This Information Prepared in Cooperation with Gallagher Benefit Services, Inc.

“MNSure” – New Minnesota Insurance Marketplace

March 21, 2013

(This information prepared in cooperation with Gallagher Benefit Services, Inc.)

HF 5 (Chief Author Rep. Joe Atkins, DFL) and SF 1 (Senators Lourey, Metzen, Sheran and Bakk, DFL-Eagan), legislation that establishes the infrastructure for the state’s “health insurance exchange” as required by federal health care reform law, was presented to the Governor and signed into law on March 20, 2013. The bill titles the Minnesota health insurance exchange the “Minnesota Insurance Marketplace.”

Background

· Under federal health care reform, states have the option of creating their own health insurance exchange or using one supported in whole or in part by the federal Department of Health and Human Services. An exchange is an arrangement through which private and non-profit insurers offer small employers (up to 100 employees) and individuals the ability to purchase health insurance.

· Minnesota is one of 18 states listed on the federal web site (www.healthcare.gov) as opting for a state-run exchange.

· Minnesota’s website on health reform is located at: http://mn.gov/health-reform/

· The Minnesota exchange website is: http://mn.gov/hix/

Provisions of the Legislation

· Establishes a board of directors consisting of seven members in the executive branch of state government, one of whom is the state Commissioner of Human Services, to oversee the exchange. It also establishes term limits for the board members and clarifies that the board will be subject to the Open Meeting Law.

· One of the more important aspects of this bill is that it does not prohibit “qualified individuals” or “qualified employers” from selecting a health plan offered outside of the Marketplace.

§ A “qualified employer” under federal health care reform is defined as generally meaning a “small employer” who elects to make all full time employees eligible for one or more qualified health plans available in the small group marketplace offered through the exchange.

§ The Affordable Care Act defines a “small employer,” for the purposes of health coverage, as an employer with at least one but not more than 100 employees. Pursuant to 1304(b)(3), each State has the option to limit small employers to having no more than 50 employees until 2016. According to the Minnesota exchange web site, the exchange will only be offered to employers with no more than 50 employees at this point but may be opened to larger employers beginning in 2017.

§ Effective 2017, the state may elect to expand the term “qualified employer” to mean large employers also.

§ A “qualified individual” is an individual who seeks to enroll in a qualified health plan through an exchange, resides in the State and is not incarcerated.

· No health insurance carrier is required to participate in the Marketplace, however, for those that do opt to participate; beginning January 1, 2015, the board will approve two health plans. One of those plans offered must be the most popular plan measured by participation in each of the catastrophic, bronze, silver and gold actuarial levels for each service area that they offer coverage to in the individual and small group markets.

§ Small group market means the market for health insurance coverage offered to a small employer as defined as an employer that employed an average of no less than two nor more than 50 current employees on business days during the preceding calendar year and that employs at least two current employees on the first day of the plan year. If a carrier does not offer at least two of these plans then it must offer all of its health plans in each of the service areas. If health insurance carriers offer health plans outside of the Marketplace they must also offer both the silver and gold actuarial level plans offered in the Marketplace.

· The bill also provides for a navigator, in person assisters and call centers to assist individuals with the process of seeking insurance through the exchange.

· All employers will be required to provide a written notice to each employee informing them of the existence of the State’s exchange and how to get in contact with the exchange, among other items.

§ The notice was originally scheduled to be distributed by March 1, 2013, but the requirement has been delayed until late summer or fall of 2013, which will coordinate with the first open enrollment period for the Exchanges.

Resources & Further Information

· The League is currently planning informational sessions on the employer shared responsibility requirements for large applicable employers (50 or more full time and full-time equivalent employees) in various locations throughout the state in April, May and June and a webinar later this summer on the Minnesota exchange program and how small employers can analyze their options in the new system. Watch the League’s web site for more information.