On April 3, 2023, Gov. Whitmer issued a letter to the Department of Insurance in response to the judgment issued by a Texas federal district court in Braidwood Management Inc. v. Becerra. The judgment invalidates and prohibits enforcement of certain ACA preventive care requirements on a nationwide basis. More information concerning this case can be found in an April 11, 2023, article in Compliance Corner.

Gov. Whitmer stated concern that the ruling would put the state’s citizens at risk, so the letter instructs the department to do the following:

• Promptly issue guidance to help inform Michiganders of which preventive care services are affected by the court’s decision.
• Immediately begin working with Michigan’s health insurers to determine what steps can be taken to ensure that Michigan families continue to have affordable coverage for these lifesaving healthcare services.
• Develop recommendations as to other ways the State of Michigan can take action to ensure every Michigander continues to receive preventive healthcare now and in the future.

In addition, Gov. Whitmer announced that, as of April 6, 2023, insurers representing 100% of the fully insured health insurance market in Michigan have agreed to maintain no-cost preventive healthcare services.

Employers with policies issued in the state should be aware of these developments.

Letter »
April 6, 2023, Announcement »

On March 17, 2023, Director Fox issued Bulletin No. 2023-07-BT/CF/CU/INS, announcing that the state will prohibit health insurance plans from discriminating based on sex, sexual orientation and gender identity.

On March 16, 2023, Gov. Whitmer signed into law an amendment to the Elliott-Larsen Civil Rights Act that included sexual orientation and gender identity and expression as legally protected civil rights in the state. Pursuant to the amendment, the bulletin asserts that health insurance plans cannot deny access, limit benefits, impose additional cost-sharing, or engage in discriminatory marketing practices based on an individual's sex, which now explicitly includes gender identity and sexual orientation.

Employers with plans regulated by the state should be aware of this development.

Bulletin No. 2023-07-BT/CF/CU/INS »

On January 10, 2023, the Department of Insurance and Financial Services published a consumer guide to help consumers in the state understand the state’s surprise billing law. Act 368, signed into law in 2020, prohibits out-of-network providers in the state from billing a patient for an amount greater than the applicable in-network coinsurance, copay or deductible. Instead, the out-of-network provider must submit a claim to the patient’s insurer for an amount established in the law. This prohibition generally applies to covered healthcare services provided by an out-of-network provider in an emergency. It also applies if an out-of-network provider bills a patient after treating them at a participating health facility and the patient did not have the ability or opportunity to choose an in-network provider.

The law also requires out-of-network providers to provide a disclosure before providing a non-emergency healthcare service. The disclosure must state that the patient’s health insurer may not provide coverage for all the scheduled healthcare services and that the patient may be responsible for the cost of the services. The disclosure must also state that the provider must provide a good faith estimate of the cost of the healthcare services and that there is a right to request an in-network provider. The disclosure directs the patient to their insurer for information on in-network services.

Employers with plans governed by the state should be aware of this law. Self-insured plans in the state are not subject to the state law but may be subject to the federal No Surprises Act.

Consumer Guide »
Act 368 »

A Michigan court has delayed the effective date of its July 19, 2022, ruling in Mothering Justice et al. v. Nessel, et al. The ruling, first covered in our August 2, 2022, edition of Compliance Corner, found that the state’s legislature violated the Michigan Constitution when it amended two recently adopted ballot initiatives in 2018. As a result, the court voided Michigan’s then-current Paid Medical Leave Act (PMLA) and minimum wage laws, reverting to versions of those laws originally adopted by the legislature, versions that provide expanded paid sick leave and a higher minimum wage.

The latest court order recognizes concerns regarding the ability of employers and state agencies to immediately accommodate the statutory changes. With these concerns in mind, the court delayed the effectiveness of its ruling until February 20, 2023. Employers in Michigan should monitor the state’s Department of Labor and Economic Opportunity website for updates and work with legal counsel to modify their paid leave policies and compensation practices as necessary.

On July 19, 2022, in Mothering Justice et al. v. Nessel, et al., a Michigan court ruled that the state’s legislature violated Michigan’s Constitution when it amended two recently adopted ballot initiatives in 2018. The court’s ruling voids Michigan’s current Paid Medical Leave Act (PMLA) and current minimum wage laws and reverts to versions of those laws originally adopted by the legislature, versions which provide expanded paid sick leave and a higher minimum wage.

The original law called the Earned Sick Time Act (ESTA) and the increased minimum wage law were proposed as ballot initiatives and enacted by the legislature on September 5, 2018. Soon after, in December 2018, before the ESTA and new minimum wage law became effective, the legislature significantly amended the adopted initiatives. The ESTA was amended to exempt employers with fewer than 50 employees, reduce the annual leave entitlement hours and remove a section giving employees protection from retaliation. This amended ESTA became the PMLA. We reported on both the ESTA and PMLA in the October 3, 2018, and January 8, 2019, editions of Compliance Corner. The minimum wage law was amended to reduce the increase and eliminate wage increases specific to tipped employees. The amended laws were then signed into law in December 2018 by outgoing governor Rick Snyder and became effective March 29, 2019.

In striking down the amended laws, the Michigan court found the legislature’s single session “adopt and amend” strategy violated the Michigan Constitution by denying the people of Michigan a vote between the ballot initiative version and the legislature’s modified version. Consequently, the court voided the PMLA and existing minimum wage law and ordered the ESTA and higher minimum wage ($12.00/hour) to be immediately reinstated as law. However, the legislature quickly appealed the court’s decision and requested the law reversal be stayed until the appeals court can decide the matter.

At this point, Michigan’s paid sick leave law and minimum wage requirements remain uncertain. Employers in Michigan should monitor the state’s Department of Labor and Economic Opportunity website for updates and work with legal counsel to modify their paid leave policies and compensation practices as necessary.

Mothering Justice v. Nessel »

On March 29, 2021, the Department of Insurance and Financial Services (DIFS) issued Bulletin 2021-18 reminding issuers that DIFS will allow issuers offering ACA-compliant individual health coverage outside of the marketplace to participate in the Special Enrollment Period (SEP) to the same extent as issuers offering ACA-compliant individual coverage on the marketplace. This is not new guidance; rather, Bulletin 2021-18 supersedes Bulletin 2021-08 (previously reported on in the February 17, 2021, edition of Compliance Corner).

This information may continue to be of use to employees who have not been able to enroll in other coverage. As a reminder, this SEP for non-exchange coverage would likely not give rise to a qualifying event that would allow employees to terminate their employer group health plan coverage. It’s also important to note that these private health plans often meet ACA requirements, but consumers would not qualify for premium tax credits in order to help pay for them.

Bulletin 2021-18 »

On February 11, 2021, the Department of Insurance and Financial Services (DIFS) issued Bulletin 2021-08 providing notification that DIFS will allow issuers offering ACA-compliant individual health coverage not on the Marketplace to participate in the Special Enrollment Period (SEP) to the same extent as issuers offering ACA-compliant individual coverage on the Marketplace.

Executive Order 14009 issued by President Biden on January 28, 2021 (see our Compliance Corner article "Biden Administration Issues Executive Order to Strengthen the ACA and Create a Special Enrollment Period" from January 28, 2021, for more information) permits a 90-day SEP on the federal marketplace exchange, allowing uninsured and under-insured individuals to apply for coverage during the ongoing COVID-19 public health emergency. The SEP begins February 15, 2021, and continues through May 15, 2021.

The DIFS bulletin explains that all issuers offering coverage that is not offered on the Marketplace who choose to participate in the SEP must comply with all applicable state and federal statutes, including MCL 500.3472(1) which prohibits discrimination based on health status, claims experience, receipt of healthcare or medical condition during open enrollment.

This information may be of use to employees who have not been able to enroll in other coverage. However, this SEP for non-exchange coverage would likely not give rise to a qualifying event that would allow employees to terminate their employer group health plan coverage. It’s also important to note that these private health plans often meet ACA requirements, but consumers would not qualify for premium tax credits in order to help pay for them.

Bulletin 2021-08 »

On August 27, 2020, Gov. Whitmer issued Executive Order 2020-172, which provides protections for employees who stay home when they (or their close contacts) are sick due to COVID-19. As background, such protections were originally provided by Executive Order 2020-36 (as reported in the April 28, 2020, Compliance Corner), but have since been rescinded by Executive Order 2020-166 (which is now replaced by Executive Order 2020-172).

While the order largely focuses on job-protection requirements for employees as described above, it also provides guidance regarding how to treat employees who are absent from work for reasons related to COVID-19. Specifically, the order explains that employers must treat employees (who stay at home when they are at risk of infecting others with COVID-19) as if they were taking medical leave under Michigan’s Paid Medical Leave Act, as mentioned in the original order.

Importantly, the order is revised once again to clarify the definition of the principal symptoms of COVID-19 that will trigger COVID-19 leave protections under Michigan law, defining those symptoms to be:

• A fever, uncontrolled cough or shortness of breath that cannot be explained by a known medical or physical condition; or
• At least two of the following: loss of smell or taste, muscle aches, sore throat, severe headache, diarrhea, vomiting, or abdominal pain, which cannot be explained by a known medical or physical condition.

Meaning, there is no longer protected leave under Michigan law for employees who exhibit any isolated COVID-19 symptom (e.g., a sore throat). In addition, employers are now permitted to request documentation from employees to verify their protected leave (the prior orders prohibited employers requiring such documentation).

For more information on protections for employees related to COVID-19 leave under Michigan law, see Executive Order 2020-172. While this guidance does not impact a group health plan directly, employers should be aware of these requirements as it impacts required leave administration.

Executive Order No. 2020-172 »

On August 11, 2020, the Department of Insurance and Financial Services (DIFS) issued Bulletin 2020-34-INS reiterating that DIFS interprets “sex” in all rules it administers to include sexual orientation and gender identity. As such, discrimination based on sexual orientation and gender identity is prohibited.

As background, United States Supreme Court recently concluded in Bostock v. Clayton County, Georgia that the term “sex” includes sexual orientation and gender identity. Further, the court concluded that discrimination based on sexual orientation and gender identity violates Title VII of the Civil Rights Act of 1964. This recent decision provides additional support for DIFS to affirm its interpretation of “sex” in the rules it administers.

While the bulletin does not introduce any new guidance, employers should be aware that sexual orientation and gender identity discrimination is prohibited in Michigan and confirm their policies are compliant with this guidance.

Bulletin 2020-34-INS »

On June 2, 2020, Gov. Whitmer and the Michigan Department of Insurance and Financial Services alerted Michiganders that COVID-19 testing, for those who meet the testing criteria, should be covered by most health insurance plans without any cost sharing.

As background, federal law (via the FFCRA and CARES Act) requires most insurance plans to cover diagnostic COVID-19 testing and related services with no cost sharing. Consumers are urged to contact their insurance company to determine what is covered if they are being tested at a location that requires prepayment (or indicates they will be billed).

While this alert is aimed at consumers, employers with employees located in Michigan should be aware of these reminders.

Consumer Alert: Diagnostic COVID-19 Test Costs Covered by Insurance Plans »

On May 26, 2020, Gov. Whitmer issued Executive Order No. 2020-104, which enables qualified medical professionals to order COVID-19 tests and also encourages the establishment of community testing locations. In light of the continued COVID-19 public health emergency, Gov. Whitmer ordered that testing for COVID-19 should be available to any individual with reason to be tested for COVID-19 without any out-of-pocket cost. Further, an individual may receive a test at a community testing location without obtaining an order from a medical provider in advance.

While this order does not directly impact benefits administration, employers should be aware of these developments.

Executive Order No. 2020-104 »

On May 14, 2020, Gov. Whitmer issued Executive Order 2020-86 expanding the use of telehealth services in light of the COVID-19 public health emergency. Highlights of the order’s requirements include:

• Authorizing and encouraging all health care providers to utilize telehealth services when medically appropriate with patient consent (which can be verbal).
• In-person examination is not required to be conducted by the physician before prescribing medication (except for methadone).
• Healthy Michigan and private insurers are encouraged to reimburse for telehealth services.

While the above primarily applies to insurers and health care providers, employers should be aware of this development.

Executive Order 2020-86 »

On April 13, 2020, the Department of Insurance and Financial Services (DIFS) issued Bulletin 2020-16, advising all insurers doing business in Michigan to consider flexibility regarding premium payment and claims filing. Specifically, DIFS encourages insurers to:

• Provide a 60-day grace period for premium payments (to avoid cancellation due to nonpayment)
• Adjust claim filing deadlines to accommodate insureds who may encounter difficulty in timely providing notice of a claim as a result of COVID-19

While the bulletin impacts insurers, employers should be aware of these developments.

Bulletin 2020-16 »

On April 15, 2020, the Department of Insurance and Financial Services (DIFS) issued a press release announcing that the department is prioritizing health insurance appeals related to a denial of coverage for COVID-19 testing or treatment.

As background, participants have a right to an independent external review in the event an insurance claim is denied. Given the COVID-19 public health crisis, claims related to COVID-19 treatment denials are given first priority for review to determine if the denial was appropriate.

DIFS reminds consumers to contact the department with any questions about a health insurance denial, loss of health coverage due to job loss or other health insurance concerns. Employers should be aware of these developments and communicate with employees accordingly.

Press Release: DIFS to Prioritize Coronavirus-Related Health Insurance Appeals »

On April 3, 2020, Gov. Whitmer issued Executive Order 2020-36, which provides protections for employees who stay home when they (or their close contacts) are sick, as related to COVID-19. While the order largely focuses on job-protection requirements for employees as described above, as well as provides directives for individuals who test positive for COVID-19 (or have related symptoms), it also provides guidance regarding how to treat employees who are absent from work related to COVID-19. Specifically, the order explains that employers must treat employees (who stay at home when they are at risk of infecting others with COVID-19) as if they were taking medical leave under Michigan’s Paid Medical Leave Act.

Further, the order states that should an employee have no paid leave, the leave may be unpaid. Employers may, but are not required to, deduct any hours that the employee stays home from work from the employee’s accrued leave. In addition, the length of an employee’s leave is not limited by any amount of leave that such employee has accrued under the Paid Medical Leave Act and must extend (paid or unpaid) as long as the employee remains away from work during time periods required in the order.

Employers should be aware of these requirements.

Executive Order 2020-36 »

In addition, on March 25, 2020, (and effective through April 22, 2020), the Office of the Governor released Executive Order 2020-25 providing guidance that pharmacies can dispense emergency refills of up to a 60-day supply of any non-controlled maintenance medication. To that end, insurers must allow for early refills of all 30-day or 60-day covered prescription maintenance medications.

Employers should be aware of these developments.

Executive Order 2020-25 »

On March 12, 2020, Gov. Whitmer announced that her administration is expanding access to telemedicine for Michigan residents. Effective immediately, Medicaid beneficiaries are able to receive services in their home while the ongoing efforts to contain the spread of COVID-19 continue. In addition, certain insurance plans such as Blue Cross Blue Shield of Michigan, Blue Care Network of Michigan, Priority Health, Meridian, CVS Health, McLaren and Health Alliance Plan likewise announced that they will cover virtual care and telemedicine, and that they will waive cost sharing for COVID-19 testing.

Further, Gov. Whitmer urged the Trump administration to allow for a special enrollment period under the ACA to allow for more individuals to sign up for coverage with the hopes of mitigating the spread of the virus.

Employers with employees in Michigan should confirm with their carriers, as applicable, when addressing questions regarding health insurance coverage and COVID-19.

Press Release »

The Department of Licensing and Regulatory Affairs updated its paid medical leave poster, which was revised in October 2019.

As background, effective March 29, 2019, covered employers with 50 or more employees are required by law to post in a conspicuous place accessible to eligible employees the Required Poster: General Requirements – Paid Medical Leave Act. In addition to describing generally Michigan's laws regarding paid medical leave, the poster explains how paid leave accrues, who is eligible for leave under the Paid Medical Leave Act, and what are permitted uses for paid leave.

Employers with employees in MI should be sure to use the updated poster in compliance with the Paid Medical Leave Act. While the Paid Medical Leave Act only requires it be posted in English, Spanish and Arabic versions are also available.

Paid Medical Leave Act – Required Poster (English) »
Medical Leave Act – Required Poster (Spanish) »
Paid Medical Leave Act – Required Poster (Arabic) »

On May 30, 2019, Gov. Whitmer signed Senate Bill 1 (now 2019 Pub. Acts 21 and 22). The law will take effect July 1, 2020, and could impact the coordination of benefits between auto insurance and health insurance by potentially shifting the cost of medical and recovery bills resulting from motor vehicle accidents from auto insurance to health insurance under certain circumstances.

Under current law, Michigan requires no-fault automobile insurance policies that cover all medical and recovery costs associated with motor vehicle accidents. However, Michigan residents can opt for coordinated coverage, which makes a resident’s health insurance the primary payer for those costs. By shifting this responsibility to health insurance, the resident’s auto insurance premiums are reduced. If the resident opts for uncoordinated coverage, auto insurance pays those costs and charges a higher premium. However, employer health plans can either exclude or limit coverage for motor vehicle accidents, forcing employees to obtain unlimited coverage auto insurance.

The new legislation requires residents to choose from different levels of auto insurance coverage, each level lowering the cap on the amount that auto insurance must pay for medical and recovery costs associated with motor vehicle accidents (the levels start at unlimited coverage, then cap at $500,000, then cap at $250,000, then cap at $50,000, then no coverage). The new legislation also introduces the concept of “qualified health coverage,” which is health coverage that doesn’t exclude or limit coverage for injures related to motor vehicle accidents and has an annual deductible of $6,000 or less per individual (the deductible component can be adjusted under certain circumstances). Employer-sponsored health plans may be covered under this definition.

These changes could result in employer-sponsored health plans covering medical and recovery costs associated with motor vehicle accidents when they did not have to before. Although two of the new levels of auto insurance coverage set the cap quite high ($500,000 and $250,000), if a resident has qualified health coverage (among other requirements), then a resident could select a level of auto insurance coverage that caps such coverage at $50,000 or even no coverage. These developments could require employer-sponsored plans that meet the definition of “qualified health coverage” to pay for those costs. They may also subject employer-sponsored health plans that designate themselves as secondary payers to liability for such costs that exceed the cap placed upon auto insurance coverage.

Employer-sponsored health plans that cover Michigan residents should consider whether to amend their plan documents in light of this new law and consult with outside counsel in order to determine the best way to do so.

2019 Pub. Act 21  »
2019 Pub. Act 22  »

On December 18, 2019, the Michigan Supreme Court issued a 4-3 ruling that denied the state legislature’s request for advice on whether lawmakers are allowed to adopt ballot initiatives headed to voters (including one concerning paid sick leave) and then change them after election day. The court denied this request because it believed that it lacked jurisdiction to provide such advice, since there wasn’t a lawsuit alleging an “actual controversy.”

As reported in October 3, 2018, and January 8, 2019, editions of Compliance Corner, the state legislature adopted the initiative petition creating an Earned Sick Time Act on September 5, 2018, enacting it as Public Act 338 of 2018. On December 13, 2018, Gov. Snyder approved Public Act 369 of 2018 that amended Public Act 338’s provisions prior to its effective date (March 29, 2019). If the legislature had not adopted the initiative petition, and the voters approved it in a state-wide vote, then the law could only be amended with a three-quarters vote in the legislature. By adopting the petition, the legislature needed only a simple majority to amend it.

Since the state’s Office of Attorney General had issued conflicting opinions about the legality of this “adopt-and-amend” practice, the legislature asked the court to provide an authoritative opinion.

As reported previously in Compliance Corner, the new law revises the original law's provisions by exempting more employers, lowering the leave accrual and use requirements, and repealing employees' ability to sue employers for violations.

Specifically, among other things, the bill would amend the Earned Sick Time Act to do all of the following:

• Rename the act the Paid Medical Leave Act.
• Lower the number of hours that could generally be accrued from 72 to 40, and provide that an eligible employee could accrue one hour for every 35 hours worked, instead of one for every 30.
• Limit the application of the law to employers with 50 or more employees.
• Eliminate relatives of a domestic partner from the list of qualifying family members for whom the employee could use paid medical leave time.

For the time being, the Paid Medical Leave Act, as adopted and amended, stands. Employers with employees residing in Michigan should comply with it. However, an actual lawsuit challenging the law is a real possibility so employers should keep an eye on legal developments.

Public Act 369 »
Michigan Supreme Court Opinion »

In 2018 Michigan passed new legislation, specifically 2018 PA 175, called the Insurance Provider Assessment Act (IPAA).

As background, this new tax replaces the prior tax through a companion act, specifically 2018 PA 173, which was known in MI as the Health Insurance Claims Assessment (HICA). The HICA tax applied to insurance providers (i.e., health insurers and third-party administrators of self-insured plans). The HICA tax was repealed retroactively as of Oct. 1, 2018, and the IPAA tax does not affect self-funded plans or their administrators, but the IPAA tax does apply to carriers. So, employers with fully insured plans in MI will have the new tax reflected in their premiums.

Employers with self-insured plans will want to confirm with their third-party administrators that the HICA tax was not assessed on paid claims on or after Oct. 1, 2018. They should also verify that their third-party administrators have complied with the final HICA tax payments and reporting obligations. The final quarterly return was due Oct. 31, 2018, and the 2018 annual return filing deadline was Feb. 28, 2019.

Instructions and guidance on the IPAA tax are available on the MI Department of Treasury’s website. Under the IPAA, special rules apply to the initial assessment. The MI Department of Treasury will notify all carriers of the total amount of the assessment, prorated for two quarters, based on the number of member months reported in 2017. This prorated assessment is payable in two equal installments due Jan. 30, 2019, and April 30, 2019. Beginning in 2019, the Department is required to notify all taxpayers of the amount of the annual assessment by June 15, which will then be payable in quarterly installments beginning July 30.

Michigan Department of Treasury IPA Website »

The Michigan Department of Licensing and Regulatory Affairs has issued its paid medical leave poster, which implements posting requirements that take effect March 29, 2019.

As background, effective March 29, 2019, covered employers with 50 or more employees are required by law to post, in a conspicuous place accessible to eligible employees, WHD 9911 Required Poster: General Requirements – Paid Medical Leave Act. This new paid medical leave law was covered in the Jan. 8, 2019, edition of Compliance Corner.

On Dec. 13, 2018, Governor Snyder approved a paid medical leave law that takes effect on March 29, 2019, and revises a previously enacted earned sick time law that had an April 1, 2019, effective date and was included in the Oct. 3, 2018, edition of Compliance Corner.

As background, the legislature adopted the initiative petition creating an Earned Sick Time Act on Sept. 5, 2018, enacting it as Public Act 338 of 2018. Senate Bill 1175 (now Public Act 369 of 2018) would amend Public Act 338’s provisions prior to its effective date.

The new law revises the original law's provisions by exempting more employers, lowering the leave accrual and use requirements, and repealing employees' ability to sue employers for violations.

Specifically, among other things, the bill would amend the Earned Sick Time Act to do all of the following:

• Rename the Act the Paid Medical Leave Act.
• Lower the number of hours that could generally be accrued from 72 to 40, and provide that an eligible employee could accrue one hour for every 35 hours worked, instead of one for every 30.
• Limit the application of the law to employers with 50 or more employees.
• Eliminate relatives of a domestic partner from the list of qualifying family members for whom the employee could use paid medical leave time.

As for takeaways for employers, the law takes effect in March of this year and employers should be mindful of upcoming compliance requirements. Additional guidance will likely be forthcoming. Ultimately, employers that have employees in Michigan will want to work with outside counsel to incorporate the new requirements into their overall leave policy.

Public Act 369 »

On Sept. 5, 2018, the Michigan legislature enacted a paid sick leave law that was proposed through an initiative petition. Specifically, the new law requires employers to provide eligible employees with paid sick leave for reasons related to personal or family health needs, domestic violence, sexual assault, or public health needs. If the legislature hadn't enacted the proposed law, it would have appeared on the Nov. 6, 2018, election ballot for approval or rejection by MI's voters.

MI employers with one to nine employees are required to provide employees with one hour of paid sick and safe leave for every 30 hours worked. An employee may use up to 40 hours of paid earned sick time per year, unless the employer sets a higher limit. If an employee of a small business accrues more than 40 hours of earned sick time in a calendar year, the employee is entitled to use an additional 32 hours of unpaid earned sick time in that year, unless the employer allows more. The employee must be able to use paid sick time before unpaid time.

Employees of larger MI employers accrue a minimum of one hour of paid earned sick time for every 30 hours worked and may use up to 72 hours of paid earned sick time per year, unless the employer allows more. Sick time earned by an employee would carry forward from year to year. However, regardless of the carryover, the use limits still apply per single year.

The act includes accrual calculations, notice and documentation requirements, and violations and remedies. The act is effective April 1, 2019.

MI Time to Care petition »
Michigan Initiatives »

On Sept. 24, 2018, Director McPharlin issued Bulletin 2018-21-INS to reiterate Michigan’s requirements on association health plans (AHPs) and that state law continues to regulate AHPs.

As background, on June 21, 2018, the DOL issued final regulations regarding association health plans (AHPs). Under the regulations, a group or association of employers may act as a single “employer” sponsor of an association health plan under ERISA. The federal regulations attempted to encourage the creation of these associations, but emphasized that the states retain their authority to regulate AHPs. This bulletin clarifies the coordination with MI law.

The main purpose of this bulletin is to remind insurers that the state retains the right to regulate MEWAs, regardless of changes to federal law. Employers should be aware that their participation in a fully insured MEWA will likely fall under MI’s jurisdiction. The state also took the time to reiterate that an organization operating (or seeking to operate) a self-funded MEWA must be licensed as an insurance carrier to do so or risk being considered an illegal operation.

Lastly, fully-insured associations created in a state other than MI must comply with all applicable MI insurance law if coverage is issued to an employer with a physical presence in MI that employs at least one MI resident.

Bulletin 2018-21-INS »

On Sept. 14, 2018, Director McPharlin issued Bulletin 2018-20-INS to reiterate Michigan’s requirements that relate to short-term, limited duration health insurance policies. The bulletin states that such plans are limited in duration to 185 days or less out of any 365-day period.

As background, the HHS and DOL issued final regulations regarding short-term, limited duration health plans on Aug. 1, 2018. The regulations extend the permissible policy time frame to no more than 12 months (an increase from the previous maximum of three months) and allow such a policy to be renewed or extended for a period of up to 36 months in total. Such short-term policies are exempt from the ACA’s individual market rules, but remain subject to state regulation.

The primary purpose of this bulletin is to remind insurers of MI’s requirements for short-term, limited duration health policies. Employers should be aware that though these plans may be a lower cost option for individuals that just experienced a separation of employment, it doesn’t change an employer’s obligation to make an offer of COBRA (or state continuation), if otherwise required.

Bulletin 2018-20-INS »

The Michigan Department of Civil Rights has updated its Employment Discrimination Poster. The updated poster includes a reminder to employees that there is a time period in which they may request accommodations for a disability from their employers. It also contains updated contact information for the department. The revision date is February 2017.

Poster »

On Feb. 8, 2017, Jackson City Council approved an ordinance (No. 2017-03) that prohibits discrimination based on sexual orientation and gender identity in employment, housing and public accommodations. The ordinance applies to employers in the city employing one or more persons. All complaints must be filed within 30 days of the incident with the city's Human Relations Commission. From there, complaints are forwarded to the city attorney's office for investigation and prosecution.

This ordinance is effective March 10, 2017.

Ordinance No. 2017-03 (page 34) »

On July 8, 2015, the Michigan Department of Insurance and Financial Services (DIFS) released Bulletin 2015-17-INS. This bulletin supersedes Bulletin 2014-16-INS, and updates the minimum benefit levels for substance abuse benefits covered under health insurance plans. Specifically, the new minimum substance abuse benefit level, which is effective April 1, 2015 through March 31, 2016, is $4,309.

This bulletin only applies to grandfathered plans, small group market transitional plans, extended transitional plans and to individual market transitional and extended transitional plans that have a renewal date prior to July 1, 2014. The law has limited application because large group plans are subject to the Mental Health Parity and Addiction Equity Act; and non-grandfathered small group plans became subject to mental health parity requirements because of PPACA’s essential health benefits requirement.

Bulletin 2015-17-INS »

On Jan. 16, 2015, the U.S. Supreme Court agreed to decide whether Michigan must permit same-sex marriage and recognize such marriages lawfully performed out-of-state (DeBoer v. Snyder, cert. granted (U.S. Jan. 16, 2015) (No. 14-571)). The Supreme Court will evaluate the following issues for Michigan and three other states(Kentucky, Tennessee, and Ohio):

1) Does the Fourteenth Amendment require a state to license a marriage between two people of the same sex?2) Does the Fourteenth Amendment require a state to recognize a marriage between two people of the same sex when their marriage was lawfully licensed and performed out-of-state?

We are expecting further guidance and will report such in future editions of Compliance Corner.

No. 14-571  »

On Dec. 17, 2014, the Michigan Department of Insurance and Financial Services (DIFS) released Bulletin 2014-16-INS. This bulletin supersedes Bulletin 2013-06-INS, and updates the minimum benefit levels for substance abuse benefits covered under health insurance plans. Specifically, the new minimum substance abuse benefit level, which is effective April 1, 2014 through March 31, 2015, is $4,240.

This bulletin only applies to grandfathered plans, small group market transitional plans, extended transitional plans, and to individual market transitional and extended transitional plans that have a renewal date prior to July 1, 2014.

Bulletin 2014-16-INS  »