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Making the individual and small group markets in Minnesota competitive September 6, 2013
1 | September 6, 2013
What is MNsure?
About MNsure
MNsure is Minnesotas new health insurance marketplace where individuals and small businesses can access quality health insurance. This new marketplace will allow Minnesota families, small businesses, and individuals to directly compare health insurance plans and to choose the plan that best fits their needs and budget.
2 | September 6, 2013
Help is Here
Financial assistance will be available to help cover the cost of health care insurance premiums for qualifying individuals and small businesses. Some Minnesotans may qualify for no-cost or low-cost plans. The following sections and tables in this packet outline the criteria for financial assistance and tax credits. Minnesotans have several options to help them find the right health insurance plan, get questions answered, and enroll. People can find help online at MNsure.com, in-person with experts throughout the state, or by calling MNsure toll free at 1-855-3MNSURE (1-855-3667873).
3 | September 6, 2013
What is MinnesotaCare?
MinnesotaCare is a subsidized health care coverage program for lower income Minnesotans without access to affordable employer-based health care coverage and who are not eligible for Medical Assistance. Enrollees pay a monthly premium, determined by a sliding-fee scale based on family size and income. Starting in 2014, adults with incomes between 133 percent and 200 percent of the federal poverty level are eligible for MinnesotaCare. Starting October 1, 2013, eligibility and enrollment for MinnesotaCare will be available through MNsure.
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Through MNsure some individuals and families may qualify for financial assistance through tax credits that will immediately lower the cost to consumers for private health insurance. Financial assistance also may be available through no-cost or low-cost coverage under Medical Assistance or MinnesotaCare.
100% 1 2 3 4 5
For each additional person, add
133%
$15,282 20,628 25,975 31,322 36,668 $5,347
200%
$22,980 31,020 39,060 47,100 55,140 $8,040
275%
$31,597 42,652 53,707 64,762 75,817 $11,055
300%
$34,470 46,530 58,590 70,650 82,710 $12,060
400%
$45,960 62,040 78,120 94,200 110,280 $16,080
HOUSEHOLD SIZE
MEDICAL ASSISTANCE
MINNESOTA CARE
Once you know how your income relates to the federal poverty level, you can determine the maximum percentage an individual or family is required to pay.
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200% 6.30%
250% 8.05%
400% 9.50%
After you have established where your annual income falls on the federal poverty level and the maximum percentage from the tables above, you can use the equation below to calculate how these factors affect the final cost of an individual or familys chosen plan. The examples below illustrate how the final cost to consumers is calculated taking premium assistance into account at different health plan levels. Generally, if a person chooses a lower priced plan, they would pay a lower premium after the tax credit is taken into account. However, plans with lower premiums may have higher deductibles and out-of-pocket costs. People who earn less than 250 percent of the federal poverty level will also recieve additional cost-sharing subsidies to help them cover out-of-pocket costs. The cost of the second-lowest priced silver plan for a 25-year-old in Region 1 is $240 per month. If a 25-year-old persons income in Region 1 is 200 percent of the federal poverty level, or a total annual income of $22,980, the following formula would calculate the monthly available tax credit.
If the individual chose a bronze plan with a lower price of $184, their monthly cost for that coverage would be $65 after the application of the tax credit.
If the individual chose a gold plan with a higher price of $256, their monthly cost for that coverage would be $137 after the application of the tax credit.
6 | September 6, 2013
Starting in 2014, adults with incomes between 133 percent and 200 percent of the federal poverty level are eligible for MinnesotaCare. Enrollees pay a monthly premium, determined by a sliding-fee scale based on family size and income. The table below shows the monthly premium starting in 2014 for an adult enrolling in MinnesotaCare, based on federal poverty level. Monthly Per Adult Premium $21 $25 $29 $33 $38 $43 $50
Federal Poverty Level 133% - 140% 141% - 150% 151% - 160% 161% - 170% 171% - 180% 181% - 190% 191% - 200%
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8 | September 6, 2013
Below, in alphabetical order, are the companies that are certified to offer plans through MNsure for individuals and small businesses. Individual Market Blue Cross Blue Shield Group Health Inc Medica of Wisconsin PreferredOne UCare Small Group Market Blue Cross Blue Shield Medica of Wisconsin PreferredOne
9 | September 6, 2013
The tables below provide the lowest monthly cost of health insurance for a 25 year-old individual living in the selected region shown in orange above, based on annual income (a detailed county listing for each region is on page 8). You can see if you qualify for no-cost or low-cost programs like Medical Assistance and Minnesota Care, or if you are eligible for premium assistance (tax credits) that will lower your monthly health care costs.
Key Facts
Individuals with annual incomes of up to $15,282 qualify for Medical Assistance Individuals with annual incomes of $15,283 to $22,980 qualify for Minnesota Care Individuals with annual incomes of $22,981 to $45,960 are eligible for premium assistance (tax credits) see page 5 for more information.
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51 | September 6, 2013
The charts below provide the lowest monthly cost of health insurance for a 40 year-old individual living in the selected region shown in orange above, based on annual income (a detailed county listing for each region is on page 8). You can see if you qualify for no-cost or low-cost programs like Medical Assistance and Minnesota Care, or if you are eligible for premium assistance (tax credits) that will lower your monthly health care costs
Key Facts
Individuals with annual incomes of up to $15,282 qualify for Medical Assistance Individuals with annual incomes of $15,283 to $22,980 qualify for Minnesota Care Individuals with annual incomes of $22,981 to $45,960 are eligible for premium assistance (tax credits) see page 5 for more information.
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The charts below provide the lowest monthly cost of health insurance for a 60 year-old individual living in the selected region shown in orange above, based on annual income (a detailed county listing for each region is on page 8). You can see if you qualify for no-cost or low-cost programs like Medical Assistance and Minnesota Care, or if you are eligible for premium assistance (tax credits) that will lower your monthly health care costs
Key Facts
Individuals with annual incomes of up to $15,282 qualify for Medical Assistance Individuals with annual incomes of $15,283 to $22,980 qualify for Minnesota Care Individuals with annual incomes of $22,981 to $45,960 are eligible for premium assistance (tax credits) see page 5 for more information.
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55 | September 6, 2013
The charts below provide the lowest monthly cost of health insurance for a family of four living in the selected region shown in orange above, based on annual income (a detailed county listing for each region is on page 8). You can see if you qualify for no-cost or low-cost programs like Medical Assistance and Minnesota Care, or if you are eligible for premium assistance (tax credits) that will lower your monthly health care costs
$0
$0
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$0
$0
57 | September 6, 2013
The charts below provide the lowest monthly cost of health insurance for a small business of five employees ages 20, 30, 35, 40, and 50. This example assumes all employees are enrolled in the same plan. The charts also illustrate eligibility for the small business premium tax credits referenced on page 8.
$1,305 $653
$1,305 $326
$1,305 $261
$1,305 $131
$1,305 $0
$653
$979
$1,044
$1,175
$1,305
$1,527 $764
$1,527 $382
$1,527 $305
$1,527 $153
$1,527 $0
$764
$1,145
$1,222
$1,374
$1,527
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$1,805 $903
$1,805 $451
$1,805 $361
$1,805 $181
$1,805 $0
$903
$1,354
$1,444
$1,625
$1,805
$2,374 $1,187
$2,374 $594
$2,374 $475
$2,374 $237
$2,374 $0
$1,187
$1,781
$1,899
$2,137
$2,374
59 | September 6, 2013