Michigan House Bill 6237 amends the Publicly Funded Health Insurance Contribution Act to modify how public employers pay for employee medical benefits. The bill retains existing options that cap employer contributions at specific dollar amounts or limit them to 80% of total plan costs, with annual adjustments based on healthcare inflation. Starting in 2027, the legislation introduces new requirements mandating that public employers pay a minimum amount toward these plans, effectively establishing a floor for employer contributions rather than just a ceiling. These changes apply to state and local government employees and elected officials, while existing collective bargaining agreements are generally exempt until they expire or are renegotiated.
This bill requires health insurance plans in Michigan to count payments made by patients or on their behalf toward out-of-pocket maximums and cost-sharing requirements for prescription drugs. The rule applies to both standard plans and high-deductible plans, with a specific exception for high-deductible plans where counting such payments would disqualify a patient's health savings account. The legislation takes effect for policies delivered, issued, or renewed in the state after December 31, 2025.
This bill requires health insurance policies in Michigan to cover the diagnosis, treatment, and prevention of pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections and pediatric acute onset neuropsychiatric syndrome. It mandates that insurers provide these benefits without higher copayments or deductibles than other covered services and prohibits denying coverage based on a patient's medical history or previous use of different diagnostic names. Additionally, the legislation sets specific rules for timely authorization, limits on lifetime coverage, and the use of standardized medical codes for billing purposes.
This bill requires health insurance companies in Michigan that cover prescription drugs to also provide epinephrine at no cost to the insured. The law applies to insurers delivering, issuing, or renewing health policies within the state and mandates that they include this specific medication without charging the patient. By adding a new section to the state's insurance code, the measure ensures immediate coverage for emergency allergy medication as part of existing drug benefits.
This bill requires health insurers in Michigan to treat the closure or removal of a health system from their network as a significant event affecting coverage. It allows individuals with group disability insurance to cancel their policies without penalty if a network health system is shut down or dropped, and it mandates that insurers offer replacement coverage to those displaced by such changes. Additionally, the law ensures that any deductibles or out-of-pocket maximums paid under the original policy are credited toward the new policy. A "health system" is defined broadly to include hospitals, physician practices, and other related healthcare facilities under common ownership or control.
This bill requires health insurance companies in Michigan to limit the co-pay or coinsurance for insulin to no more than $35 per 30-day supply. The rule applies to at least one product within each major type of insulin, including rapid-acting, long-acting, and premixed varieties, and prevents insurers from bypassing this limit by raising costs elsewhere or changing benefit categories. While the $35 cap is set as a maximum, insurers are allowed to charge less, and the limit only applies to insulin products; other medical costs can remain higher. The amount will be automatically adjusted each July starting in 2027 based on changes in the local Consumer Price Index.
This bill requires health insurance companies in Michigan to cover prescription inhalers for asthma and other serious breathing conditions without charging the patient. It specifically prohibits insurers from denying or limiting coverage based on how often a patient needs to refill their inhaler, as long as a doctor has prescribed the medication. The law defines covered devices to include metered-dose inhalers, nebulizers, and dry powder inhalers, while excluding over-the-counter temporary relief products. By mandating that these prescriptions be provided at no cost to the insured, the legislation ensures immediate access to necessary life-saving medication for those with life-threatening bronchial ailments.
This bill requires health insurance companies in Michigan to cover insulin and specific diabetes-related devices without charging patients any cost-sharing fees. The law explicitly removes deductibles, copayments, coinsurance, and other out-of-pocket expenses for these items, ensuring they are fully paid by the insurer. It applies to all policies that are delivered, issued, or renewed within the state, directly affecting both insurance providers and insured individuals with diabetes. The provision covers essential supplies such as blood glucose test strips, glucometers, lancets, and insulin syringes alongside insulin itself.
This bill requires health insurance plans in Michigan to count payments made by patients or on their behalf toward meeting out-of-pocket maximums and cost-sharing limits for prescription drugs. It applies to both standard plans and high-deductible health plans, though it includes a specific rule for high-deductible plans to ensure compliance with federal health savings account regulations. The law takes effect for policies delivered, issued, or renewed after December 31, 2025, and explicitly defers to federal law if any conflict arises.
This bill requires health insurers in Michigan to treat the closure or removal of a health system from their network as a qualifying event for a special enrollment period. Under this rule, individuals who lose access to their current doctors or hospitals due to these changes would be allowed to sign up for new health insurance plans outside of the usual annual open enrollment window. The legislation defines a "health system" broadly to include hospitals, physician practices, and other related care facilities that operate under common ownership or control. By codifying this requirement, the bill aims to ensure that people can maintain continuous coverage when their existing healthcare options are no longer available.
