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SB-976, As Passed Senate, June 18, 2026
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SENATE BILL NO. 976
A bill to amend 1956 PA 218, entitled
"The insurance code of 1956,"
by amending section 2212a (MCL 500.2212a), as amended by 2023 PA
161.
THE PEOPLE OF THE STATE OF MICHIGAN ENACT:
Sec. 2212a. (1) An insurer that delivers, issues for delivery, 1
or renews in this state a health insurance policy shall provide a 2
written summary of the health insurance policy in plain English to 3
insureds. The written summary must provide a clear, complete, and 4
accurate description of all of the following, as applicable: 5
May 14, 2026, Introduced by Senators WOJNO, HERTEL, KLINEFELT, POLEHANKI, GEISS,
CAMILLERI, SANTANA, SHINK and CAVANAGH and referred to Committee on Health
Policy.
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(a) Uniform definitions of standard insurance terms and 1
medical terms so that a consumer may compare health coverage and 2
understand the terms of, or exceptions to, the consumer's coverage, 3
in accordance with the most recent guidance issued by the United 4
States Department of Health and Human Services. 5
(b) A description of the coverage, including cost sharing, for 6
each category of benefits in the most recent guidance issued by the 7
United States Department of Health and Human Services. 8
(c) The exceptions, reductions, and limitations of the health 9
insurance policy. 10
(d) The cost-sharing provisions of the coverage, including 11
deductible, coinsurance, and copayment obligations. 12
(e) The renewability and continuation of coverage provisions. 13
(f) Coverage examples. 14
(g) A statement about whether the health insurance policy 15
provides minimum essential coverage as defined under section 16
5000A(f) of the internal revenue code of 1986, 26 USC 5000A, and 17
whether the health insurance policy's share of the total allowed 18
costs of benefits provided under the health insurance policy meets 19
applicable requirements. 20
(h) A statement that the summary is only a summary and that 21
the health insurance policy should be consulted to determine the 22
governing contractual provisions of the coverage. 23
(i) Contact information for questions. 24
(j) An internet web address where a copy of the actual 25
individual coverage policy or group certificate of coverage can be 26
reviewed and obtained. 27
(k) For insurers that maintain 1 or more networks of 28
providers, instructions for obtaining a list of network providers. 29
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(l) For insurers that use a formulary in providing prescription 1
drug coverage, instructions for obtaining information on 2
prescription drug coverage. 3
(m) Instructions for obtaining the uniform glossary, as 4
described in subdivision (c), (a), and a contact telephone number 5
to obtain a paper copy of the uniform glossary, and a disclosure 6
that paper copies are available. 7
(n) As directed by the department, any other information 8
required by the exchange created under the Michigan health 9
insurance exchange act. 10
(2) An insurer, or a group health plan to the extent the group 11
health plan has contractually agreed to distribute the written 12
summary under subsection (1), shall provide the written summary 13
under subsection (1) as follows: 14
(a) To the applicant not later than 7 business days after the 15
date of the receipt of the application. 16
(b) By the first date of coverage if the information provided 17
at the time of application has changed. 18
(c) To the insured not later than 30 days after the effective 19
date of a renewal of the policy. 20
(d) On request of the insured, not later than 7 days after the 21
request. 22
(3) An insurer shall provide on request to insureds covered 23
under a policy issued under section 3405 a clear, complete, and 24
accurate description of any of the following information that has 25
been requested: 26
(a) The current provider network in the service area, 27
including names and locations of affiliated or participating 28
providers by specialty or type of practice, a statement of 29
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limitations of accessibility and referrals to specialists, and a 1
disclosure of which providers will not accept new subscribers. 2
(b) The professional credentials of affiliated or 3
participating providers, including, but not limited to, affiliated 4
or participating providers who are board certified in the specialty 5
of pain medicine and the evaluation and treatment of pain and have 6
reported that certification to the insurer, including all of the 7
following: 8
(i) Relevant professional degrees. 9
(ii) Date of certification by the applicable nationally 10
recognized boards and other professional bodies. 11
(iii) The names of licensed facilities on the provider panel 12
where the provider currently has privileges for the treatment, 13
illness, or procedure that is the subject of the request. 14
(c) The licensing verification telephone number for the 15
department of licensing and regulatory affairs that can be accessed 16
for information as to whether any disciplinary actions or open 17
formal complaints have been taken or filed against a health care 18
provider in the preceding 3 years. 19
(d) Any prior authorization requirements and any limitations, 20
restrictions, or exclusions, including, but not limited to, drug 21
formulary limitations and restrictions by category of service, 22
benefit, and provider, and, if applicable, by specific service, 23
benefit, or type of drug. 24
(e) The financial relationships between the insurer and any 25
closed provider panel, including all of the following as 26
applicable: 27
(i) Whether a fee-for-service arrangement exists, under which 28
the provider is paid a specified amount for each covered service 29
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rendered to the participant. 1
(ii) Whether a capitation arrangement exists, under which a 2
fixed amount is paid to the provider for all covered services that 3
are or may be rendered to each covered individual or family. 4
(iii) Whether payments to providers are made based on standards 5
relating to cost, quality, or patient satisfaction. 6
(f) A telephone number and address to obtain from the insurer 7
additional information concerning the items described in 8
subdivisions (a) to (e). 9
(4) On request, any of the information provided under 10
subsection (3) must be provided in writing. An insurer may require 11
that a request under subsection (2) be submitted in writing. 12
(5) A health insurer shall not deliver or issue for delivery a 13
policy of insurance to any person in this state unless all of the 14
following requirements are met: 15
(a) The style, arrangement, and overall appearance of the 16
policy do not give undue prominence to any portion of the text. 17
Every printed portion of the text of the policy and of any 18
endorsements or attached papers must be plainly printed in light-19
faced type of a style in general use, the size of which must be 20
uniform and not less than 10-point with a lowercase unspaced 21
alphabet length, not less than 120-point in length of line. As used 22
in this subdivision, "text" includes all printed matter except the 23
name and address of the insurer, the name or title of the policy, 24
the brief description, if any, and captions and subcaptions. 25
(b) Except as otherwise provided in this subdivision or except 26
as provided in sections 3406 to 3452, exceptions and reductions of 27
indemnity are set forth in the policy and are printed, at the 28
insurer's option, with the benefit provision to which they apply or 29
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under an appropriate caption such as "EXCEPTIONS" or "EXCEPTIONS 1
AND REDUCTIONS". If an exception or reduction of indemnity 2
specifically applies only to a particular benefit of the policy, a 3
statement of the exception or reduction must be included with the 4
benefit provision to which it applies. 5
(c) Each form, including riders and endorsements, is 6
identified by a form number in the lower left-hand corner of the 7
first page of the form. 8
(d) The policy contains no provision that purports to make any 9
portion of the charter, rules, constitution, or bylaws of the 10
insurer a part of the policy unless the portion is set forth in 11
full in the policy. This subdivision does not apply to the 12
incorporation of or reference to a statement of rates, 13
classification of risks, or short-rate table filed with the 14
director. 15
(6) Subject to section 2266, the information required under 16
this section may be provided electronically. 17
(7) As used in this section, "board certified" means certified 18
to practice in a particular medical or other health professional 19
specialty by the American Board of Medical Specialties, the 20
American Osteopathic Association Bureau of Osteopathic Specialists, 21
or another appropriate national health professional organization. 22
Enacting section 1. This amendatory act does not take effect 23
unless Senate Bill No. 973 of the 103rd Legislature is enacted into 24
law. 25