EXTRA: MNsure ushers in new era of health coverage options

12:52 AM, Sep 6, 2013   |    comments
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ST PAUL, Minn. -- Minnesotans got their first look Friday at the health plans that will be sold on the state's health insurance exchange, known as MNsure.

In all 141 different private insurance plans will be offered through the exchange, with as many as five different carriers competing for business in the Twin Cities area.

The actual premiums will vary depending on income, age, smoking status and where the customer lives. But on average those premiums will be less expensive in Minnesota than in any other state with its own health exchange.

Details on the rates are available at this link on the MN Dept of Commerce website , and details about the provider networks set up by the companies can be found through this link at the MN Dept of Health website.

MNsure's role explained

The legislature created the new health coverage marketplace to help residents take care of the discounts and tax credits that will become available as part of the Affordable Care Act, to make the premiums for those private insurance plans less expensive.

Persons looking for individual plans, and small business owners who'd like to secure coverage for their employees will be able to go online October 1 and shop for coverage.

"It makes getting coverage more simple because you'll be able to compare it in an apples to apples way," April Todd-Malmlov, MNsure's executive director, told KARE.

"People will be looking at the same benefits across all the carriers, being able to compare the premiums and the co-pays for those plans in the same way across all the carriers."

The state's banking on an advertising campaign featuring the iconic figures of Paul Bunyan and Babe the Blue Ox to draw consumers to MNsure.org to learn more about the new marketplace.

But Todd-Malmlov still spends a lot of time explain to people what MNsure is, and isn't.

"MNsure is not insurance," she remarked.

"We are the place that allows you to compare other insurance options and providing assistance to, to purchase that coverage."

The state projects 300,000 uninsured Minnesotans will gain coverage using MNsure as a portal to coverage, while as many as one million consumers will buy their insurance through the exchange eventually.

All of the shopping and transactions can be done online, or in person with the help assistants and "navigators" who will be positioned throughout the state in clinics, hospitals and community centers.


Customer pool

Most of those Minnesotans who now qualify for Medical Assistance, which is Minnesota's version of Medicaid, will use the exchange to re-enroll.

Those on Medicare will remain on Medicare. The exchange is designed mainly to serve those who are uninsured, or pay too much for coverage on the individual market because of pre-existing conditions.

Owners of small businesses -- those with fewer than 50 employees -- will also be able to use the exchange to purchase coverage for their staff members. Tax credits will make those plans more affordable.

Most people who now get their coverage through their employers will find keeping it the least expensive option.

"If you have employer-based coverage and you like that coverage, and it's affordable for you, you don't have to do anything October first," Todd-Malmlov explained.

An "affordable" premium, for the purposes of the Affordable Care Act, is one that costs less than 9.5 percent of your annual income for an individual policy.

You can still buy a plan on the exchange if you have a chance to buy it through your employer, but you won't be able to take advantage of the discounts and tax credits if you're offered affordable insurance through your job.

People and small businesses in Wisconsin will shop for plans on the federal exchange at Healthcare.gov, because that state doesn't have its own exchange, but they'll qualify for the same subsidies and tax credits as Minnesotans.

"What Minnesotans will get is much more personalized information, more on-the-ground assistance,"Todd-Malmlov said.

"And, uniquely in Minnesota we have the Minnesota Care program which will reduce premiums even further for some individuals than what would be available through the federal exchange in Wisconsin."

Costs and Credits

The out of pocket costs of policies sold through MNsure will vary depending on which plan you pick, and on your income level. Families can earn up to 400 percent of federal poverty level - or $94,000 for a family of four -- and still qualify for a discount.

But all plans sold through the exchange will have to carry a set of "essential benefits" such as preventative care, prescription drugs, lab tests and maternity care to name a few examples.

The plans sold through the exchanges will be rated as bronze, silver, gold and platinum.

"The difference between the metal tiers -- bronze, silver, gold and platinum -- is really about how much cost-sharing, how much you're going to pay in deductibles, co-insurance or co-pays," Todd-Malmlov said.

Several political ad campaigns launched by groups opposed to ObamaCare have suggested that patients will be asked to switch physicians or hospitals as part of health care reform.

That would only apply if an individual's physician is not in the provider network established for the plan they buy.  In most cases, patients could still see out-of-network providers, but pay a higher co-pay.

Opponents of the Affordable Care Act also have warned of personal privacy breaches, because of the vast computer server networks created as part of the new system.

That added Internet infrastructure was required so that the health exchanges could communicate with the IRS and Social Security and state human services agencies, to double check income eligibility and ensure that insurance customers aren't covered by more than one public health plan.

Small Business Hook

Todd Mikkelson and Heidi Marty are among the small business owners who are hopeful MNsure will make it easier to do business in Minnesota.

Their company in Spring Park makes an precision water spray rack that builders and architects use to field test newly installed windows, to make sure they meet strict international standards for water protection.

Marty takes on the annual task of finding health coverage on the open market, which costs $400 per month with a moderate deductible.

"There are a lot of people in these same circumstances as we're in, people looking for their own health care, trying to find the best deals," Marty told KARE.

"I'm anxious to see what the exchange is all about. I'm hoping that it's going to provide some options."

Mikkelson, who learned about the exchange through a nonpartisan trade group known as Small Business Minnesota,  said the convenience of the exchange is also very appealing.

"Heidi spends a lot of time shopping for affordable insurance, time that she'd rather devote to running this business," he remarked.

Another appealing aspect of the Affordable Care Act for Mikkelson and Marty is the opportunity to offer coverage to new employees, should they choose to expand their operation.

"It would be great to be able to say to them that, in addition to this hourly rate, we can offer you this insurance coverage," Marty said.

They're not the only entrepreneurs drawn to the new exchange.

Lynne Dablow of Cambridge, who owns a business that trains service animals, said she's thrilled at the possibility of buying health coverage that's not tied to a job.

"It became a possibility that I would be able to go through open enrollment, and I really was very encouraged, and positive, and confident," Dablow told KARE.

Dablow is a breast cancer survivor who has been cancer free for five years. And while the milestone is worth celebrating for Dablow and her loved ones, it could still count against her on the open insurance market.

In fact, Dablow held onto another full-time job in the Twin Cities longer than she had intended to because she worried her pre-existing condition would make it harder to get coverage on her own.

But, beginning in 2014 the Affordable Care Act will make it illegal to deny health insurance based on a pre-existing condition.  That gave Dablow the confidence to leave her job and go on a COBRA plan temporarily, in hopes of enrolling in a new plan through MNsure.

"So, I did, I left my job. And, and, I'm going after my dream."

Dablow's latest dream is to drive a vintage RV to antique shops across central Minnesota, to buy collectibles she can sell online.

It's a business plan that also allows her to spend more time with her 88-year-old mother, Betsy, who lives in an assisted living apartment complex in Cambridge.

"This allows me to step out, go after my dream of continuing to build the one businesses out at the farm, with our animals. But also come here and care for my mom, and to start the other business."

(Copyright 2013 by KARE. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.)

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