Private Exchange

Learn more about this full-service solution for individuals to purchase health coverage through an online marketplace.

Michigan Health Insurance Exchange

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.

Essential Health Benefits

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 Health Insurance Exchange Stats:

  • Total Residents: 9,883,000
  • Total Health Expenditures (in millions): $65,888
  • Exchange Decision: Planning for Partnership Exchange
  • Total Health Insurance Exchange Grant: $41,517,021
  • EHB Benchmark Plan Status: Recommended

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.