Employee Benefits Questions from Michigan Employers, Answered.
The questions HR leaders and owners ask us most, grouped by topic. Each one links to the full answer, with the sources behind it. If yours is not here, send us your renewal and we will answer it for your group.
Renewals, Rates and Loss Ratio
What is a rate guarantee in health insurance?
Answered in: What Is a Rate Guarantee in Group Health Insurance?.
Can we keep the rebate?
Answered in: What Employers Do With an MLR Rebate.
What are the MLR thresholds?
Answered in: MLR Rebate Thresholds: 80 and 85 Percent.
What is the MLR rule?
Answered in: The ACA Medical Loss Ratio Rule: What Insurers Must Spend.
Does loss ratio matter more on level-funding?
Answered in: Loss Ratio on Level-Funded and Self-Funded Plans.
What does incurred mean?
Answered in: Incurred but Not Reported Claims and Your Loss Ratio.
What is pooling?
Answered in: Pooling and Large Claims in Your Loss Ratio.
What is credibility?
Answered in: Experience Rating and Credibility in a Group Renewal.
Carriers and Networks
What is a narrow network?
Answered in: Priority Health Employer Guide: Network Solutions and Renewal Questions.
Is HAP still the same company?
Answered in: Health Alliance Plan (HAP) Employer Guide: Henry Ford Health Select and 2027 Renewal Questions.
What is the difference between a BCN HMO and a BCBSM PPO?
Answered in: Blue Care Network Employer Guide: HMO Plans, Referrals and Renewal Questions.
What kinds of employer plans does BCBSM offer?
Answered in: Blue Cross Blue Shield of Michigan Employer Guide: Plans, Networks and Renewal Questions.
What is an aggregating specific deductible?
Answered in: What Is an Aggregating Specific Deductible?.
What is an embedded deductible?
Answered in: Embedded vs. Non-Embedded Deductible.
What is a POS plan?
Answered in: POS Health Plans for Employers: How They Work.
What is an EPO?
Answered in: EPO Health Plans for Employers: How They Work.
Broker and Consultant Questions
What is the difference between small group and large group?
Answered in: What We Provide Small Groups: The Details Behind Your Renewal and Plan.
What does detailed insight into my plan include?
Answered in: Detailed Insight Into What Is Going On in Your Benefit Plan.
What is a level-funded plan?
Answered in: Creative Employee Benefit Plan Structures for Michigan Employers.
Is a benefits broker automatically an ERISA fiduciary?
Answered in: Is Your Benefits Broker an ERISA Fiduciary? Employer Guide.
Does the Michigan independent review process apply to our self-funded plan?
Answered in: Michigan Independent Review of Health Claim Denials: Employer Guide.
Leave and Disability
Why align handbook and plan documents?
Answered in: Leave Policy Language: Aligning the Handbook and the Plan.
How do employees pay premiums on unpaid leave?
Answered in: Collecting Employee Premiums During Unpaid Leave.
Does using sick time affect eligibility?
Answered in: Benefit Eligibility, Waiting Periods and Leave.
Do we have to keep health insurance during FMLA?
Answered in: Group Health Coverage During FMLA Leave.
Does short-term disability cover childbirth?
Answered in: Pregnancy and Short-Term Disability: What Employers Should Know.
Are pretax disability premiums a good idea?
Answered in: Short-Term Disability Paid Pretax Through a Section 125 Plan.
Are benefits taxable if the employee pays after-tax?
Answered in: Employee-Paid Short-Term Disability: After-Tax Premiums.
Are employer-paid disability benefits taxable?
Answered in: Employer-Paid Short-Term Disability: How Benefits Are Taxed.
ACA and Compliance
What is an evidence of coverage?
Answered in: What Is an Evidence of Coverage (EOC)?.
What is the 2027 ACA affordability percentage?
Answered in: The 2027 ACA Affordability Percentage Is 10.22%: Employer Guide.
Does the ACA affordability test apply under 50 employees?
Answered in: Does the ACA affordability test apply to employers with fewer than 50 employees?.
What is the penalty for unaffordable coverage in 2027?
Answered in: What is the penalty for unaffordable coverage in 2027?.
Does the 2027 percentage apply to my plan year?
Answered in: Does the 2027 affordability percentage apply to my plan year?.
What is the 2027 ACA affordability percentage?
Answered in: What is the 2027 ACA affordability percentage?.
Who has to file Forms 1094-C and 1095-C?
Answered in: Prepare Your 1094-C and 1095-C Filings for 2027.
Why write down which safe harbor I used?
Answered in: Document Your Affordability Safe Harbor.
ICHRA, QSEHRA and HRAs
What is an individual coverage HRA?
Answered in: What Is an Individual Coverage HRA and Is It Affected by 2027 Premiums?.
What do I compare an HRA allowance with?
Answered in: Review Your HRA Allowance for 2027.
Why look at ICHRA allowances again for 2027?
Answered in: Individual Coverage HRA Allowances for 2027: Employer Guide.
Is an HSA an ERISA plan?
Answered in: Is It an ERISA Plan? HRAs, HSAs, Wellness Programs and EAPs: Employer Guide.
Benefit Terms Explained
What does AD&D stand for?
Answered in: What Is AD’D Insurance?.
What does PEPM stand for?
Answered in: What Does PEPM Mean in Employee Benefits?.
Where these details come from.
This page links to answers rather than giving them, and each linked page carries its own Sources section with the laws, rules and carrier materials it relies on. These are the main federal references behind the compliance answers.
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.