Plain-English Guide

Which Carriers Will Quote Your Group

A carrier can sell group coverage in Michigan and still decline to quote your group, or quote only some of its products. Who can quote you depends on a few things worth confirming before a comparison is built.

Have Us Review Your Situation

What Decides It

Four factors

Employer Size

Small group and larger group markets follow different rules and have different carriers and products.

County

Some products and networks are offered only in parts of the state.

Funding Structure

A carrier may quote fully insured but not level-funded or self-funded, or the reverse.

Timing

Open enrollment windows and effective dates affect what a carrier will take on.

How We Confirm

Before we build a comparison

Ask for the exact product

We ask each carrier which product and network it will quote, not just whether it will quote.

Check who is actually underwriting

Some arrangements involve more than one carrier. We confirm whose card and whose claims process you will have.

Report what is not quotable

If a carrier will not quote, we say so rather than leaving it in the comparison.

In Practice

An illustration of how this plays out

This is a composite example to show the reasoning, not a description of a specific client.

The situation

An employer asked a carrier directly for a quote and was told the product it wanted was not available at its size.

What we did

We checked which products and funding structures were quotable for its size and county before building the comparison.

What changed

The comparison covered the options that could actually be bought, not products that would have been declined late in the process.

Questions To Ask

Confirm early so nothing is declined late

Which product and network will you quote?

The answer should name a specific product, not just the carrier.

Is the funding structure available to us?

Fully insured, level-funded and self-funded are not offered by every carrier at every size.

What is the effective-date deadline?

Late in the cycle a carrier may decline or limit what it will take on.

Who is underwriting?

Some arrangements involve more than one carrier, which changes the card and the claims path.

Common Questions

Questions we get

Why would a carrier not quote us?

Size, county, funding structure and timing are the usual reasons.

Does CFH quote every carrier?

Yes. We quote every carrier. Whether a given carrier or product can actually quote your group depends on employer size, county, funding structure and timing, so we confirm that first and tell you which are quotable.

Where can I see the carriers?

Start with our overview of who sells group plans in Michigan.

Does a decline affect other carriers?

No. Each carrier decides on its own.

Why does size matter?

Small group and larger group markets follow different rules and have different products.

Sources

The law behind this page.

Public Health Service Act section 2715 (42 U.S.C. § 300gg-15), Summary of Benefits and Coverage; Michigan Department of Insurance and Financial Services.

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.

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