Employers have no obligation under Michigan law to offer long-term care insurance to their employees. However, if long-term care insurance is among the benefits offered, certain state law requirements limit how the plan may be designed.
A long-term care policy may not limit or exclude coverage by type of illness, type of provider, territorial limitations, treatment, medical condition, or accident (other than a motor vehicle accident), except for:
• Preexisting conditions;
• Mental or nervous disorders that may include only neurosis, psychoneurosis, psychopathy, psychosis, or mental or emotional diseases or disorders (but not Alzheimer's disease or related disorders);
• Alcoholism or drug addiction; and
• Illnesses, treatments, or medical conditions arising out of any war or act of war (whether declared or undeclared); participation in a felony, riot, or insurrection; service in the armed forces or auxiliary units of the armed forces; or suicide, attempted suicide, or an intentional self-inflicted injury (MI Comp. Laws Sec. 500.3905).
A “preexisting condition” is a condition for which medical advice or treatment was recommended by, or received from, a provider of healthcare services within the six months immediately before the effective date of coverage (MI Comp. Laws Sec. 500.3901). Generally, a preexisting condition limitation period in a long-term care insurance policy may not be longer than six months after the effective date of coverage (MI Comp. Laws Sec. 500.3911).
Additionally, a long-term care insurance policy cannot condition benefits on the prior institutionalization of the insured or the prior receipt of a higher level of institutional care (MI Comp. ...