Insurance: health benefits; certification for qualified health plan and qualified dental plan; provide for. Amends 1956 PA 218 (MCL 500.100 - 500.8302) by adding sec. 3406mm. TIE BAR WITH: SB 0973'26

2025-2026 Regular Session Introduced by Darrin Camilleri and 9 co-sponsors

The bill would let Michigan certify health and dental plans through the state exchange, with rules to align certification with federal standards.

referred to Committee on Insurance

#insurance:exchanges #insurance:healthbenefits

Summary of SB 975 (2025-2026, Michigan)

Purpose and intent

SB 975 would amend the Michigan Insurance Code to formalize state-level certification of health-related plans.

The bill authorizes the director of the state insurance regulator to contract with the Michigan Health Insurance Exchange Act’s exchange to certify two types of plans: qualified health plans and qualified dental plans.

The enactment is contingent on the passage of SB 973 in the 103rd Legislature.

Key provisions and changes

Section 3406mm (newly added):

The director shall contract with the exchange established by the Michigan Health Insurance Exchange Act to certify:
- Qualified health plans (QHPs)
- Qualified dental plans
The director shall, by rule, establish criteria for certifying QHPs and qualified dental plans under federal law.
The section preserves the director’s broader authority to regulate the business of insurance in Michigan and to require compliance with applicable federal and state laws, even for certified plans.
Definitions:
- “Qualified dental plan” = as defined in section 103 of the Michigan Health Insurance Exchange Act.
- “Qualified health plan” = as defined in section 1261 of the same act.

Enacting clause clarifies that this act takes effect only if SB 973 (also relating to the exchange) becomes law.

Affected entities and stakeholders

Michigan Department of Insurance and Financial Services (the director) would gain authority to contract with the state health insurance exchange for certification functions.

Qualified health plans (QHPs) and qualified dental plans operating in Michigan would be subject to certification criteria set by the director and exchange rules.

Individuals and small employers seeking or purchasing QHPs and qualified dental plans may be affected by the certification standards and potential market changes tied to certified plans.

Providers and carriers offering or aspiring to offer QHPs/dental plans could be impacted by the compliance requirements and any subsequent rule changes.

Procedural and timeline aspects

The bill creates a prerequisite linkage to SB 973; it does not take effect unless SB 973 is enacted into law.

Implementation would occur through future rulemaking by the director, establishing the certification criteria aligned with federal requirements.

The governance mechanism relies on a contract between the state regulator and the Michigan Health Insurance Exchange Act’s exchange.

Potential impacts and considerations

Institutional: Clarifies and centralizes certification responsibilities for health and dental plans through the state exchange mechanism.

Regulatory: Introduces rulemaking to define certification criteria, ensuring consistency with federal standards.

Market: Could influence which plans qualify for sale or participation in the Michigan exchange, potentially affecting plan availability and consumer choice.

Compliance: Maintains broad authority for the director to regulate insurance and enforce applicable laws, ensuring that certified plans remain compliant.

Note: Because the enacted provisions hinge on SB 973, a companion bill, the full scope and timing of effective changes will depend on the passage and final language of that related measure.