Senate Bill 1245 Summary

• Creates Chapter 37B establishing guaranteed issue health plans (standard and enhanced) that carriers must offer to Michigan residents without health-based exclusions, subject to limited exceptions for fraud, non-payment, or residency outside coverage area.

• Establishes MI-Health Board (13 members including state officials and appointed representatives from actuaries, health economists, HMOs, hospitals, and advocacy groups) to develop standard and enhanced guaranteed issue health plan designs based on January 1, 2009 market coverage levels.

• Allows board to waive certain insurance mandates (sections 3406a through 3616a) for guaranteed issue plans if real cost savings are achieved and affordability is maximized.

• Creates Health Care Affordability Fund financed by assessment fees on health care corporations equivalent to taxes they would owe if subject to Michigan business tax; fund revenues subsidize premiums for individuals with household income up to 300% of federal poverty level.

• Modifies existing HMO requirements to allow contracts under Chapter 37B to not include basic health services and permits one contract under Chapter 37A to exclude basic health services.