Michigan Small Business Health Insurance Options
The Complete Michigan Small Business Health Insurance Guide – 2024 Edition
HSA for America’s Complete Guide for Michigan Small Businesses. This guide is designed for companies in Michigan that have 30 employees or less. It is designed to provide small business owners and professionals with the information they need to offer their employees the best healthcare options available.
Benefits Options for Michigan Small Business Health Insurance
Michigan’s small businesses have many choices when it concerns providing employee health coverage.
It is the most affordable option, but also the one that’s most prevalent, to have a traditional health care plan.
Prices differ by age. But according to information from the Kaiser Family Foundation for 2021, an employee’s and family’s average cost of group insurance sponsored by their employer was $20142.
Health insurance that’s cost-effective. This will allow you to remain competitive and offer the compensation and benefits you need in order to keep your best talent.
Michigan’s employees pay an average of $4,072 towards health insurance.
Michigan’s businesses have many other choices that could reduce their expenses. This includes:
- HSAs are health-savings accounts.
- The Health Reimbursement Arrangements (HRAs)
- Memberships in direct primary care
- Shared health care programs
The right strategy for small businesses is dependent on many factors. These include the size of your organization, budget available, as well as age, medical needs, and other requirements, of both your staff and those of their families.
Read on the go, download our Complete Guide To Small Business Healthcare Plans.
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Geographical Issues for Michigan Small Business Health Insurance
Michigan offers a diverse healthcare system that encompasses both urban centers like Detroit, Lansing or Grand Rapids as well as rural areas such Midland and Traverse.
Michigan business owners need to be careful about the distribution of their workers throughout the state. If the executives are located at Grand Rapids, they may not be interested in choosing an HMO with a network that only allows workers and family to see doctors within its boundaries. However, many employees in Caledonia work and live far away from Grand Rapids.
Michigan Small Business Group Health Insurance
The most popular choice of group health coverage for Michigan employers is traditional group insurance.
This is the most expensive.
This is how it works
A third-party insurer, usually a corporation that makes money from insurance policies, is contracted by an employer to provide health benefits for its employees. If the employer so desires, they can also include their dependents.
All employers that have at least 50 employees are required to offer ACA-qualified insurance plans for employees who work over 30 hours a week. If they don’t, then they must pay a fine.
It must provide the minimum essential coverages, or MECs as they are called in the Affordable Care Act. They are:
- Patients can receive ambulatory services without needing to go into hospital.
- Emergency Services
- Hospitalization can include overnight hospital stays and surgery.
- The care of newborns, pregnant women, and mothers (both before and afterwards)
- Treatment for substance abuse disorders, mental illness and behavioral problems (including counseling and therapy)
- Prescription drugs
- The Rehabilitation and habilitative Services and Devices (services or devices designed to assist people with chronic illnesses, injuries or disabilities in gaining or recovering mental or physical skills).
- Laboratory services
- Chronic disease management and prevention services
- Adult dental coverage and adult vision insurance are not considered essential health benefits.
The ACA mandates that insurance companies cover contraception and breastfeeding.
The traditional option of health insurance, while expensive for companies, has the advantage that it is guaranteed to enroll.
If the worker applies during their initial enrollment, triggered when they are first eligible for coverage, a special period triggered after a life-changing event or the annual open enrollment starting November 1, the insurer cannot deny them or increase the cost of the policy because of a medical history.
Small Businesses in Michigan Are Not Required to Provide Health Insurance
In accordance with the Affordable Care Act employers employing fewer 50 people are not obliged to offer insurance.
Michigan’s state law has no requirements. The law in Michigan does not require employers with fewer 50 workers to offer any type of health insurance.
The penalty is not applicable to you.
But it is a smart idea to offer health care benefits to all companies, including small ones. Without them it could be very difficult to find and retain employees.
Michigan is one of the states with the lowest unemployment and where employers compete fiercely for talented employees.
Michigan employers could save money by providing a health-sharing plan or medical cost sharing (more information below) and paying some of or all the expenses for their employees.
HRA Alternative for Michigan Small Business Health Insurance
If you prefer, your small business can provide a Qualified Small Employee Health Reimbursement Agreement (QSEHRA) to help employees purchase their own personal health insurance. This arrangement is tax-free.
QSEHRAs offer the following advantages to employers:
1.) There are no minimum contributions
QSEHRAs do not require you to make a certain minimum amount every year like pension plans. Employers can choose their own HRA budget, which they may change each year depending on cash flow.
A QSEHRA allows you to control the budget of your medical benefits.
2.) Flexibility
It is possible to offer different amounts to employees depending on their marital and family status. It is possible to discriminate and offer a bigger benefit for employees with children than those who do not have any.
3.) Employees and employers are both eligible to receive tax-free treatment
Employer contributions are tax deductible. Like cash benefits, QSEHRA does not require your employees to pay taxes on their benefit as long they are covered by a health coverage plan which includes 10 of the essential protections stipulated under the Affordable Care Act.
A QSEHRA offers a more attractive alternative to a simple health insurance stipend, which employees may use for other purposes or even purchase insurance.
4.) QSEHRAs support employee choice
Many traditional group insurance plans limit the options available to employees who are in a wide range of situations.
They are usually overpriced, and not suitable for employees, because HR and management choose them, and not the workers.
The QSEHRA gives workers and their family a much wider range of choices and allows them to choose the best health care plan for themselves.
Michigan Taxed Employer Health Coverage
Under federal and Michigan law, the premiums that you as an employee pay for your health insurance are fully deductible as a business cost. These premiums are not taxable for the employee.
The overall cost of health sharing plans is lower. Employees can deduct the monthly cost of these plans from their taxes. Employer assistance to pay health-sharing costs is taxable for the employee.
Michigan Small Business Health Insurance: The Disadvantages
There are some disadvantages of traditional health care for employees and employers.
- Cost
We have already mentioned that the cost to provide health insurance is high. This can be especially true for industries with a large labor force, where costs per employee are higher than revenue.
Many workers are overburdened by the requirements of health insurance coverages mandated by Washington and Lansing.
Traditionally, health insurers must price mental and drug addictions, as well as maternity coverage. Many workers are not interested in these benefits.
It makes them less cost efficient and effective.
- Inflexibility
The majority of group health plans offer an all-encompassing strategy which does not always meet employee needs or budgets. The nature of employer-sponsored health insurance group plans is to only offer a few solutions, which may not suit the needs and budgets of specific employees.
Some workers may find it more cost-effective to purchase their own health insurance plan through the private market, taking advantage of subsidies under the Affordable Care Act.
A less expensive plan of health sharing, as discussed in the following paragraphs, may suit them better. The innovative, affordable and flexible alternatives to traditional health insurance are a good solution for employees who do not have pre-existing health conditions.
The following sections will discuss in detail health sharing plans.
- Administrative burden
This includes managing the documentation and compliance. You will also audit plans to verify that no non-qualified employees have been enrolled in them. And you’ll be answering staff member questions. They are vital to the smooth running of a company’s insurance program.
The plans can be very burdensome for employers with a small headcount who cannot justify hiring a staff member to handle the HR plan full-time.
However, they are an enormous burden on very small businesses who lack the manpower to hire a HR department to administer the plan.
The business owner can use other methods, like the Health Insurance Reimbursement Arrangements.
They encourage them to take out their own policies through Affordable Health Care Act. The Affordable Care Act may offer subsidies to workers. The process also eliminates the need for the employer to be involved, thus reducing administrative and overhead expenses.
Michigan Health Sharing Plans
Michigan small business owners can save money by using health-sharing plans instead of expensive, overpriced insurance.
Michigan businesses are using medical cost-sharing programs as an affordable alternative to group health plans. Health sharing is a great way for companies to save money on their premiums.
Michigan’s small businesses can save as much as $10,000 per annum per employee, for family insurance, or $3,500 annually for single coverage.
The programs are a new way to fund healthcare. They allow companies to provide employees with high-quality care while keeping costs down. The premise behind health sharing programs is to share resources between a group or organization.
In health sharing programs, participants pay a fixed amount per year instead of paying insurance premiums.
Health Sharing Plans vs. Health Insurance
Not all health plans offer the same coverage as insurance.
Health sharing associations are not insurance companies, but voluntary groups that agree to pay for the medical bills of their members. Health Sharing Ministries are non-profit groups, as opposed to insurance companies that are typically for-profit.
Coverages That Are Mandated
Health insurance plans are not required to meet these federal or state requirements. These requirements do not apply to health-sharing organizations.
Those who are never drug users, for instance, do not need to be covered for the costs of addiction treatment. They also don’t cover any injuries caused by a member’s drunken driving.
There Are Pre-Existing Conditions
The health sharing plan may not share costs for pre-existing diseases until a certain waiting period has passed.
The waiting period for surgery is often imposed by the insurance companies, except when it comes to accidents and injury which were unforeseeable at the moment of enrollment.
They also help to reduce adverse selection. These waiting periods are a good way for health sharing groups to offer a comprehensive set of benefits, at a fraction of the cost of a nonsubsidized ACA group health policy in Michigan or via Healthcare.gov.
Nota that plans that offer health sharing do not qualify as subsidies under the Affordable Health Care Act. Even if you qualify for a government subsidy depending on your circumstances, switching to health sharing is still a good idea.
Michigan employers are often better off switching to a health sharing plan, as small-group health plans no longer qualify for ACA premium subsidy.
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Health Sharing and Network Restrictions in Michigan
Health-sharing plans are often more flexible when choosing healthcare providers. They offer an alternative to traditional managed care arrangements such as PPOs and HMOs. These plans represent the majority of employer sponsored group health plans.
Most health sharing organizations Michigan does not limit patients to only in-network providers. Members of health-sharing plans can select their doctor. People should be able to choose the doctor they want.
Does Your Business Need To Offer Health Sharing?
Each business is unique. It takes careful consideration to choose the right plan for your business, regardless of whether you’re using a traditional health insurance or health-sharing plan.
It’s simple for Michigan business owners to receive a complete case analysis with recommendations specific to their organization and employees.
We’ll get started by clicking here, to schedule an appointment with a Personal Benefits Manager licensed in Michigan.
A prepared employee count will be helpful.
Switching to health coverage can often save employees thousands of dollars. However, health sharing might not be the best option if there are employees with pre-existing illnesses.
Free consultations and analyses are available.
Michigan Small Business Health Insurance May Be Eligible To Receive Reimbursement for Medical Expenses
Employer-funded health reimbursement arrangements (HRAs), which reimburse employees tax-free for personal healthcare expenses, are a type of HRA.
Michigan small companies often simply stop offering group health coverage. Instead, small Michigan businesses establish HRAs and give workers money for them to purchase their own individual insurance policies with pre-tax dollars.
So, workers can take advantage and reduce their net costs.
Employees can also use their HRA to pay other expenses, including prescriptions, deductibles, copays, durable medical equipment, etc. HRA benefits, once again, are not taxed to employees.
An HRA is a great alternative to a formal plan for group health insurance. It allows your employees to choose whichever health insurance suits their needs.
Click here to learn more about HRAs for small businesses.
HRAs for Michigan Small Business Health Insurance – QSEHRAs
QSEHRA or Qualified Small Employee Health Reimbursement Agreement (pronounced “Cue Sarah”) is the special HRA type that small businesses can utilize.
This benefit is intended for businesses with fewer 50 full-time staff or its equivalent.
Business owners can set the maximum QSEHRA amount they wish to contribute, as long as it is within certain parameters. Michigan employers may contribute $5,850 to individual employees up to $487.50 each month and up $11,800 to employees with families up to $983.33 each month as of 2023.
This money is used by employees to buy insurance on their own via an online insurance exchange or a Personal Benefits Manager. It preserves eligibility for subsidies, something they could not receive under a company-paid health plan.
Employers can reimburse their employees either for the premiums alone or for both premiums and additional medical expenses.
QSEHRAs, Special Enrollment Periods and the Qualified Self-Employed Health Reimbursement Account
Employees will be eligible for the Special Enrollment period if you change your insurance to an HRA. This is a period of 60 days when your employees are able to buy their ACA-qualified health insurance without any medical underwriting.
The QSEHRA will ensure your employees’ coverage is not interrupted when you decide to replace the group health insurance program with one.
The Michigan Small Business Health Insurance Advantages of HRAs
Health Reimbursement Arrangements, or HRAs, have many advantages.
Tax-free benefits are available to both you and your employees when you purchase HRA benefits.
HRA money is not released to your employees until after it has been paid. As operating capital, it remains yours. This money doesn’t need to be placed with anyone else.
HRA benefits can be tailored to suit the needs of employers, with many options available. This includes what expenses your company is willing and able to pay for.
HRAs are designed with a lot of flexibility by the employer, including which expenses they will reimburse.
Employees don’t lose their health insurance coverage when they quit the company or switch to contractor status. According to the QSEHRA model, each worker is the owner of his/her insurance and can control it. Employer not.
The Michigan Small Business Health Insurance Disadvantages of HRAs
It is not the desire of all employees to have to choose and research their own plan. Some workers will need additional help to make the switch.
You can get help from your HSA for America Benefits Manager if this happens. This ensures that no worker gets left behind.
Your employees can also click this Link or call 800-913-0172 to schedule an appointment.
Click on for more information about alternative health insurance plans available to small business owners in Michigan.
The Direct Primary Care Advantage
Direct Primary Care plans, or DPCs for short, are an alternative model of healthcare that has been gaining in popularity both across Michigan and the nation.
This is a model based on membership: Your employees can receive as many consultations as they require, whether in-person or through telehealth, for an affordable flat monthly fee.
DPC’s monthly membership fees start at just $80 and are a viable option for people to take care of their health, without having to pay copayments.
DPC offers members access to all routine, primary, preventive care and chronic services.
The following are some examples of direct primary healthcare services:
Some of the most common medical services offered by doctors who practice Direct Primary care include:
- Preventive care.DPC doctors are committed to preventive care and offer routine screenings and checkups.
- DPC Doctors treat injuries and illnesses that are acute, including infections, colds and influenza, minor injuries and skin conditions.
- Chronic disease management. DPC doctors assist patients in managing chronic conditions such as hypertension, diabetes, asthma, arthritis and more. These doctors offer ongoing treatment, monitor patients, and adjust their plans of care as required.
- Comprehensive physical exams. DPC doctors provide comprehensive physical examinations that assess health overall, identify possible risks, and offer personalized health advice.
- Urgent care. DPC is often able to offer same-day, or the next-day, urgent care.
- To ensure that patients receive timely attention, they can make appointments for any non-emergency health issues.
- Laboratory and diagnostic service. DPCs may perform or arrange a range of lab tests including blood analysis, urine testing, imaging (X rays, ultra-sounds), electrocardiograms, and more.
- Medication management. DPC Doctors can prescribe medications. Monitor their effectiveness. And make any adjustments needed. Additionally, DPC doctors provide medication education and counselling.
- Medicine management. DPC physicians can prescribe medications and monitor their efficacy, making adjustments as required. Also, they provide counseling and education about medication use.
- Mental Health services DPC practices often include mental healthcare services in their overall care. DPCs may also refer their patients to mental health professionals for therapy or counseling.
- Minor procedures. DPCs are equipped to carry out minor surgeries in their own offices.
- Care coordination, referrals. DPC’s doctors coordinate and advocate for their patients, coordinating with specialist physicians, hospitals and other healthcare professionals when referrals are required.
There are also no deductibles or co-pays because there isn’t an insurance company. Monthly subscriptions cover everything. It allows workers who are strapped for cash to receive the medical care they need immediately. Patients no longer need to postpone their doctor’s appointments because of a high deductible or copay.
Patients can select supplemental plans to cover additional services, such as accident insurance, high-deductible health plans or health sharing plans. DPC members can choose to cover routine health care at a lower cost by opting for healthsharing instead of traditional insurance.
HSAs for Michigan Small Business Health Insurance
Health Savings Accounts (HSAs) can help employees manage medical expenses and lower premiums for their workplace insurance.
Michigan businesses and residents need all the tax breaks they can get. It’s good to know that employer contributions made by employees into their Health Savings Accounts are fully deductible from Michigan corporate income taxes as compensation expenses.
HSAs enable individuals to pre-tax funds for future medical needs. HSAs allow both employees and their employers to contribute, up to the annual limits set annually by Congress.
HSAs allow for tax-deferred investment growth and tax-free withdrawals.
Qualification for HSAs
To participate in a HSA and to receive pretax employer contributions to the account, employees need to enroll in a High Deductible Health Plan (HDHP).
IRS definition of a High Deductible Health Plan for 2023 is any plan which has a deductible at least $3,000 for family plans/$1,500 for individuals.
Total annual HDHP out-ofpocket costs (including copayments, deductibles, and other coinsurances) cannot be higher than $7500 for individuals or $15,000. The limit is not applicable to outside-of-network providers. ).
Can I combine HSAs & health sharing?
HSA America offers only the HSA-SECURE plan.
HSA SECURE Plan provides a way for you to enjoy the advantages that come from combining a healthsavings account and the advantages of cost-savings through healthsharing.
In order to qualify for the program, an employee must earn income through a business, or be self-employed.
HSA SECURE will not be available for straight W-2 workers. HSA-SECURE may work for you if the employee has a side business, freelance or other part time job and is in excellent health.
As a small business, you may want to consider the HSA-SECURE Plan as an option that can save both your and partners money.
HSA SECURE is only available to employees who enroll on their own. If they already have an HSA established, then you can still make pretax contributions on their behalf up to the limit Congress sets each year.
HSA SECURE is available by clicking on the link below.
Michigan Small Business Health Insurance Taxation of Benefits?
After you’ve learned a little bit more about all the other options that are available for small business owners in addition to health insurance as it is known today, we have a short table showing how they will be taxed.
| Plan Type | Employer | Workers |
|---|---|---|
| Traditional health insurance premiums | Tax deductible. May qualify for a tax credit (see below) | Non-taxable |
| HSA contributions | Tax deductible | Pre-tax, up to certain limits. No income limitations. |
| Health sharing costs | Tax deductible as a compensation expense | Taxable as ordinary W-2 income |
| Health reimbursement arrangements | Tax deductible | Benefits are non-taxable to the employee |
| HSA withdrawals | N/A | Withdrawals for qualified medical expenses are tax-free. Otherwise taxable as ordinary income. A 20% penalty for non-qualified withdrawals applies up until age 65. |
| Direct primary care costs | Tax deductible as a compensation expense | Taxable to the employee |
Michigan Small Business Health Insurance Care Pyramid
A good employee health benefits package should address all levels of the Employee Healthcare Pyramid – from routine preventive care, through primary care access for maintenance and early detection of health problems, all the way through catastrophic incidents, as shown below:
On the left side, you will find a list of common solutions based on traditional insurance that can be used to address the different levels of the Care Pyramid.
On the right side, you will find a list of more affordable alternatives to offer meaningful protection at every level of Pyramid.
The design of a good plan provides affordable options for employees at every level. This ensures that employees don’t have to put off or delay care for lack of funds.
It is possible to design a personalized plan with the help of your personal benefits manager. The plan can be designed for all levels of care in the Care Pyramid and at fractions of the cost of traditional group plans.
Michigan Small Business Health Insurance Tax Credit
Small Business Health Care Tax Credit was passed alongside the ACA and allows small business to claim a tax credit for up to 50 percent of employee health care costs.
The program was designed for businesses that have fewer than 25 employees or who hire workers with lower salaries.
Both for-profits and non-profits can generally claim this credit.
* Employ fewer than 25 people and pay an average salary of $53,000 (excluding all owner salaries). Owners are generally not considered when calculating the average salary and number of employees for a business. The number of employees are also based on the “full-time equals”. Two half-time workers would be equal to one full-time worker.
*Paying at least 50% of employee premiums;
* Offer Affordable Care Act-qualified coverage available on the state exchange (in Michigan’s case, on healthcare.gov, the federal online insurance marketplace website.)
Once an employer reaches 25 employees, or if the average salary is $53,000 or more, then tax credits are eliminated.
What is the process for claiming credit?
The IRS Form 8941, which is required for small tax-exempt companies to file their tax returns, must be attached to your tax return.
You are exempt from taxation on contributions made to your employee’s health coverage.
This year, I haven’t paid taxes on my business. Am I still eligible to claim the credit?
Yes. The tax credit may be used as a way to reduce income tax liabilities incurred in the prior year, or it can also be carried forward and offset over 20 years.
This credit is refundable for businesses that are exempted from paying taxes.
To learn all about the Small Business Health Care Tax Credit consult your tax professional.
Combining Michigan Small Business Health Insurance Strategies
Combining different health insurance programs could be the smartest move you make to maximize your coverage.
Employers often find that by combining several healthcare packages, they can control their healthcare costs as well as provide full coverage to all of their employees.
One cost-effective approach is to combine a Direct Primary Care plan (DPC) that provides normal primary health care with an affordable health sharing plan covering catastrophic events.
This strategy is more cost-effective for both your business and your employees.
Employees can be given more options and lower costs by allowing them to choose between a Health Sharing Plan or an Individual Health Insurance plan. They may also have the option of funding a Health Savings Account for HDHP plans that qualify for HSAs
How to proceed?
The best way to proceed is by putting together a business health plan and contacting us.
The HSA for America Benefits Manager you are connected to will discuss with you your workforce and family, budget needs, employee contributions, as well as any existing conditions that need to be taken into consideration when creating a new program.
Our PBMs include many successful businessmen and entrepreneurs. The PBMs understand the needs of business owners and know what is required to retain and recruit top talent.
What if I offer both health insurance and health sharing?
You can provide both plans side-by-side, so that employees have the option to select which one best suits their requirements.
If too many of your employees choose to opt out, then you may not be able to keep a group insurance plan. You can use an HRA as a reimbursement for the employee’s individual health insurance. This will cost close to the same.
Michigan Small Business Health Insurance: Frequently Asked Questions
How do health sharing plans and insurance for small business differ?
The traditional health insurance plan is offered by the insurance company, whereas health sharing is when members contribute to a fund to pay for each other’s healthcare expenses.
Do health-sharing plans have waiting periods for conditions that preexist?
Some health sharing plans do have waiting periods before they cover pre-existing medical conditions. For more details on specific plans, it’s best to consult the plan guidelines.
In Michigan, can employer contributions to HSAs be claimed as a deduction from the state’s income tax?
Yes. In Michigan, employer contributions to employee HSAs can be deducted from the state’s income tax.
What is the Small Business Health Care Tax Credit and how do I claim it?
For-profit small businesses can claim the tax credit on their annual income tax returns with IRS Forms 8941, whereas tax-exempt businesses need to file Form 990T.
HSA for America is not a tax advisor. For more information, employers should contact their tax advisor.
Do health-sharing plans cover maternity benefits in Michigan?
In Michigan, maternity benefits, including prenatal, postnatal, and labor care, are included in many health insurance plans and health sharing programs. Some health sharing plans restrict the cost-sharing benefit for children born outside marriage.
Are there restrictions on how large a business can be to qualify for the Michigan Small Business Programs?
QSEHRAs are only open to employers that have fewer 50 employees. You can still get HRAs if you are an employer with more than 50% of employees.
You must also comply with the ACA’s requirement that you provide a qualified plan of health insurance for your employees or face a penalty. You should speak to your Personal Benefits Coordinator if your company is about to or plans on hiring its 50th full time worker, or equivalent, in the next few months. Your plan could be affected.
What are the benefits of Health Savings Accounts for Michigan employees?
HSAs are a way for individuals to put money aside before taxes to pay future medical expenses. Employees and employers can both contribute to HSAs, allowing for tax benefits and savings on future healthcare costs.
In Michigan, can employers make contributions to the HSAs of their employees?
Employers can contribute to HSAs of their employees, but only up to the annual limit set by Congress.
Is it a good idea for Michigan small business owners to offer a Direct Primary Care plan (DPC), along with other options?
Small businesses can benefit from a cost-effective solution by combining DPC and low-cost options such as health sharing plans.
If a Michigan business does not owe any taxes, can it still claim the Small Business Health Care Tax Credit?
The Small Business Health Care Tax Credit may be used to reduce income taxes owed in the prior year. It can also be carried forward up to 20-years.
What exactly is an HRA (Health Reimbursement Arrangement) and how do they work?
HRAs allow employers to reimburse their employees for certain medical expenses, which aren’t covered by the employee’s insurance. Employers set the criteria for what is eligible, and they contribute accordingly.
HRAs may be combined with individual or group health plans.
Yes, HRAs work with any other type of insurance. HRAs may be used as a reimbursement for employees to pay individual insurance premiums by small business owners who have canceled their group policies. HRAs cannot reimburse health-sharing plan costs directly.
How do I know which health insurance options and cost-sharing plans are best for my Michigan business?
It’s not worth it to go at it alone. Talk to an Employee Benefits Manager. He or she can perform a free assessment and provide recommendations, based on specific requirements, your budget, the employee population, and other factors. You can work with them to design the best plan possible that will benefit your employees and keep you competitive.
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