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Self-Funded Health Plans for Michigan Employers: 2026 Decision Guide | TCHP
Michigan employers with 50 or more employees and stable workforces can save 15 to 20% on healthcare costs by moving to a self-funded or level-funded health plan. The decision depends on cash flow, workforce stability, and risk tolerance, not size alone. This guide walks Michigan CFOs and business owners through the evaluation framework, regulatory considerations, and implementation timeline for 2026.
Looking Towards 2026 – Health Plan Trends Employers Should Be Aware Of
As we approach the end of the year, we're reflecting on the 2025-2026 benefits renewal cycle, which Mike Hill calls "the most contentious I've seen...
Insights from the 2025 Health Insurance 4.0 Event
Total Control Health Plans recently hosted the second annual Health Insurance 4.0 summit for Michigan employers, highlighting industry trends and...
What’s in Store for 2025? – 2024 Health Insurance Trends
In 2024, the health insurance industry experienced significant changes. We've seen firsthand how rising costs in the marketplace have impacted both...
Is Nomi Health Right for Your Business?
Disrupting today’s healthcare landscape, Nomi Health eliminates the middleman and provides employers with increased control and transparency over...
Is A Captive Right For Your Organization?
If you’ve ever explored self-funded health plans, you may have heard of “captives”, but you might not fully understand how they function or what...
J&J Sued Over Contracting with PBM that Overcharged Health Plan, Enrollees
A new area of potential liability for employers was recently opened when a class-action suit was filed against Johnson & Johnson (J&J),...
Plan Terms – and Their Various Definitions
In early February 2024, news broke of a proposed class action lawsuit against Johnson and Johnson for breach of their fiduciary duty under ERISA,...
Reflections on the Recent Johnson & Johnson Lawsuit
For those of us in the employee benefits world, quite a bombshell was dropped on Monday, February 5th when a class action lawsuit was proposed...
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What is MLR?
MLR, or Medical Loss Ratio, is a prime example of misaligned incentives in the health care supply chain. The Medical Loss Ratio is a provision in the Affordable Care Act that was intended to keep insurance carriers from over charging their customers. It requires that carriers spend $.80 of each dollar collected in the small group market, and $.85 of each dollar collected in the large group market, to pay its customers’ medical claims and activities that improve the quality of care. The remaining portion can be used for overhead expenses, such as marketing, profits, salaries, administrative costs, and agent commissions. If health care costs go up, however, then the carrier is justified in charging higher premiums increasing the value of their 15% or 20%. With a model like this, carriers benefit when health care costs go up.