§ 500.3801 Chapter; definitions
§ 500.3803 Applicability of chapter
§ 500.3804 Applicability of chapter
§ 500.3805 Medicare supplement policy; definitions
§ 500.3807 Basic core package of benefits; standards for plans K and L; applicability of section
§ 500.3807a Medicare supplement policies or certificates with effective date for coverage on or after June 1, 2010; basic core package of benefits
§ 500.3808 Medicare supplement insurance policy; availability of benefits in MCL 500.3811(5)(c) or 500.3811a(6)(c)
§ 500.3809 Additional benefits; reimbursement for preventive screening tests and services; definitions; applicability of section
§ 500.3809a Medicare supplement policies or certificates with effective date for coverage on or after June 1, 2010; additional benefits
§ 500.3811 Basic core benefits; availability; sale of certain benefits prohibited; designations, structure, language, and format; other designations; requirements; applicability of section
§ 500.3811a Medicare supplement policies or certificates with effective date for coverage on or after June 1, 2010; basic core benefits; availability; sale of certain benefits prohibited; structure, language, des
§ 500.3813 Disability coverage; medicare supplement buyer’s guide; applicability of section
§ 500.3815 Outline of coverage; acknowledgment of receipt; compliance with notice requirements; substitute; language, format, and required items
§ 500.3817 Medicare select policies and certificates; definitions; requirements for issuance; plan of operation; filing, format, and contents; proposed changes; updated list of network providers; payment for cov
§ 500.3819 Minimum standards; suspension of benefits and premiums; notice; reinstitution; offer to exchange 1990 standardized plan to 2010 plan
§ 500.3819a Medicare supplement policies or certificates with effective date for coverage on or after June 1, 2010; minimum standards
§ 500.3821 Issuance of policy to person not enrolled in medicare parts A and B prohibited; refund; interest
§ 500.3823 Covered benefits more restrictive than benefits under medicare and required under state law prohibited; benefits for outpatient prescription drugs
§ 500.3825 Preexisting diseases or conditions; waiver prohibited
§ 500.3827 Duplicate benefits prohibited; application; statements and questions whether another policy in force; list of policies sold to applicant; notice regarding replacement coverage
§ 500.3829 Denying or conditioning issuance based on health status, claims experience, receipt of health care, or medical condition of applicant prohibited; condition; exclusion of benefits based on preexisting
§ 500.3829a Medicare supplement policies or certificates delivered, issued for delivery, or renewed on or after May 21, 2009; genetic test; definitions
§ 500.3830 Eligible person; requirements
§ 500.3830a Termination of contract or agreement; notice to individual
§ 500.3831 Individual or group expense incurred hospital, medical, or surgical policies; right of continuation, conversion, or type C medicare supplemental package; request for coverage; exclusion from preexisti
§ 500.3833 Replacement policy; waiver of certain time periods
§ 500.3835 Marketing procedures; determining appropriateness of recommended purchase or replacement; more than 1 policy prohibited; individual enrolled in medicare advantage; “notice to buyer” displayed
§ 500.3839 Renewal or continuation provision; effect of termination or replacement; elimination of outpatient prescription drug benefit
§ 500.3841 Riders or endorsements; signed acceptance or agreement; additional premium; use of certain standards, terms, and words; filing of changes in medicare benefits; elimination of duplicate benefits; notic
§ 500.3843 Disability insurance; notice; contents; applicability of subsection (1)
§ 500.3847 Advertising; filing copy with commissioner
§ 500.3849 Filing and approval requirements; deletion of outpatient prescription drug benefits; issuance of policy; use and change in premium rates; additional forms; availability; conditions and effect of disco
§ 500.3851 Aggregate benefits; rates, rating schedules, and rate revisions
§ 500.3852 Benchmark ratio
§ 500.3853 Refund or credit calculation; form; interest; due date
§ 500.3855 Annual filing of rates, rating schedule, and supporting documentation; premium adjustments; public hearing for rate increase; failure to make premium adjustments
§ 500.3857 Duties of insurer; certification of compliance with subsection (1)(a)
§ 500.3859 Prohibited conduct; violation as misdemeanor; penalty
§ 500.3861 Probable cause of violation; notice of hearing; opportunity to confer and discuss; hearing; applicability of MCL 500.2038 to 500.2040; violation; penalty

Terms Used In Michigan Laws > Chapter 500 > Act 218 of 1956 > Chapter 38

  • 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.
  • Answer: The formal written statement by a defendant responding to a civil complaint and setting forth the grounds for defense.
  • Applicant: means :

    (i) For an individual medicare supplement policy, the person who seeks to contract for benefits. See Michigan Laws 500.3801

  • 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
  • Bankruptcy: means when a medicare advantage organization that is not an insurer has filed, or has had filed against it, a petition for declaration of bankruptcy and has ceased doing business in this state. See Michigan Laws 500.3801
  • 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
  • Certificate: means any certificate delivered or issued for delivery in this state under a group medicare supplement policy. See Michigan Laws 500.3801
  • Certificate form: means the form on which the certificate is delivered or issued for delivery by the insurer. See Michigan Laws 500.3801
  • Commissioner: means the director. See Michigan Laws 500.102
  • Complaint: A written statement by the plaintiff stating the wrongs allegedly committed by the defendant.
  • Continuous period of creditable coverage: means the period during which an individual was covered by creditable coverage, if during the period of the coverage the individual had no breaks in coverage greater than 63 days. See Michigan Laws 500.3801
  • 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.
  • Creditable coverage: means coverage of an individual provided under any of the following:

    (i) A group health plan. See Michigan Laws 500.3801

  • Department: means the department of insurance and financial services. See Michigan Laws 500.102
  • Direct response solicitation: means solicitation in which an insurer representative does not contact the applicant in person and explain the coverage available, such as, but not limited to, solicitation through direct mail or through advertisements in periodicals and other media. See Michigan Laws 500.3801
  • Employee welfare benefit plan: means a plan, fund, or program of employee benefits as defined in section 3 of subtitle A of title I of the employee retirement income security act of 1974, 29 USC 1002. See Michigan Laws 500.3801
  • 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
  • Entitlement: A Federal program or provision of law that requires payments to any person or unit of government that meets the eligibility criteria established by law. Entitlements constitute a binding obligation on the part of the Federal Government, and eligible recipients have legal recourse if the obligation is not fulfilled. Social Security and veterans' compensation and pensions are examples of entitlement programs.
  • 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.
  • 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 324.51502
  • Insolvency: means when an insurer licensed to transact the business of insurance in this state has had a final order of liquidation entered against it with a finding of insolvency by a court of competent jurisdiction in the insurer's state of domicile. See Michigan Laws 500.3801
  • 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
  • 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
  • Insurer: includes any entity, including a health care corporation operating pursuant to the nonprofit health care corporation reform act, 1980 PA 350, MCL 550. See Michigan Laws 500.3801
  • Interest rate: The amount paid by a borrower to a lender in exchange for the use of the lender's money for a certain period of time. Interest is paid on loans or on debt instruments, such as notes or bonds, either at regular intervals or as part of a lump sum payment when the issue matures. Source: OCC
  • 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.
  • Medicaid: means title XIX of the social security act, 42 USC 1396 to 1396v. See Michigan Laws 500.3801
  • Medicare: means title XVIII of the social security act, 42 USC 1395 to 1395hhh. See Michigan Laws 500.3801
  • Medicare advantage: means a plan of coverage for health benefits under medicare part C as defined in section 12-2859 of part C of medicare, 42 USC 1395w-28, and includes any of the following:

    (i) Coordinated care plans that provide health care services, including, but not limited to, health maintenance organization plans with or without a point-of-service option, plans offered by provider-sponsored organizations, and preferred provider organization plans. See Michigan Laws 500.3801

  • Medicare supplement policy: means an individual, nongroup, or group policy or certificate that is advertised, marketed, or designed primarily as a supplement to reimbursements under medicare for the hospital, medical, or surgical expenses of persons eligible for medicare and medicare select policies and certificates under section 3817. See Michigan Laws 500.3801
  • Misdemeanor: Usually a petty offense, a less serious crime than a felony, punishable by less than a year of confinement.
  • 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 324.30501
  • PACE: means a program of all-inclusive care for the elderly as described in the social security act. See Michigan Laws 500.3801
  • person: may extend and be applied to bodies politic and corporate, as well as to individuals. See Michigan Laws 324.30503
  • Policy form: means the form on which the policy or certificate is delivered or issued for delivery by the insurer. See Michigan Laws 500.3801
  • Probable cause: A reasonable ground for belief that the offender violated a specific law.
  • 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
  • Recourse: An arrangement in which a bank retains, in form or in substance, any credit risk directly or indirectly associated with an asset it has sold (in accordance with generally accepted accounting principles) that exceeds a pro rata share of the bank's claim on the asset. If a bank has no claim on an asset it has sold, then the retention of any credit risk is recourse. Source: FDIC
  • Remainder: An interest in property that takes effect in the future at a specified time or after the occurrence of some event, such as the death of a life tenant.
  • Rescission: The cancellation of budget authority previously provided by Congress. The Impoundment Control Act of 1974 specifies that the President may propose to Congress that funds be rescinded. If both Houses have not approved a rescission proposal (by passing legislation) within 45 days of continuous session, any funds being withheld must be made available for obligation.
  • Restitution: The court-ordered payment of money by the defendant to the victim for damages caused by the criminal action.
  • seal: shall be construed to include any of the following:

    (a) The impression of the seal on the paper alone. See Michigan Laws 324.30505

  • Secretary: means the secretary of the United States department of health and human services. See Michigan Laws 500.3801
  • Service area: means that term as defined in section 3501, unless the context requires otherwise. See Michigan Laws 500.116
  • Service of process: The service of writs or summonses to the appropriate party.
  • Settlement: Parties to a lawsuit resolve their difference without having a trial. Settlements often involve the payment of compensation by one party in satisfaction of the other party's claims.
  • Social security act: means the social security act, 42 USC 301 to 1397jj. See Michigan Laws 500.3801
  • 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 324.51501
  • United States: shall be construed to include the district and territories. See Michigan Laws 324.51501
  • User fees: Fees charged to users of goods or services provided by the government. In levying or authorizing these fees, the legislature determines whether the revenue should go into the treasury or should be available to the agency providing the goods or services.