Group Health Plans for Employees in Several States
When employees live or travel outside Michigan, a regional network that works well at home may leave them with little in network elsewhere. The answer is usually a national network, or a regional carrier with a partner network behind it.
Three ways to cover a multi-state workforce
A National Carrier
A national network follows employees across states under one plan.
A Regional Carrier With a Partner Network
Some Michigan carriers partner with national carriers. Priority Health and Cigna, for example, share networks.
A Mix by Location
Some employers use different arrangements for different groups, at the cost of more administration.
Four tests
Where Employees Actually Live
Map every employee and dependent by ZIP code and state.
Dependents Away From Home
College students and remote family members need coverage where they live.
Travelers
Frequent travelers need urgent and emergency coverage, and sometimes routine care, outside the home area.
Claims and ID Cards
Confirm whose card employees carry and where claims go.
An illustration of how this plays out
This is a composite example to show the reasoning, not a description of a specific client.
The situation
An employer with remote employees in several states was on a regional plan with limited out-of-state access.
What we did
We mapped where employees and dependents lived and compared a national network, a regional carrier with a partner network, and a mix by location.
What changed
The group chose an arrangement that covered out-of-state employees without paying for national breadth it did not need in Michigan.
Looking at where claims actually happen.
The simplest test for a multi-state workforce is geographic. List where employees and dependents live, where they work and where they travel, then compare the list to each network. Gaps tend to appear in the places you would not think of first, such as a dependent at college or an employee who works remotely from another state.
Cost and administration enter the decision too. A national carrier can simplify matters but may price differently from a Michigan-focused one, and a mix by location adds work for HR. Weigh the number of employees affected, the likelihood of their needing care and how much complexity your team can handle. Confirm network details with the carriers.
Questions for a multi-state workforce
Where do employees and dependents actually live?
Use ZIP codes, not just the employer’s state of record.
What is covered away from home?
Routine, urgent and emergency care can each be handled differently.
Whose ID card do they carry?
Partner arrangements can change the logo on the card and where claims go.
What does administration look like?
A mix by location means more than one plan to manage.
How do we handle remote employees in other states?
Check that the carrier is licensed and the network is available in that state. Some arrangements have restrictions on where the group can be located, so ask early.
Does state of residence change the rules?
It can affect which laws and rates apply. Ask your advisor and the carrier about the states where your employees live.
Questions we get
Does a national network cost more?
Not always. Network breadth is one factor among several in price.
How do dependents away at college get covered?
It depends on the plan and network. We confirm this before you choose.
What is the Priority Health and Cigna alliance?
A network partnership for employer-sponsored group plans. See our guide to it.
Is a national network always the answer?
No. Breadth that employees do not use is cost without value.
What about employees who move?
Plan rules differ on moves between states. We confirm them before you choose.
The law behind this page.
Public Health Service Act section 2715 (42 U.S.C. § 300gg-15), Summary of Benefits and Coverage; Michigan Department of Insurance and Financial Services.
Send us your renewal.
We’ll tell you whether it looks competitive, where we see opportunity, and the five questions we’d put to your carrier. No cost, and no obligation to move anything.
The renewal letter
Your current plan summary
Contribution split by tier
Enrolled counts by tier
Four documents — two more if your group is 50 or more. Nothing else; every extra one is a reason to postpone.
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