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How are insurance rates regulated for HMOs?
Health Maintenance Organizations (HMOs) selling group or individual health care coverage in Michigan must file base rates and their rating methodology for approval by DIFS. Rates for the individual and small group (employer group sizes up to 50) markets must comply with both Michigan law and the Affordable Care Act (ACA) rating requirements. Large group rates must comply with Michigan law. In order for DIFS to grant rate approval, the rates must be compliant with the applicable statutory standards.