ABA Coverage in Level-Funded Plans in Michigan
A level-funded plan can look like insurance but usually works as a self-funded plan.
What level funding means for ABA
Usually self-funded
A level-funded arrangement is generally a self-funded plan paired with stop-loss coverage, so the employer’s plan document, not the state mandate, would decide ABA coverage.
Do not assume it carries over
Because the mandate applies to insurers, coverage that looks identical to a fully insured plan may differ on ABA. Ask for the autism provision.
Read the stop-loss terms
Stop-loss contracts can exclude or limit certain claims, so check how a high-cost ABA claim would be handled.
Ask the right question
Ask whether the arrangement is a policy issued in Michigan or a self-funded plan, and ask who is responsible for autism benefits.
Back to the ABA guide.
ABA Coverage in Level-Funded Plans in Michigan: short answers
Does the mandate apply to level-funded plans?
If the plan is self-funded, no. If a licensed insurer issues a policy, it does. The structure decides, so confirm it.
Does ABA coverage show up in the summary of benefits?
It may or may not. Ask for the plan document language that addresses autism and ABA.
Who can help us compare?
We compare fully insured and level-funded options side by side, including autism provisions.
ABA Coverage in Level-Funded Plans in Michigan: not legal advice. Send us your renewal.
Where these details come from
The laws and rules named on this page link to the official text. This is general information, not legal advice, and rules change, so check the current text.
State of Michigan: Autism Legislation
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