Multi-state & multinational

The network gets thin the moment you hire outside your home market.

A plan that works well in one metro can be close to unusable two states away, and nothing in the renewal paperwork will tell you. Employees discover it instead, one at a time, when the nearest in-network specialist is ninety minutes from home. We are licensed in twenty-six states, with offices in Michigan, Colorado and Texas, and we place coverage for employees working outside the United States.

Tell us where your people are

What follows the employee

Compliance applies where the work happens, not where the headquarters sits.

This is the principle employers most often get wrong, and it is the one that creates real exposure. Hiring one person in another state can import that state’s rules into your plan and your payroll without anyone deciding to take them on.

State continuation rules

Some states extend continuation rights beyond federal COBRA, particularly for employers too small to be subject to COBRA at all. Others do not. Michigan, for example, has no state mini-COBRA — so a Michigan employer under twenty employees has no continuation obligation, federal or state, while the same employer with staff in another state may well have one there.

Paid leave mandates

State paid family and medical leave programs are spreading, each with its own contribution mechanics, notice duties and interaction with your disability plan. They attach to the employee’s work location, and they do not wait for you to notice them.

Reporting and furnishing

Several states run their own ACA-style furnishing mandates that federal relief does not override. An employer comfortable with its federal reporting can still be late in a state where it has three people.

The compliance calendar in full →

The network problem

One plan, several states, and a network that does not cover your newest hires.

It is a solvable problem, but only if someone is looking before the complaints start.

Map the population first

Employees plotted against the network they actually have, by state and by metro. A carrier strong in one market can be a second-tier network in another, and the difference does not appear in the rate.

Choose the structure

National network, a wrap arrangement, or more than one carrier by region — each has a cost and an administrative consequence. We price them rather than assert a preference.

Say it at enrollment

Employees outside the home market need to be told plainly how their own network works. Most of the dissatisfaction we see in multi-state plans is an expectations problem, not a coverage problem.

Growing across state lines →

Outside the United States

Employees abroad are not a footnote on a domestic plan.

Expatriate coverage

Employees sent abroad need coverage that travels with them, including evacuation and repatriation provisions a domestic plan does not contemplate.

Local national staff

People hired in-country are usually better served by local arrangements than by an extension of the United States plan, which often cannot legally or practically deliver care where they live.

One review, not several

Domestic and international arrangements looked at on the same schedule, so the international piece stops being the thing nobody has examined since it was set up.

Send us the renewal and tell us the states →

Let’s get to work

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.

What to send

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.

CFH Insurance Consultants

An independent employee benefits consulting firm. We look at the entire benefits program — cost, plan performance, risk and administration.

Michigan41000 Woodward Ave, Suite 350 East
Bloomfield Hills, MI 48304
248.370.8853
ColoradoColorado Springs
719.425.2649
TexasHouston
281.404.5670

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