Michigan Health Insurance Coverage...
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If you are searching for ways to lower your health insurance costs and you live in the State of Michigan...We, here at HealthInsureCoverage.com, work hard to supply you with the information you need to make an informed decision regarding your health insurance needs and requirements.

• What kind of protections are afforded you in the State of Michigan if you want to participate in health insurance Group Health Plans?
     Your protections will vary somewhat, depending on whether your plan is a fully insured group health plan or a self-insured group health plan. The plan's benefits information must indicate whether the plan is self-insured.
• You have to be eligible for the group health plan.
     For example, your employer may not give health benefits to all employees. Or, your employer may offer an HMO plan that you cannot join because you live outside of the plan’s service area.
• You cannot be turned away or charged more because of your health status.
     Health status means your medical condition or history, genetic information or disability. This protection is called nondiscrimination. Employers may refuse or restrict coverage for other reasons (such as part time employment), as long as these are unrelated to health status and applied consistently.
• Discrimination due to health status is not permitted.
     The Ajax Company has 200 employees and offers two different health plans. Full time employees are offered a high option plan that covers prescription drugs; part time employees are offered a low option plan that does not. This is permitted under the law. By contrast, in a cost-cutting move, Ajax restricts its high option plan to those employees who can pass a physical examination. This is not permitted under the law.
• You must be given a special opportunity to sign up for your group health plan if certain changes happen to your family.
     In addition to any regular enrollment period your employer or group health plan offers, you must be offered a special, 30-day opportunity to enroll in your group health plan after certain events. You can elect coverage at this time. If your group health plan offers family coverage, your dependents can elect coverage as well. Enrollment during a special enrollment period is not considered late enrollment.
• Certain changes can trigger a special enrollment opportunity.
  * The birth, adoption, or placement for adoption of a child
  * Marriage
  * Loss of other coverage (for example, that you or your dependents had through yourself or another family member and lost because of death, divorce, legal separation, termination, retirement, or reduction in hours worked)
  
• When you begin a new job, your employer may require a waiting period before you can sign up for health coverage.
  These waiting periods, however, must be applied consistently and cannot vary due to your health status.
• If you have to take leave from your job due to illness, the birth or adoption of a child, or to care for a seriously ill family member, you may be able to keep your group health coverage for a limited time.
     A federal law known as a Family and Medical Leave Act (FMLA) guarantees you up to 12 weeks of job protected leave in these circumstances. If you qualify for leave under FMLA, your employer must continue your health benefits. You will have to continue paying your share of the premium.
     The FMLA applies to you if you work at a company with 50 or more employees. If you qualify for leave under the FMLA, your employer must continue your health benefits. You will have to continue paying your share of the premium.
     If you decide not to return to work at the end of the leave period, your employer may require you to pay back the employer’s share of the health insurance premium. However, if you don't return to work because of factors outside your control (such as a need to continue caring for a sick family member, or because your spouse is transferred to a job in a distant city) you will not have to repay the premium. For more information about your rights under FMLA, contact the U.S. Department of Labor.
• Can a Group Health Plan limit my coverage for pre-existing conditions?
     When you first enroll in a group health plan, the employer or insurance company may ask if you have any pre-existing conditions. Or, if you make a claim during the first year of coverage, the plan may look back to see whether it was for such a condition. If so, it may try to exclude coverage for services related to that condition for a certain length of time. However, federal and state laws protect you by placing limits on these pre-existing condition exclusion periods under group health plans.
• The Look Back Period.
     A group health plan can count as pre-existing conditions only those for which you actually received (or were recommended to receive) a diagnosis, treatment or medical advice within the 6 months immediately before you joined that plan.
• Under group health plans, coverage for pre-existing conditions can be excluded only for a limited time.
     The maximum period varies, depending on the type and size of the health plan you are in. Also, if you enroll late (after you were hired and not during a regular or special enrollment period), coverage for your pre-existing condition can be excluded by self-insured plans for as long as 18 months. You will receive credit toward your pre-existing condition exclusion period for any previous continuous coverage.

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