Group disability insurance; issuance; filing and approval of form
§ 500.3402 Disability insurance policy; provisions required
§ 500.3402a Group disability insurance policy; provisions required
§ 500.3402b Group or nongroup disability insurance policy; coordination of benefits; provision; limitation; “other coverage” defined; payment by each insurer
§ 500.3402c Family expense insurance policy
§ 500.3402d Blanket disability insurance; coverage
§ 500.3402e Blanket disability insurance policies; issuance
§ 500.3402f Blanket disability insurance policy; provisions
§ 500.3402g Blanket disability insurance policy; certificate; payment of benefits
§ 500.3402h Legal liability of policyholder
§ 500.3403 Health insurance policy offering dependent coverage; required provisions; denial prohibited; grounds
§ 500.3404 Insurance policy issued for delivery to nonresident
§ 500.3405 Prudent purchaser agreements with providers of hospital, nursing, medical, surgical, or sick-care services; rates; discrimination prohibited; optometry, chiropractic, and physical therapy service
§ 500.3405a Use of most favored nation clause
§ 500.3406 Disability insurance policy; provisions required, captions, omissions, substitutions
§ 500.3406a Reconstructive surgery following mastectomy; prosthetic device
§ 500.3406b Coverage for mental health services by mental health care provider
§ 500.3406c Hospice care; definition; description of coverage
§ 500.3406d Coverage for breast cancer diagnostic services, breast cancer outpatient treatment services, and breast cancer rehabilitative services; coverage for breast cancer screening mammography; definitions
§ 500.3406e Coverage for drug used in antineoplastic therapy and cost of its administration; conditions
§ 500.3406h Eligibility of parent for dependent coverage; health coverage of child through noncustodial parent; duties of insurer; court or administrative order and notice required
§ 500.3406i Individual eligible under title XIX of social security act; assignment of rights of insured to department of social services
§ 500.3406j Insured or applicant as victim of domestic violence; refusal to provide coverage prohibited; liability; “domestic violence” defined
§ 500.3406k Emergency health services; medically necessary coverage; “stabilization” defined
§ 500.3406l Medical transportation services; reimbursement; exception
§ 500.3406m Access by insured to obstetrician-gynecologist
§ 500.3406n Access to pediatric care services
§ 500.3406o Insurer providing prescription drug coverage; formulary restrictions; expedited review of coverage for nonformulary alternative; determination; subject to 500.3406w
§ 500.3406p Establishment of program to prevent onset of clinical diabetes required; survey; coverages; “diabetes” defined
§ 500.3406q Off-label use of approved drug; coverage; conditions; compliance; use of copayment, deductible, sanction, or utilization control; limitation; definitions
§ 500.3406r Coverage for obstetrical and gynecological services by physician or nurse midwife
§ 500.3406s Diagnosis and treatment of autism spectrum disorders; coverage; prohibition; availability of other benefits; conditions; qualified health plan offered through American health benefit exchange pursuant
§ 500.3406t Synchronizing insured’s or enrollee’s multiple maintenance prescription drugs
§ 500.3406u Coverage for prescription eyedrops; requirements; “prescriber” defined
§ 500.3406v Coverage for emergency supply of insulin
§ 500.3406w Temporary emergency and early refills for prescription drugs; inapplicable after March 31, 2021
§ 500.3406x Nonopioid directive form; website
§ 500.3406y Nonopioid directive form; enrollment
§ 500.3407 Entire contract; changes
§ 500.3407a Conduct on behalf of or information provided to insured by health care provider; prohibition or discouragement by disability insurer
§ 500.3407b Undergoing genetic testing as condition of issuing, renewing, or continuing policy; disclosure of genetic testing or genetic information; definitions
§ 500.3408 Time limit on certain defenses; incontestable policy
§ 500.3409 Disability insurance policy; mandatory notices as to cancellation and refund of premium
§ 500.3410 Grace period; provision required
§ 500.3411 Reinstatement; provision required
§ 500.3412 Notice of claim; provision required
§ 500.3413 Claim forms; provision required
§ 500.3414 Proofs of loss; provision required
§ 500.3416 Time of payment of claims; provision required
§ 500.3418 Payment of claims; provision required
§ 500.3420 Physical examinations and autopsy; provision required
§ 500.3422 Legal actions; provision required
§ 500.3424 Change of beneficiary; provision required
§ 500.3425 Health insurance policy; coverage for intermediate and outpatient care for substance use disorder required; charges, terms, and conditions; reduction of coverage; deductibles and copayment provisions;
§ 500.3426 Offer of wellness coverage by insurer
§ 500.3428 Provider network
§ 500.3430 Optional policy provisions; insurance commissioner’s approval
§ 500.3432 Change of occupation; optional provision
§ 500.3434 Misstatement of age; optional provision
§ 500.3436 Other insurance with same insurer; optional provision
§ 500.3438 Insurance with other insurers; optional provision; expense incurred benefits
§ 500.3440 Insurance with other insurers; other benefits
§ 500.3444 Relation of earnings to insurance; optional provision
§ 500.3446 Unpaid premium; optional provision
§ 500.3448 Cancellation; optional provision
§ 500.3450 Conformity with state statutes; optional provision
§ 500.3452 Illegal occupation or criminal activity; optional provision; definitions
§ 500.3460 Order of certain policy provisions
§ 500.3462 Third party ownership of policy
§ 500.3464 Foreign or alien insurers; provision required by other state law; domestic insurers; provision required by other state or country
§ 500.3466 Filing procedure; insurance commissioner, regulatory powers
§ 500.3468 Provisions violating code; construction of noncomplying policies and provisions
§ 500.3470 Age of insured; provision regulations
§ 500.3471 Provision and nondisclosure of large employer group claims utilization and cost information; civil liability immunity; definitions
§ 500.3472 Open enrollment period; prohibitions; establishment of reasonable periods for health insurance policies; minimum standards for frequency and duration of open enrollment periods; denial of coverage
§ 500.3474 Risk classification; rates; filing requirements
§ 500.3474a Premium rate after January 1, 2014; basis; factors
§ 500.3475 Reimbursement for services by licensed psychologist, podiatrist, or chiropractor; section inapplicable to policy involving prudent purchaser agreement
§ 500.3476 Telemedicine services; provisions; definitions
§ 500.3477 Use of financial incentive or payment to act as inducement to deny, reduce, limit, or delay services; prohibition; exception

Terms Used In Michigan Laws > Chapter 500 > Act 218 of 1956 > Chapter 34 - Disability Insurance Policies

  • Adjourn: A motion to adjourn a legislative chamber or a committee, if passed, ends that day's session.
  • Advice and consent: Under the Constitution, presidential nominations for executive and judicial posts take effect only when confirmed by the Senate, and international treaties become effective only when the Senate approves them by a two-thirds vote.
  • Affiliated provider: means a health professional, licensed hospital, licensed pharmacy, or other person that has entered into a participating provider contract, directly or indirectly, with a health maintenance organization to render 1 or more health services to an enrollee. See Michigan Laws 500.3400
  • Amendment: A proposal to alter the text of a pending bill or other measure by striking out some of it, by inserting new language, or both. Before an amendment becomes part of the measure, thelegislature must agree to it.
  • Annuity: A periodic (usually annual) payment of a fixed sum of money for either the life of the recipient or for a fixed number of years. A series of payments under a contract from an insurance company, a trust company, or an individual. Annuity payments are made at regular intervals over a period of more than one full year.
  • Appropriation: The provision of funds, through an annual appropriations act or a permanent law, for federal agencies to make payments out of the Treasury for specified purposes. The formal federal spending process consists of two sequential steps: authorization
  • Assets: (1) The property comprising the estate of a deceased person, or (2) the property in a trust account.
  • Beneficiary: A person who is entitled to receive the benefits or proceeds of a will, trust, insurance policy, retirement plan, annuity, or other contract. Source: OCC
  • Bequest: Property gifted by will.
  • Commissioner: means the director. See Michigan Laws 500.102
  • Concurrent resolution: A legislative measure, designated "S. Con. Res." and numbered consecutively upon introduction, generally employed to address the sentiments of both chambers, to deal with issues or matters affecting both houses, such as a concurrent budget resolution, or to create a temporary joint committee. Concurrent resolutions are not submitted to the President/Governor and thus do not have the force of law.
  • Continuance: Putting off of a hearing ot trial until a later time.
  • Contract: A legal written agreement that becomes binding when signed.
  • Corporation: A legal entity owned by the holders of shares of stock that have been issued, and that can own, receive, and transfer property, and carry on business in its own name.
  • Department: means the department of insurance and financial services. See Michigan Laws 500.102
  • Dependent: A person dependent for support upon another.
  • Devise: To gift property by will.
  • Director: means , unless the context clearly implies a different meaning, the director of the department. See Michigan Laws 500.102
  • Disability insurance policy: includes an insurance policy or insurance contract that insures against loss resulting from sickness or from bodily injury or death by accident, or both, including also the granting of specific hospital benefits and medical, surgical, and sick-care benefits to an individual, family, or group, subject to the exclusions provided in this section. See Michigan Laws 500.3400
  • Donor: The person who makes a gift.
  • Enrollee: means an individual who is entitled to receive health services under a health insurance contract, unless the context requires otherwise. See Michigan Laws 500.116
  • Equitable: Pertaining to civil suits in "equity" rather than in "law." In English legal history, the courts of "law" could order the payment of damages and could afford no other remedy. See damages. A separate court of "equity" could order someone to do something or to cease to do something. See, e.g., injunction. In American jurisprudence, the federal courts have both legal and equitable power, but the distinction is still an important one. For example, a trial by jury is normally available in "law" cases but not in "equity" cases. Source: U.S. Courts
  • Evidence: Information presented in testimony or in documents that is used to persuade the fact finder (judge or jury) to decide the case for one side or the other.
  • Ex officio: Literally, by virtue of one's office.
  • Fiscal year: The fiscal year is the accounting period for the government. For the federal government, this begins on October 1 and ends on September 30. The fiscal year is designated by the calendar year in which it ends; for example, fiscal year 2006 begins on October 1, 2005 and ends on September 30, 2006.
  • Fraud: Intentional deception resulting in injury to another.
  • Freedom of Information Act: A federal law that mandates that all the records created and kept by federal agencies in the executive branch of government must be open for public inspection and copying. The only exceptions are those records that fall into one of nine exempted categories listed in the statute. Source: OCC
  • Germane: On the subject of the pending bill or other business; a strict standard of relevance.
  • Gift: A voluntary transfer or conveyance of property without consideration, or for less than full and adequate consideration based on fair market value.
  • Grace period: The number of days you'll have to pay your bill for purchases in full without triggering a finance charge. Source: Federal Reserve
  • group disability insurance: means voluntary disability insurance that covers 2 or more employees or members, with or without their eligible dependents, written under a master policy issued to a governmental corporation, unit, agency, or department of a governmental entity, to a corporation, copartnership, or individual employer, or, on application of an executive officer or trustee of the association, to an association that has a constitution or bylaws and that is formed in good faith for purposes other than that of obtaining insurance, and under which officers, members, employees, or classes or departments of the association may be insured for their individual benefit. See Michigan Laws 500.607
  • Guardian: A person legally empowered and charged with the duty of taking care of and managing the property of another person who because of age, intellect, or health, is incapable of managing his (her) own affairs.
  • Health insurance policy: means an expense-incurred hospital, medical, or surgical policy, certificate, or contract. See Michigan Laws 500.608
  • Health maintenance organization: means that term as defined in section 3501. See Michigan Laws 500.106
  • in writing: shall be construed to include printing, engraving, and lithographing; except that if the written signature of a person is required by law, the signature shall be the proper handwriting of the person or, if the person is unable to write, the person's proper mark, which may be, unless otherwise expressly prohibited by law, a clear and classifiable fingerprint of the person made with ink or another substance. See Michigan Laws 8.3q
  • Indemnification: In general, a collateral contract or assurance under which one person agrees to secure another person against either anticipated financial losses or potential adverse legal consequences. Source: FDIC
  • insurance contract: means a contract of insurance, indemnity, suretyship, or annuity issued or proposed or intended for issuance by a person engaged in the business of insurance. See Michigan Laws 500.116
  • Insurance producer: means that term as defined in section 1201. See Michigan Laws 500.116
  • insured: as used in this chapter , shall not be construed as preventing a person other than the insured with a proper insurable interest from making application for and owning a policy covering the insured or from being entitled under such a policy to any indemnities, benefits and rights provided therein. See Michigan Laws 500.3462
  • Insurer: means an individual, corporation, association, partnership, reciprocal exchange, inter-insurer, Lloyds organization, fraternal benefit society, or other legal entity, engaged or attempting to engage in the business of making insurance or surety contracts. See Michigan Laws 500.106
  • Jurisdiction: (1) The legal authority of a court to hear and decide a case. Concurrent jurisdiction exists when two courts have simultaneous responsibility for the same case. (2) The geographic area over which the court has authority to decide cases.
  • Large employer: means an employer that is not a small employer as defined in section 3701. See Michigan Laws 500.116
  • Lease: A contract transferring the use of property or occupancy of land, space, structures, or equipment in consideration of a payment (e.g., rent). Source: OCC
  • Liabilities: The aggregate of all debts and other legal obligations of a particular person or legal entity.
  • month: means a calendar month; the word "year" a calendar year; and the word "year" alone shall be equivalent to the words "year of our Lord". See Michigan Laws 8.3j
  • Oversight: Committee review of the activities of a Federal agency or program.
  • Participating provider: means a provider that, under contract with an insurer that issues policies of health insurance or with such an insurer's contractor or subcontractor, has agreed to provide health care services to covered individuals and to accept payment by the insurer, contractor, or subcontractor for covered services as payment in full, other than coinsurance, copayments, or deductibles. See Michigan Laws 500.116
  • person: may extend and be applied to bodies politic and corporate, as well as to individuals. See Michigan Laws 8.3l
  • Presiding officer: A majority-party Senator who presides over the Senate and is charged with maintaining order and decorum, recognizing Members to speak, and interpreting the Senate's rules, practices and precedents.
  • Public law: A public bill or joint resolution that has passed both chambers and been enacted into law. Public laws have general applicability nationwide.
  • Quorum: The number of legislators that must be present to do business.
  • Rate: means the cost of insurance per payroll before adjustment for an individual insured's size, exposure, or loss experience. See Michigan Laws 500.2402
  • Recess: A temporary interruption of the legislative business.
  • seal: shall be construed to include any of the following:
  (a) The impression of the seal on the paper alone. See Michigan Laws 8.3n
  • Service area: means that term as defined in section 3501, unless the context requires otherwise. See Michigan Laws 500.116
  • shall not apply: means that the pertinent provision is not operative as to certain persons or things or in conjunction with a particular date or dates. See Michigan Laws 8.4c
  • state: when applied to the different parts of the United States, shall be construed to extend to and include the District of Columbia and the several territories belonging to the United States; and the words "United States" shall be construed to include the district and territories. See Michigan Laws 8.3o
  • Statute: A law passed by a legislature.
  • subscriber: means an individual who enters into an insurance contract for health insurance, or on whose behalf an insurance contract for health insurance is entered into, with an insurer. See Michigan Laws 500.116
  • Trustee: A person or institution holding and administering property in trust.
  • United States: shall be construed to include the district and territories. See Michigan Laws 8.3o