Group Health Insurance in Michigan: Plans, Funding Options and Carrier Guides
This page is the map. Choose how the plan is funded, which carrier fits, and what the rules require, then follow the guide that goes deep. We are an independent Michigan advisory firm that shops the market, runs the renewal and handles compliance.
How the Plan Is Funded
The funding structure decides who carries the claims risk. It is the first decision in any renewal.
Compare Funding Options
Fully insured, level-funded and self-funded side by side.
Fully Insured Group Health Insurance
The carrier takes the risk for a fixed premium.
Level-Funded Health Plans
A fixed monthly payment with a chance of a refund.
Self-Funded Health Plans
The employer funds claims and controls the plan.
ASO Health Plans
Administrative services without insurance risk.
Self-Funded vs Fully Insured Calculator
Test the numbers for your own group.
Protecting and Managing a Self-Funded Plan
Taking on risk only works with protection and discipline around it.
Stop-Loss Insurance
How stop-loss limits an employer's exposure.
Stop-Loss Negotiation
Where the leverage is at placement and renewal.
Group Captives
Sharing stop-loss risk across a group of employers.
Reference-Based Pricing
Paying providers on a Medicare-based reference.
High-Cost Claimant Management
Handling the claims that drive cost.
Choosing a TPA
What to look for in a claims administrator.
Michigan Carrier Guides
We quote matching plan designs across carriers and compare price, network and renewal history.
Blue Cross Blue Shield of Michigan
When Blue wins and when it does not.
Priority Health
Where it fits and what we test.
Health Alliance Plan (HAP)
A Southeast Michigan option tied to Henry Ford Health.
McLaren Health Plan
A regional option tied to McLaren Health Care.
Plans by Company Size and Situation
Different groups need different answers.
Small Group Health Insurance
Coverage for smaller employers.
Companies With 2 to 50 Employees
What matters at this size.
Companies With 51 to 249 Employees
Where funding choices open up.
Retiree Medical Benefits
Coverage for retirees and Medicare coordination.
Association Plans and MEWAs
How multi-employer arrangements work.
Michigan Health Insurance Broker
How we work with Michigan employers.
Rules Every Plan Sponsor Has to Follow
Compliance is part of the work, not an add-on.
Compliance Overview
What we track for employers.
Medicare Rules for Employer Plans
Coordinating group coverage with Medicare.
ERISA Preemption
Why state and federal rules differ by funding type.
Transparency in Coverage
Machine-readable file requirements.
Michigan Prompt Pay Rules
How claim payment timing works.
Summary Plan Description vs Benefits Guide
Why the two documents are not the same.
Which Path Fits Your Group
Most employers fall into one of these situations. Start with the one that sounds most like yours.
You Want Predictability and Simplicity
Start with the fully insured guide and compare carriers on matching designs.
Your Claims Have Been Favorable
Read about level-funded plans and test the numbers in the calculator.
You Want Control and Transparency
Study self-funded plans, stop-loss and group captives.
Your Renewal Just Arrived and It Is High
Send it to us through our renewal form for a second opinion before you accept it.
The Group Health Planning Calendar
The employers that manage cost best treat benefits as a year-round program.
Months 1 to 3: Review Results
Look at last year's claims, utilization and employee feedback, and set goals for the next plan year.
Months 4 to 6: Strategy and Funding
Decide whether the current funding structure still fits and what plan design changes to test.
Months 7 to 9: Market and Renewal
Collect renewals, quote the market and compare carriers and structures.
Months 10 to 12: Implement and Communicate
Finalize the decision, run open enrollment and confirm compliance filings and disclosures.
Laws and rules referenced
29 U.S.C. § 1001 et seq. (ERISA) — Employee Retirement Income Security Act: reporting, disclosure and fiduciary rules for employer-sponsored benefit plans.
This page is general information, not legal or tax advice. Rules change and facts matter, so confirm your situation with counsel or a qualified advisor.
Not sure where to start? Send us your renewal
Send us your renewal or book a 30-minute call, and we will tell you which of these paths fits your group. Our office is at 41000 Woodward Avenue, Suite 350 East, Bloomfield Hills, MI 48304. Call 248.370.8853.
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