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HB 6030

Insurance: health insurers; closure or removal of health system from an insurer's network; establish procedures. Amends 1956 PA 218 (MCL 500.100 - 500.8302) by adding sec. 3406uu.

2025-2026 Regular Session Introduced by Matt Koleszar and 5 co-sponsors

The bill lets health-system closures/removals count as special enrollment events for Michigan group disability policies, with options to switch plans and credits for prior costs.

bill electronically reproduced 06/02/2026
#insurance:healthbenefits #insurance:healthinsurers
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Bill Summary · HB 6030

Summary of HB 6030 (Michigan 2025-2026)

Purpose and intent

HB 6030 adds a new section (3406uu) to the Michigan Insurance Code (1956 PA 218) to address how health system closures or removals from an insurer’s network affect group disability insurance policies. The bill establishes special enrollment and policy-termination rights for insured individuals when a health system in the insurer’s network closes or is removed, and it requires insurers to offer comparable coverage and credit prior out-of-pocket costs in certain scenarios. The aim is to protect insured individuals from penalties or loss of coverage when network changes impact access to a health system.

Key provisions

  1. Special enrollment and qualifying events (for group disability policies)

    • An insurer that sells, issues for delivery, or renews group disability policies in Michigan must treat the closure of a health system or removal of a health system from its network as a qualifying event for a special enrollment period.
    • This aligns with federally defined special enrollment triggers (45 CFR 155.420).

  2. Right to terminate without penalty

    • An insured may terminate their group disability policy without penalty if a health system in the insurer’s network is closed or removed from the network.

  3. Right to obtain a policy from another insurer

    • If a health system closure/removal impacts an insured under another insurer’s network, the insured is eligible to be offered a group disability policy by the insurer, even under the circumstances described.

  4. Credit for prior out-of-pocket costs

    • If the insured accepts a new group disability policy under the circumstances described (i.e., after a network change affecting a health system), the insurer must credit the insured for any deductibles or out-of-pocket maximums previously paid under the prior insurer’s policy.

  5. Definitions (for clarity)

    • Health system: An entity or affiliated group under common ownership/governance/control that operates or manages one or more hospitals and may include physician practices, outpatient facilities, long‑term care facilities, laboratories, and other health-care‑related operations.
    • Qualifying event: As defined in 45 CFR 155.420 (federal definitions used for special enrollment).
    • Special enrollment period: As defined in 45 CFR 155.420 (federal definitions used for special enrollment).

Who is affected

  • Primary audience: Insurers issuing group disability insurance policies in Michigan.
  • Covered individuals: Enrollees in group disability plans who are impacted by health system closures or removals from insurer networks.
  • Potential beneficiaries: Individuals seeking continuity of coverage or favorable transition terms after a health system departure from a network, including those switching carriers.

Procedural and timeline aspects

  • The bill creates a new enacted section (3406uu) to be applied to group disability policies delivered, issued for delivery, or renewed in Michigan.
  • It relies on federal definitions for “qualifying event” and “special enrollment period” (45 CFR 155.420), signaling alignment with federal standards.
  • The bill does not specify exact implementation dates beyond enactment; more detail would likely come from the bill’s effective date and any subsequent administrative guidance.

Potential impacts and considerations

  • Consumer protections: Provides clearer rights to enroll or switch plans without penalties when a health system changes network status, potentially reducing gaps in coverage.
  • Financial considerations: The credit for prior deductibles or out-of-pocket costs eases transitions between plans, mitigating double payment burdens.
  • Market effect: Insurers may adjust enrollment processes to accommodate these special enrollment triggers and ensure timely notice when a health system changes status in-network.
  • Federal alignment: Uses federal definitions for qualifying events and special enrollment, which may aid consistency with Marketplace or group insurance practices.

Sponsorship

  • Primary sponsor: Rep. Jason Morgan
  • Co-sponsors: Jaz Martus, Carrie Rheingans, Matt Koleszar, Regina Weiss, Matt Longjohn

This summary captures the bill’s core objectives and provisions. For a complete understanding, readers should consult the bill text and any fiscal analyses or committee reports as the bill progresses.

Compiled from official sources — confirm details with the bill’s official record.

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