How your insurance rates are set

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Michigan Health Insurance – Employer Help – Learn More

If you've ever wondered how we decide what to charge for employer-sponsored health insurance, this article explains how rates are set.

Coverage, quality care and customer service are all critical factors when deciding on employer-sponsored health insurance. But we know in many cases, cost is most important.

How do we decide what to charge? Every business and organization is different. Your insurance rates will be too. 

A business or organization is considered a small group if you have 50 or fewer eligible employees. 

How insurance rates are set for small group plans that go into effect after Jan. 1, 2014

As part of the Affordable Care Act, some of the factors we use to set rates for small group plans will change. Beginning Jan. 1, 2014 your rates will be based on:

  • How many people are on the plan. For families, we only charge a premium for the three oldest children (up to age 21).
  • Geographic area (where your business is located).
  • The age of those covered by the plan, with limits on how much members can be charged based on their age.

Questions? Contact us and we'll help.

Does your business have more than 50 full-time employees? You'll get the most accurate information about how your rates are set from your sales representative.

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