A guide to employee health benefits, in plain language.
Employee benefits language gets thrown around loosely. This guide breaks down the terms HR teams and business owners search for most — what they mean, and how to tell if they actually fit your workforce.
HDHPs trade a lower premium for a higher deductible — and unlock the HSA.
An HDHP pairs a lower monthly premium with a higher deductible than a traditional plan, and it is the only plan type that lets employees contribute to a Health Savings Account.
How It Works
Employees pay more out of pocket before coverage kicks in, in exchange for a lower monthly premium and HSA eligibility.
Who It Fits
A good fit for a healthy, cost-conscious workforce; harder on employees who have predictable, ongoing care needs.
The most underused benefit most companies already pay for.
An EAP is a confidential, employer-paid benefit — available to employees, often their households too, at no direct cost per use.
What’s Actually Covered
Short-term counseling, legal and financial consultations, and crisis support are typical.
Why It Goes Unused
Underuse is usually a communication problem, not a design problem — employees simply do not know the benefit exists.
Fully insured, level-funded, or self-funded — the difference is who carries the risk.
How group medical coverage actually works for an employer comes down to a funding decision, before it comes down to a carrier decision.
Fully Insured
The carrier sets the rate and carries the risk. Predictable cost, least flexibility.
Level-Funded
A fixed monthly payment with a stop-loss cap; the employer can share in a good claims year.
Self-Funded
The employer pays claims directly, subject to compliance obligations like PCORI and Section 105(h) testing.
Marriage, a new job, and moving out don’t end dependent coverage — turning 26 does.
Federal law sets one bright line for when a dependent comes off a parent’s health plan, and Michigan does not extend it further than most employers assume.
The Age-26 Rule
Under the ACA, a health plan that covers dependents must keep an adult child eligible until age 26 — regardless of marital status, student enrollment, employment, or whether the dependent still lives at home. Coverage runs through the end of the month (or, on some plans, the end of the plan year) the dependent turns 26.
Michigan Follows the Federal Line
A handful of states extend dependent eligibility past 26 for adult children who are not disabled. Michigan is not one of them — the federal age-26 cutoff is the rule here, with no state add-on. The common exception: a dependent unable to support themselves due to a disability that began before the cutoff can often stay on the plan longer, under that plan’s own terms.
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.
Bloomfield Hills, MI 48304
248.370.8853
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719.425.2649
Houston, TX 77084
281.404.5670
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