McLaren Health Plan - Our Plans

McLaren Health Plan
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About McLaren Health Plan

McLaren Health Plan (MHP) has been operating as a Michigan-based licensed Health Maintenance Organization (HMO) since 1998 and currently delivers health care benefits to 260,000 members. The HMO was started to serve Michigan’s Medicaid population and has added group, individual and Medicare products along with a Third Party Administrator called Health Advantage, Inc., for self-funded employer groups. In 2015, MHP was awarded the right to operate in and service every county in the lower peninsula of the state of Michigan – the only provider-owned health plan to achieve this designation by the Michigan Department of Community Health. MHP has earned the prestigious Pinnacle Award every year since 2013 from the Michigan Association of Health Plans and is also accredited by the National Committee for Quality Assurance (NCQA).

McLaren Health Plan offers:

Community - Commercial & Marketplace
Group/Individual

Fully-Insured Plans

Fully-insured health plans are the more traditional way to structure an employer-sponsored health plan. With a fully-insured health plan, the company pays a premium to the insurance carrier. The premium rates are fixed for a year, based on the number of employees enrolled in the plan each month.

McLaren Health Plan offers fully-insured plans for small and large group employers on the Health Maintenance Organization (HMO), Point-of-Service (POS) and High Deductible platforms.

Small Group Plans

Small group plans can be purchased on the Health Insurance Marketplace or directly from McLaren Health Plan. They are for employers with 50 or fewer employees. McLaren Health Plan offers fully-insured plans for small groups on the Health Maintenance Organization (HMO) platform.

Large Group Plans

Large group plans are not available on the Marketplace and must be purchased directly from McLaren Health Plan. Large groups are defined as employer groups with 51 or more full-time equivalent employees. McLaren Health Plan offers plans for large groups on the Health Maintenance Organization (HMO), Point-of-Service (POS) and High Deductible platforms with a variety of benefit options.

Individual Plans

Individuals plans are purchased by individuals to cover themselves and their qualified dependents. The individual is responsible for paying the premium. Tax credit may be available to qualified individuals who purchase their plans on the Marketplace.

McLaren Health Plan offers plans on the Marketplace. You also may purchase Individual plans directly from McLaren Health Plan. There are a number of plans to choose from, with a variety of premiums and benefit options.

Learn more about our Community - Commercial and Marketplace Insurance

Healthy Michigan

The Healthy Michigan Plan (sometimes referred to as “Medicaid Expansion”) provides health care benefits to qualified Michigan residents aged 19-64 at a low cost so more people can have health care coverage.

Learn more about McLaren Health Plan Healthy Michigan Insurance

McLaren Health Advantage
Group Insurance

Self-funded plans (also known as Administrative Services Only or ASO plans) are plans in which the employer assumes the financial risk for providing health care benefits to its employees. Rather than paying an insurance company to pay medical, dental and vision claims, the employer is responsible for the cost of the claims, using a third-party administrator to process the claims on its behalf. Companies that decide to offer self-insured plans usually do so for cost savings and to control the plans offered.

McLaren HealthAdvantage is a wholly owned subsidiary of McLaren Health Plan, and is a Michigan third-party administrator (TPA) that administers self-funded products to employer groups with 50 or more employees.

Learn more about McLaren Health Advantage - Group Insurance

Medicaid / MIChild

Medicaid is a jointly funded, Federal-State health insurance program for low-income and needy people. It covers children, the aged, blind and/or disabled and other people who are eligible to receive federally assisted income maintenance payments.

Learn more about McLaren Medicaid / MIChild

Medicare Supplement

A Medicare Supplement plan works with Original Medicare coverage, and depending on the plan, covers all or a part of your Medicare deductibles and coinsurances.

A Supplement plan, also referred to as Medigap coverage, is health care coverage that is in addition to Original Medicare. A Supplement plan helps to fill in the “gaps” in coverage in Original Medicare.

Learn more about McLaren Medicaid / MIChild

McLaren DirectCare with Roundstone

With McLaren DirectCare with Roundstone from McLaren Health Plan, employers will band together with mid-market employers to collectively self-insure with the efficiency of a large organization. And through McLaren DirectCare, they will get the best possible prices from McLaren Health Care, featuring a fully integrated health network of 14 hospitals, ambulatory surgery centers, imaging centers and a 490-member employed primary and specialty care physician network, as well as access to more than 68,000 providers and 141 hospitals across the state. And, they have the possibility of receiving a distribution of savings at the end of the year.

Learn more about McLaren DirectCare with Roundstone