The health insurance marketplaces launching in Minnesota and several other states across the country are one of the Affordable Care Act’s biggest changes to health care policy.
The marketplaces are designed as an easy and effective way to help people buy insurance to satisfy the mandate that requires all Americans to be insured starting next year or pay a penalty.
Minnesota’s marketplace, MNsure, is set to open Oct. 1. The Daily News spoke with MNsure public relations officer John Reich to learn the details of the new marketplace.
What will the marketplace do?
Reich said MNsure is designed to be a one-stop shop for finding health insurance. Instead of requiring people to go out and find plans individually from a number of different companies, the marketplace collects all of that in one place and offers easy-to-use comparison tools.
The system also allows a user to instantly see their eligibility for state and federal health care plans, as well as what subsidies or tax credits they qualify for, depending on their income.
Small businesses can use the system to help find insurance quotes in real time that best fit their employees.
How do I use the marketplace?
Reich said using the marketplace will be just like shopping online.
Users will create an account. Then they’ll check to see if they’re eligible for financial assistance or public healthcare plans.
Then they’ll be shown a list of plans, and can compare and contrast options.
Finally, they’ll check out using an automated payment system just like at any other online retailer.
MNsure will process the initial payment; the user will be then directed to the insurance provider to set up future payments.
How does my business use the marketplace?
Small businesses can provide what are called defined contribution programs if they have fewer than 50 full-time employees. Tax credits are also available the next two years for businesses with fewer than 25 employees and with average wages less than $50,000.
The program allows businesses to select a number of options for employees to choose from. Businesses can then choose to contribute a certain amount to each employee who chooses a plan from the list.
Reich said this will give employers and employees more flexibility in coverage than existing group benefits packages.
What are the different kinds of plans?
As part of the Affordable Care Act, all plans on the exchange have to offer coverage of prescription drugs, emergency services, hospitalization, maternity care and a number of additional state requirements.
Outside of federal Medical Assistance and Minnesota Care, plans offered on MNsure fall under several defined categories, based on how much medical costs insurance covers.
There are four general categories of coverage: Bronze, silver, gold and platinum. On the low end, the bronze plan covers at least 60 percent of costs, and on the high end, platinum plans cover at least 90 percent of costs.
In our region, before subsidies and tax credits, rates start around $184 a month for a bronze plan for a 25-year old, and go as high as $808 a month for a 60-year-old enrolled in a platinum plan.
When do I sign up?
MNsure uses an open enrollment system similar to some employee benefits systems. For the first year, MNsure has an extended open-enrollment period — that is, the timeframe when you have to sign up for benefits — starting Oct. 1 and running through the end of March.
In future years, open enrollment will run from Oct. 1 through the end of December.
If a user applies for coverage at any point before the end of the year, the coverage starts Jan. 1. Starting in 2014, coverage will go into effect the first or last day of the month, depending on when it’s purchased.
Insurance cannot be bought or changed outside of the open-enrollment period, unless a person changes jobs, has a child, gets married or changes their circumstances in other ways.
Those who qualify for Medical Assistance will follow different rules, Reich said—enrollment is offered year-round.
My insurance will be cheaper with tax credits and subsidies. How do they work?
For individuals and families, federal tax credits and subsidies will be applied automatically to the premium and won’t have to be addressed when the user files taxes. Small business owners will still have to file credits through their taxes.
I have questions. Who do I talk to?
MNsure offers a toll-free support line at 1-855-366-7873 to answer any questions, help with technical issues or direct people to resources for issues the marketplace cannot address.
There are also local resources through what are called registered brokers or agents. Winona Agency plans to become one. Winona County, the Winona Public Library and Winona Health will also be able to provide limited support and resources.