Michigan insurance law and regulation
The state insurance department can be reached by telephone at (877) 999-6442 or by mail at PO Box 30220, Lansing MI 48909. The state children’s health insurance plan (CHIP) Web site is Michigan MIChild.
News that affects your health insurance and planning
June 16, 2019 – Status of alternative non-ACA health plans: Michigan does not require individuals to maintain adequate health coverage. The state provides no premium or cost-sharing subsidies for individual market coverage and permits insurers to sell non-compliant transitional policies in the individual market. Michigan limits the sale of short-term coverage more strictly than the federal government. A maximum policy of 6 months is allowed on an initial policy and only 6 months of short term coverage may be issued per year.
April 16, 2019 – Grand Rapids has a new Psychiatric Urgent Care Center that is expected is expected to reduce wait times for psychiatric assessments and will provide clinical services in a calm environment for those experiencing psychiatric symptoms such as: depression, anxiety, panic attacks, suicidal thoughts, disturbing thoughts, acute grief reactions, trouble managing daily activities and substance abuse disorders. The center will serve adults ages 18 to 65. It’s located on the Pine Rest Cutlerville Campus, located at 300 68th Street SE in Grand Rapids. It will be open for assessment seven days a week: Monday through Friday, 10 a.m. to 8 p.m., and Saturday and Sunday, 8 a.m. to 3 p.m. Most commercial insurance, Medicare and Medicaid health plans cover the services offered at the center. Pine Rest suggests people with Medicaid to call ahead because some plans require authorization for services. The center is staffed by multi-disciplinary team specifically trained to provide psychiatric assessments. Pine Rest anticipates serving an average of 40 people per day. For more information on the center or to make an appointment, call the Psychiatric Urgent Care Center at 616.455.9200. Walk-ins are also welcome.
March 23, 2019 – Michigan’s working poor increased to 43 percent of all households in the state, according report released by Michigan Association of United Ways. This means that 1.7 million households in the state don’t have enough money to pay for basic needs like health care. While there are no easy solutions, Freedom Benefits offers support to find limited insurance options to families in this situation.
December 9, 2018 – The Michigan Department of Insurance and Financial Services (DIFS) will study ways to end Obamacare as permitted under Section 1332 State Innovation Waiver of the Affordable Care Act. First the current health insurance market will be analyzed and a future projection prepared, alongside potential policy solutions to ongoing issues. Then an actuarial and economic analysis of that option will be analyzed. NovaRest Inc. has been hired to do this work .
The history of health care planning in Michigan (Information is outdated and links may be expired)
2/11/ 2014 Professional support for any health care reform issue is available free of charge through an arrangement with OnlineNavigator. All online inquiries are handled personally by Tony Novak, CPA. Online support is available through a number of popular social media channels including Facebook and Google+ as well as e-mail. Telephone support for insurance enrollment is available through Members Insurance Exchange at (800) 609-0683.
7/26/2013 Affordable Smart Term Life Insurance is now available to most Michigan residents from age 20 through 60 directly online with no physical exam, agent appointment or telephone verification. Most policies are issued on the same day with coverage amounts of $25,000 up to $350,000. The level premium life insurance is available for terms of 10, 15, 20 and 30 years. Sample rates for $150,000 coverage for a preferred risk male age 30, non-tobacco $30.85 per month; tobacco user $49.55 per month. A preferred risk female age 30 non-tobacco user would be $26.49 per month and a tobacco user would be $40.96 per month. Rates are higher for older applicants and lower health risks as described online. Pricing is based on input you provide about your medical history but, unlike most other life insurers, does not consider family medical history. Coverage is issued by innovative National Life Group, rated “A” by A.M. Best Company for 2013.
3/11/2013 This page was updated to include a link to the insurance plan that will be used to determine specific “essential health benefits” for insurance that qualified for 2014 federal tax purposes. Also, a link to additional covered benefits required by state law. Non-qualified insurance is likely to continue to be available at a lower cost that does not include these benefits nor qualify for federal tax purposes.
7/18/2012 Michigan joined a growing number of states that have declined to implement a state-run health insurance exchange under the timeline established by the federal government. The federal government will step in with its own exchange if Michigan hasn’t made progress by mid-November. Michigan had previously received a federal grant of $1 million to explore health insurance exchange options. Meanwhile, there are likely to be a strong commercial health insurance exchange in the state and OnlineNavigator is available on request to serve the same role as a government-appointed insurance navigator.
6/25/2012 Michigan State University dropped its requirement that students maintain health insurance after opposition from lawmakers. Freedom Benefits previously voiced the opinion that the requirement went beyond the limits of law or common sense financial planning. Insurance will continue to be available at www.freedombenefits.net on a voluntary basis and the school will ask students during each semester’s enrollment whether they have insurance coverage.
4/27/2012 – UnitedHealthcare named Grand Rapids and Murfeesboro Michigan as a top insurance growth markets for affordable health insurance based on a study of individual health insurance rates across the country. The study was designed to uncover areas of opportunity for consumers to save money by switching to one of the innovative plans offered through UnitedHealthOne.
2/21/2012 Guaranteed Issue Coverage – Michigan Department of Licensing and Regulator Affairs provides this statement regarding guaranteed issue individual health insurance for individuals with preexisting medical conditions: “If you do not have access to group health coverage, individual health coverage may be purchased. With an individual policy you are the policyholder. Your policy can cover you and your entire family. Just like group coverage, the contract must include specific minimum benefits required by Michigan law. Please be aware that an insurance company can deny coverage for a pre-existing condition under an individual insurance policy. However, Blue Cross Blue Shield of Michigan cannot deny coverage based on your medical condition, since it is the alternative mechanism to provide health coverage to all individuals, regardless of your health. Most HMOs are required to offer a 30 day open enrollment period each year to those seeking individual coverage. During the open enrollment period HMOs cannot deny coverage based on your medical condition”.
With the implementation of the Affordable Care Act, Michigan now offers a high risk pool through Physicians Health Plan of Mid-Michigan, a health maintenance organization. Adults with a chronic illness, or pre-existing condition, who have been without coverage at least six months, may be eligible to purchase insurance through HIP Michigan. To obtain additional information or a quote, please call Physicians Health Plan of Mid-Michigan at their toll free number 1-877-459-3113, or visit HIP Michigan. This program ends in 2013.
A detailed listing of Michigan’s health insurance mandates is reproduced on the Universal Health Insurance Blog.
2/1/2012 The Center for Consumer Information and Insurance Oversight, a division of the Center for Medicare and Medicaid Services (CMS)reported that as of June 30, 2011 Blue Cross Blue Shield of Michigan, Blue Care Network of Michigan and UnitedHealthcare are the state’s largest health insurance providers and as such, earn the right to set the benchmark for the development of the state’s essential benefit plans to debut in 2014 under health reform law.
7/12/2011 UnitedHealthOne critical illness insurance is now available. This insurance pays $10,000 to $50,000 in addition to any other insurance at the time that a diagnosis of stroke, heart attack or life-threatening cancer. Personal rates quotes are available by email fromOnlineAdviser. A brochure and application can be downloaded from www.uhcenrollment.com
2/12/2011 With dozens of health plans choices available online offering a wide range of pricing and benefits, how do you find the best combination of price and benefits? Celtic Insurance realizes that the choices can be overwhelming; the company offers more than 40 possible health plan designs in many parts of the United States. A new feature called “Help Me Choose” lets users easily and quickly select the benefits they value most and narrows the list down to a few of the best choices. No personal information is required other than zip code and date of birth.
12/16/2010 Michigan Department of Community Health officials met representatives of 44 other states and numerous employees of the federal Health and Human Services Department in Washington DC this week for a two-day working meeting to discuss the next steps in establish a government-run health insurance exchange under the American Health Benefit Exchange Model Act. Their attendance at this meeting was paid for by a $1 million federal grant awarded by HHS in September to the state for research how to set up an insurance exchange. Two states (Alaska and Minnesota) declined to participate, saying that it was a waste of taxpayer money. Four other states (not identified in press reports) that received federal grants did not send representatives to the meeting. Attendees included representatives of 16 states that are suing the federal government in an attempt to overturn the federal health reform law; specifically the requirement that forces individuals to buy health insurance on the insurance exchange or pay a hefty tax fine.
In its initial federal grant request for the insurance exchange project, the Department of Community Health said that it would: 1) Conduct the appropriate research to determine those who are potentially eligible for the Exchange and to determine how the Exchange will impact Medicaid, other public programs, and other State health plans. 2) Determine how best to establish the American Health Benefits Exchange and Small Business Health Options Program (SHOP Exchange) in Michigan, considering the needs of and options available to individuals and small groups. 3) Implement a plan for stakeholder involvement to determine how Michigan will implement the Exchange. 4) Develop an initial plan for integration of applicable State and Federal programs and current State projects. 5) Develop a plan for a governance model and structure. 6) Develop an initial plan for how the Exchange will manage reporting, accounting, and auditing functions while maintaining transparency. 7) Review technical components and interoperability of technology embedded in existing State systems and plan for the introduction of possible new systems necessary to properly run an Exchange, and 8) Review and determine the necessary State statutory and regulatory changes needed to establish the Exchange options.
The meeting reportedly did not address the role of the commercial health insurance exchanges on the implementation of new competing government systems. The model act does not address inter-state insurance exchange proposals nor insurance sales across state lines. Federal officials admitted that they may not be able to provide further guidance until 2012. Meanwhile, most states are motivated to continue to meet requirements to obtain additional funding promised by the federal government for the establishment of insurance exchange by 2014. Freedom Benefits has previously voiced the opinion that the huge amount of money being spent to set up alternate insurance sales system technologies could be better used providing health benefits to the public. We proposed on the Universal Health Insurance blog that adequate commercial insurance sales systems are already in place that could be modified in a public/private partnership to make health insurance more affordable.
5/14/2010 Diabetes Coverage: A new resource to help find health insurance for diabetics in Michigan is now available at Freedom Benefits.
3/23/2010 Michigan and ten other states including Alabama, Florida, Nebraska, North Dakota, Pennsylvania, South Carolina, South Dakota, Texas, Utah and Washington will make a joint legal challenge to the federal health reform bill on the basis that it improperly usurps state sovereignty over health insurance and that requiring health insurance is an illegal and improper government action.