What are Michigan's licensure requirements for utilization
review firms?
Michigan has no licensure requirements for utilization
review firms.
What are Michigan's licensure requirements for preferred
provider organizations (PPOs)?
Michigan does not require licensure of PPOs that
bear no insurance risk, that is PPOs that accept fee-for-service
reimbursement with no risk pooling or transfer. Licensed risk
bearers and licensed claim processors (insurers and third party
administrators) that condition the delivery of benefits upon
the use of a particular panel of healthcare providers are subject
to Michigan's Prudent Purchaser Act (PPA).
What are Michigan's licensure requirements for multiple employer
welfare arrangements (MEWAs)?
Michigan requires licensure of MEWAs that do business
with Michigan employers and are not fully insured. To obtain
licensure, a MEWA must be controlled by its members, have adequate
cash reserves, and purchase excess loss insurance. A complete
description of MEWA licensure requirements can be found in Chapter
70 or the Michigan Insurance Code.