Free Group Health Insurance Study Guide
Michigan Life, Accident & Health exam — Group Health Insurance.
The national Group Health guide covers group underwriting, the master policy and certificates, coordination of benefits, COBRA and HIPAA. This guide covers Michigan's small employer group health law in chapter 37 of the Insurance Code (MCL 500.3701–3711).
Who is a small employer (MCL 500.3701)
| Term | Michigan definition |
|---|---|
| Small employer | An employer with an average of at least 1 and no more than 50 full-time employees in the preceding calendar year (the definition since 2018) |
| Eligible employee | Full-time, normally working 30 or more hours a week. An employer may uniformly include employees working 17.5 to 30 hours. |
Participation limits (MCL 500.3709)
A carrier's minimum participation requirement may not exceed these levels:
| Eligible employees | Maximum participation requirement |
|---|---|
| 10 or fewer | 100% |
| 11 to 25 | 75% |
| 26 to 50 | 50% |
Enrollment and renewal
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Special enrollment: an employee who loses other coverage must ask to enroll within 30 days of that coverage ending (3708).
-
Renewal (3711) may be refused only for:
- fraud
- nonpayment
- failure to meet contribution or participation rules
- the carrier leaving the market
- moving out of the service area
Renewal can never be refused because of health status.
Related Michigan rules
- Prompt payment: clean claims are paid within 45 days, then interest runs at 12% (MCL 500.2006(8)).
- External review goes to the DIFS Director after internal appeals (MCL 550.1911). See the Michigan Medical Plans guide.
- Group life conversion is 31 days. See the Michigan Life Policy Provisions guide.
- Federal COBRA continuation is covered in the national guide.
Common exam traps
- Small employer: 1–50 full-time employees. Full-time means 30+ hours. Employers may include those working 17.5–30 hours.
- Participation caps: 100% / 75% / 50% by group size.
- Special enrollment after losing other coverage: 30 days.
- Health status is never a reason to nonrenew a small group.
Practice Group Health Insurance questions All Life, Accident & Health topics
Practice questions are study aids generated for exam preparation and are not actual exam questions. Content is provided for educational purposes and is not legal advice. Verify current statutes, rules, and exam specifications with the Insurance Department and the exam administrator before relying on it.
