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Michigan - Compensation & Benefit Legislation

MICHIGAN - AASHOWME

Demonstrates www.BenefitsReview.com™ site. Illustrates insurance carriers' coverages within the State.

 

MICHIGAN - ADOPTED CHILD HEALTH CARE MANDATE

OBRA 1993 (Federal) requires group health plans to honor medical and child support orders. Also, plans must treat adopted children like biological children covered by the plan, and plans are precluded from applying pre-existing condition exclusions to an adopted child where no such exclusion applies to a newborn biological child. Health plans that covered the cost of pediatric vaccines as of May 1, 1993, and fail to continue that level of coverage, will be subject to an excise tax penalty applicable to plans that fail to meet the health care continuation coverage requirements under OBRA 1993.

 

Mandatory coverage of adopted children is included in state's newborn health care mandate.

 

Preventive care for children: No.

 

(Michigan Stat. Ann. Section 24.13611)

 

MICHIGAN - ALCOHOLISM & DRUG ABUSE

Mandatory coverage for intermediate and outpatient care; coverage for inpatient care is a required option. Policyholder may decline coverage if premium increases 3% or more.

 

Minimum yearly inpatient coverage: No statutory requirements.

 

Minimum yearly outpatient coverage: $1,500 for intermediate and outpatient combined.

 

Minimum lifetime coverage: No statutory requirements.

 

(Michigan Stat. Ann. Sections 24.13425, 24.13609(1))

 

MICHIGAN - CAFETERIA PLAN TAX LAWS

State income tax, unemployment insurance tax on salary reduction: For state Unemployment Insurance purposes, the total amount of employees' salary reductions and any cash that the employee has the option to receive (whether or not the employee chooses the cash option must be treated as wages).

 

MICHIGAN - CONTINUATION OF COVERAGE CONVERSIONS

State reports no statutory requirements.

 

MICHIGAN - COORDINATION OF BENEFITS

Requires use of the birthday rule if coordinating benefits. Based on 1986 National Association of Insurance Commissioner Rules model. (Michigan Comp. Law Ann. Sections 500.3438-500.3440, 550.253)

 

MICHIGAN - COST-OF-LIVING

ERI's Relocation Assessor™ is a recommended source for U.S./Canadian cost-of-living data and U.S. Automobile Cost Survey.

 

MICHIGAN - DRUG TESTING AND EMPLOYEE ASSISTANCE BENEFITS

State has no statutory requirements.

 

MICHIGAN - GROUP HEALTH CODE ADDITIONS (MANDATED)

Antineoplastic Therapy: Hospital, medical, or surgical expense incurred policies must cover approved drugs used in antineoplastic therapy and the cost of its administration. (Michigan Comp. Laws Ann. Sections 500.3406e, 3616a.)

 

Breast Reconstruction and Prostheses: Insurers must offer hospital, medical, or surgical expense incurred policies providing benefits for prosthetic devices and reasonable charges for medical care of mastectomy patients receiving reconstructive surgery. (Michigan Comp. Laws Ann. Section 500.3613.)

 

Claims Forms: HMOs must use standard claims forms. (H4745, 1995.)

 

Coordination of Benefits: Individuals covered by more that one group disability plan may coordinate benefits and services between plans provided each plan contains provisions for coordination. Under these plans, coverage is first established under a plan in which a person's eligibility is determined on the basis of factors other than dependent status; benefits may thereafter be determined under a plan in which an individual has dependent coverage. In instances where individuals are covered under more than one policy and who are also covered under rights of continuation pursuant to federal or state law, a policy which covers the person as an employee, member, subscriber, enrollee, or retiree, or as a dependent is primary, and the continuation coverage is secondary. An HMO is not required to provide coordination of benefits for services which are not provided under its plan. (S1023, 1996) (Michigan Comp. Laws Ann. Section 550.253,3,64.)

 

Dependent Coverage: Dependent coverage offered by group health plans; hospital, medical, or surgical insurance policies; health maintenance organizations; and nonprofit health care corporations cannot deny enrollment to a covered individual's child because the child was born out of wedlock, was not claimed as a dependent on the individual's federal income tax return, or does not reside with the individual or in the plan's service are. If a parent is eligible for dependent coverage, the plan administrator in a group health plan must permit the parent to enroll a child who is otherwise eligible for coverage, a court may order enrollment. The child's coverage cannot be eliminated unless required premiums have not been paid or the plan administrator is provided with written evidence that the court order is no longer in effect or that the child is enrolled in comparable health care. (Michigan Comp. Laws Section 3406g, 3406h, 3406i (S708, 1995); 21054v, 2105w, and 21054x (H5174, 1995); 419, 419a, 419b of Section 5501.1101 (Section 709, 1995); The Group Health Plan Act (H5168, 1995.))

 

Domestic Violence: An insurer that delivers or renews an expense-incurred hospital, medical, or surgical policy in this state shall not rate, cancel coverage, or refuse to provide coverage solely because an insured person or applicant is, or has been, the victim of domestic violence. (Michigan Ann. Stat. Section 333.21072, 500.3406j)

 

Handicapped Dependents: Hospital coverage for dependent children cannot be terminated while a child is incapable of employment due to mental retardation or physical handicap and chiefly dependent on the insured. (Michigan Comp. Laws Ann. Section 500.2264.)

 

HMO Conversion Benefits: Insured persons continuously covered under a group health maintenance contract for at least three months immediately prior to termination along with their spouse and dependents, may elect coverage under an individual conversion health maintenance contract upon termination. Insured must notify HMO of election within 30 days after termination of coverage and first premium is paid at time of election. No evidence of insurability is required and pre-existing conditions shall not be excluded. An HMO need not issue a conversion if the insured is covered or eligible for coverage elsewhere; termination of insured's coverage under a group plan was because the individual failed to pay a required contribution; or the individual acted to defraud the

 

Hospices: Insurers must offer hospice care coverage to hospital, medical, or surgical expense incurred policyholders. (Michigan Comp. Laws Ann. Sections 500.3406c, 3615.)

 

Mammography Screening and Breast Cancer Treatment: Insurers must offer hospital, medical, or surgical expenses incurred policies providing coverage for breast cancer diagnostic services, breast cancer outpatient treatment or rehabilitative services, and mammography screening. (Michigan Comp. Laws Ann. Sections 500.3406d, 3616.)

 

Newborns: Policies providing family coverage must provide benefits for newborns from the moment of birth for injury or sickness including treatment of medically diagnosed congenital defects and birth abnormalities. (Michigan Comp. Laws Ann. Sections. 500.3403, 3611.)

 

Providers: Dentists, optometrists, chiropractors, podiatrists, and consulting psychologists: Costs for services must be covered if the provider is licensed, the service is within the provider's scope of service; and the service is covered by the policy. (Michigan Comp. Laws Ann. Sections 500.2239, 2243, 3400(4), 3475.) (H4572, 4573, January 5, 1995.) Public and mental health care providers: Policies covering mental health care must cover services rendered by such providers if court ordered or services are otherwise unavailable. (Michigan Comp. Laws Ann. Sections 500.3406b, 3614.)

 

Substance Abuse: Hospital, medical, and surgical expense incurred policies must provide at least $1,500 in benefits for immediate and outpatient care for substance abuse per year (amount set in 1982 to be adjusted annually according to the CPI). Coverage may be declined by the policyholder if such coverage would increase premiums by 36 percent or more. (Michigan Comp. Laws Ann. Section 500.3425.) Insurers must offer group disability insurance covering inpatient care at an approved facility agreed to by insurer and insured. (Michigan Comp. Laws Ann. Section 500.3609a.)

 

MICHIGAN - GROUP HEALTH FOR SMALL EMPLOYERS

For insurance plans offered to small employers:

 

MICHIGAN - GROUP LIFE CODE ADDITIONS

Employer required to pay part of premium: Yes.

 

Percent of employees who must elect coverage (if employees pay part of premium): 75%. Percent of employees who must be covered if employer pays all of premium: No statutory requirements.

 

Minimum number of employees in group plan: 10.

 

Employer prohibited as beneficiary: Yes.

 

Grace period (days): No statutory requirements.

 

Mandatory conversion: Yes.

 

Other provisions: None.

 

(Michigan Stat. Ann. Sections 24.12702, 24.14404, 24.14438)

 

MICHIGAN - HOLIDAYS

January 1, Washington's Birthday (or 3rd Monday in February), Memorial Day (or last Monday in May), July 4, Labor Day (or 1st Monday in September), Veterans Day, and December 25 are state holidays in all 50 states and in the District of Columbia. Other holidays under State law include: Martin Luther King's birthday (or 3rd Monday in January), Lincoln's Birthday, Columbus Day (or 2nd Monday in October), Thanksgiving. Other: If January 1, February 12, July 4, November 11, or December 25 falls on Sunday, following Monday is a holiday. (Michigan Stat. Ann. Sections 18.856, 18.861, 18.862, 18.881, 18.891)

 

MICHIGAN - IMMIGRATION (PREVAILING WAGE POLICY)

See U.S. Federal General Administrative Letter 1-2000

 

MICHIGAN - JURY DUTY & WITNESS TIME OFF

Employer Restriction For Discharging Employee For Taking Leave For Jury Service: Yes.

 

Remedies and Penalties: Violator is in contempt of court and guilty of a misdemeanor.

 

Other Requirements: Employer cannot require extra hours of work beyond those normally worked by the employee when added to the hours spent in jury duty, unless employee voluntarily agrees. (Michigan Stat. Ann. 27A.1348.)

 

Employer Restriction For Discharging Employee For Taking Leave to be a Witness: State reports no statutory requirements.

 

Remedies and Penalties: Violator is guilty of a petty misdemeanor. State reports no statutory requirements.

 

Other Requirements: None reported.

 

MICHIGAN - LEAVES OF ABSENCE

State reports no statutory requirements.

 

See U.S. Federal Family and Medical Leave Act

 

MICHIGAN - LONG TERM DISABILITY CODE ADDITIONS

State does not require employer to provide long term disability benefits; although many employers do in order to remain competitive in hiring/retention of employees.

 

See LEAVES OF ABSENCE (above), WORKERS' COMPENSATION (below) and U.S. Federal Americans With Disabilities Act

 

MICHIGAN - MANDATED PROVIDERS

Optometrists, chiropractors, dentists, and podiatrists. (Michigan Stat. Ann. Section 24.12239, 24.12243, 24.13475)

 

MICHIGAN - MENTAL HEALTH CARE

State reports no statutory requirements.

 

MICHIGAN - MINIMUM WAGE

Refer to the Federal minimum wage: $5.15 per hour (effective September 1, 1997).

 

Exemptions: Apprentices and handicapped workers in special environments may be exempt on motion. (Michigan Stat. Ann. Sections 17.255(2)-17.255(4), 17.255(7),17.255(14))

 

See U.S. Minimum Wage

 

MICHIGAN - NEW HIRE REPORTING

Who is required to report: All employers.

 

Who must be reported: All new hires and rehires.

 

Exempt from reporting: No exemptions.

 

Form(s) to file: W-4 or state form, by hard copy, magnetically, or electronically.

 

Filing deadline: Within 20 days of hire or return to work.

 

Employer information to be included: Name, address, and federal EIN .

 

Employee information to be included: Name, address, and SSN.

 

Penalty for failure to report: N/A.

 

(Michigan Stat. Ann. Section 25.176(18); Michigan Comp. Laws Ann. Section 552.518)

 

MICHIGAN - NEWBORN CARE MANDATE

Mandated coverage.

 

Preventive care for children: No. (Michigan Stat. Ann. Section 24.13611)

 

MICHIGAN - PARENTAL LEAVE

See U.S. Federal Family and Medical Leave Act

 

MICHIGAN - PRE-EXISTING CONDITIONS

State reports no statutory requirements.

 

See U.S. Federal Health Insurance Portability & Accountability Act

 

MICHIGAN - PROTECTED CLASSIFICATIONS

Age:  Yes.

Race:   Yes.

Color:   Yes.

National Origin: Yes.

Ancestry:   No specific law. State has expressed policy against discrimination.

Religion:  Yes.

Sex:  Yes.

Pregnancy:  Yes.

Sexual Harassment: Yes.

 

(Mich. Stat. Ann. Sections 3.548(202), 3.548(203), 3.548(205).)

 

MICHIGAN - SALARY SURVEY

ERI's Relocation Assessor™ is a recommended source for U.S./Canadian wages & salaries (covering 3,000 positions).

 

MICHIGAN - SHORT TERM DISABILITY CODE ADDITIONS

State does not require employer or employee participation in short term disability plans.

 

MICHIGAN - TERMINATION & SEVERANCE PAY

Date pay is due if employee is discharged: Immediately. (Law recognizes modification of payment of fringes by written contract.)

 

Date due if employee resigns: Immediately. (Law recognizes modification of payment of fringes by written contract.)

 

Wages: Yes.

 

Vacation Pay: Yes.

 

Holiday: Yes.

 

Sick leave: Yes.

 

Severance: No.

 

(Michigan Stat. Ann. Sections 17.277(1), 17.277(4), 17.277(5))

 

MICHIGAN - UNEMPLOYMENT TAX

Employer Contributions:

 

 

Voluntary Contribution Provision: Yes. Within 30 days of mailing notice but within 120 days of beginning of year.

 

(Michigan Compensation Laws Sections 421.13, 421.19, 421.19a.)

 

MICHIGAN - VACATION PAY

See TERMINATION & SEVERANCE PAY (above)

 

MICHIGAN - VOTING TIME OFF

State reports no statutory requirements.

 

MICHIGAN - WORKERS' COMPENSATION

Private Employers: Mandatory as to all employers of 3 or more, or less that 3 if 1 is employed for 35 hours per week for 13 weeks by same employer. (Note: Corporate officer who is 10% shareholder of corporation with up to 10 shareholders may reject coverage.)

 

Public Employers: Mandatory as to all public employments. Trainees in federally funded training program deemed employees of sponsoring public entity.

 

Exceptions: Professional athletes whose AWW is more that 200% of the statewide AWW; domestic servants who work less that 35 hours a week for 13 weeks a year; licensed real-estate sales person.

 

Special Coverage Provisions: Voluntary as to employer of 2 or less, and domestic service. Family members may be excluded by endorsement.

 

(U.S. Chamber of Commerce, 1994 Analysis of Workers' Compensation Laws.)