Michigan Health Insurance

Michigan (MI)

Individual Health Insurance Regulations

Medical insurance is invaluable when it comes to assuring your family's physical well-being. In the event of unforeseen circumstances of sickness or injury, suitable health coverage can save you from unanticipated medical bills. Shopping for a policy is tedious and needs evaluation of family's medical needs and finances. If you are a Michigan resident, you can choose from wide range of product alternatives. The Michigan Office of Financial and Insurance Regulations regulates the laws under which the Michigan health insurers can sell private health insurance to individuals and families.
With the exception of policies written by Blue Cross Blue Shield of Michigan, all individual policies in Michigan may be underwritten by the insurance carriers. Blue Cross Blue Shield of Michigan individual policies must be issued on a guarantee issue basis. HMO individual medical insurance policies written during the annual open enrollment period must also be offered on a guarantee issue basis. Guarantee issue polices provide individual coverage, despite the applicants past or current health history. All medically underwritten polices are subject to carrier approval, with the insurance carrier being allowed to offer full coverage as provided under the health plan; offer coverage under the health plan with specific limitations and exclusions regarding pre-existing conditions; or denying coverage altogether based upon past and current health history. Under the medically underwritten policies, insurance carriers are permitted to review your 6-month health history and add a 12-month exclusionary period limit on pre-existing health conditions, with credit for prior coverage not being required. Blue Cross Blue Shield of Michigan is required to community rate their line of individual insurance products, with no rating restriction placed on any of the other individual insurance carriers.
Search for plans and the costs associated with them using the search box above. We provide individual, family, group and student health plan quotes for you to compare on all states and zip codes. Remember that having coverage leads to a healthier lifestyle as you are able to get regular doctor checkups and therefore a low-cost premium.

Michigan (MI)

Small Group Health Insurance Regulations

Small group medical insurance is defined as a group of employees with numbers between 2 and 50 and is written on a guaranteed issue basis. Two employees must work for at least 6 months out of the year, and work 20 hours per week to eligible for the coverage. Guarantee issue policies demand that no group may be declined coverage due to past or current medical history of its employees. With the exclusion of Blue Cross Blue Shield of Michigan and HMO plans, health insurance carriers may impose an exclusionary period for pre-existing conditions on those applicants who do not have proof of prior creditable coverage. Once eligible to join the group health plan, an employer may impose a waiting period prior to allowing you to sign up for health care coverage under the group health plan. Michigan provides for group premium rates to be medically underwritten with a rate adjustment of 45%. This means that the insurance companies may charge a higher premium to small groups with a history or current status of medical conditions but may not charge those higher risk groups more than 45% of the standard published rate. Blue Cross Blue Shield may not medically underwrite for rate adjustments but may alter rates based on the geographical location of the business with a rate adjustment factor of 35%.

Michigan COBRA and Continuation Coverage

Groups of 20 or more employees must abide by federal COBRA regulations which state that a departing employee is entitled to remain on the group health plan for a period of 18 months, provided that group health plan remains in existence. An employee who has left work on his own or was terminated from the job is eligible to be covered by COBRA unless he was fired for gross misconduct. COBRA provides health coverage to individuals and their beneficiaries, spouses and dependents. The COBRA recipient will be responsible for the payment of the entire the insurance premium that the employer was paying for his coverage as well as 2% administrative costs.
Michigan does not have a state mini-COBRA law. HIPAA-eligible Individuals opting out of a group health plan, who do not have COBRA benefits available to them may obtain guaranteed issue coverage through Blue Cross Blue Shield of Michigan. Because guaranteed issue coverage is available, Michigan does not have a high-risk pool.