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While Governor Rick Snyder supports the creation of MI Health Marketplace, a nonprofit to oversee the state’s health insurance exchange, he acknowledged on November 16, 2012, that without authorizing legislation, he would plan for a state-federal partnership exchange. On March 5, 2013, Michigan received conditional approval from the U.S. Department of Health and Human Services (HHS) to establish a partnership exchange. Final approval is contingent upon the state demonstrating its ability to perform all required Exchange activities on time; complying with future regulations; establishing a memorandum of understanding (MOU) between the Michigan Department of Licensing and Regulatory Affairs (LARA) and the state’s Medicaid agency that defines each agency’s role and responsibilities; and obtaining legal and spending authority for Exchange activities.
Under the Affordable Care Act, all non-grandfathered individual and small-group plans must cover certain defined health benefits, or ‘essential health benefits’ (EHB). These benefits include: ambulatory patient services, emergency, hospitalization, maternity and newborn care, mental health, prescription drugs and more. After soliciting public comment on the decision, Michigan submitted a recommendation and gained approval for the state’s benchmark EHB HMO plan.
Michigan has conditional approval from the government for a state-federal partnership exchange. The state’s HMO plan is the benchmark for essential health benefits.
For more information about setting up a private exchange solution in Michigan, contact a representative at GoHealth today.