The right plan structure is the one your claims, your workforce and the rules all support.
Creative does not mean exotic. It means choosing how the plan is funded, who contributes what and which accounts sit beside it, on purpose. Here are the structures Michigan employers ask us about, and how we decide which ones fit.
Five ways to fund the medical plan
Fully Insured With a Contribution Strategy
The carrier takes the risk. Your lever is how much the company pays and how plans and tiers are structured.
Level-Funded Plans
A fixed monthly payment covers expected claims, administration and stop-loss, and unused claims may come back depending on the terms.
Self-Funded With Stop-Loss
The employer pays claims directly and buys stop-loss to cap the exposure. Claims data and cash flow decide whether it fits.
Group Captives
Employers pool stop-loss risk and share in the results. They bring more control and a longer commitment. CFH places group captives for clients.
Reference-Based Pricing
We advise on it case by case for an active plan, including the network disruption and balance-billing tradeoffs.
Six structures that sit beside or replace a group plan
ICHRA
The employer reimburses individual coverage and expenses, and can set different amounts by employee class.
QSEHRA
A reimbursement option for small employers that do not offer a group health plan.
Excepted Benefit HRA
A limited reimbursement account offered alongside a group plan.
HSA With an Employer Contribution
Pairs a qualifying high-deductible plan with an account the employer can fund.
Voluntary Benefits
Employee-paid coverage that widens choice without adding employer cost.
Retiree and Medicare HRAs
Reimbursement accounts for retirees, including those on Medicare.
How we decide which structure fits
Start With Claims and the Census
Group size, claims experience and funding type decide how much your own results should drive the choice.
Check the Compliance Rules First
Funding and account structures carry ERISA, ACA and nondiscrimination rules that have to be met from day one.
Ask Whether a PEO Fits
We advise on the pros, cons and exit issues. We do not run PEO transitions.
Plan structure questions from Michigan employers
What is a level-funded plan?
It is a self-funded arrangement with a fixed monthly payment that covers expected claims, administration and stop-loss. Depending on the terms, unused claims may be returned.
What is the difference between level-funded and self-funded?
Level-funded plans package the cost into a predictable monthly payment. Traditional self-funding varies with actual claims, and the employer manages the cash flow.
What is a group captive?
A captive lets multiple employers pool stop-loss risk and share in the results. It usually means more control and a longer commitment. CFH places group captives for clients.
What is an ICHRA?
An individual coverage HRA lets an employer reimburse employees for individual coverage and eligible expenses, with different amounts for different employee classes.
Which structure is cheapest?
There is no single answer. It depends on claims experience, group size, risk tolerance and how much volatility you can absorb. We model the options on your numbers.
Where do we start?
Send your renewal and plan summary. We review them in writing and show where a different structure could help or would not.
Ready? Send us your renewal, or talk it through with someone first. General information, not legal or tax advice.
Where these details come from.
IRS Publication 969: HSAs and other tax-favored health plans, including HRAs.
U.S. DOL: Health plans and benefits: Employer plan administration and compliance resources.
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.
An independent employee benefits consulting firm. We look at the entire benefits program: cost, plan performance, risk and administration.
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