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Commerce provides tips to consumers on health insurance coverage, reminder that minimum essential coverage needed by March 31 to avoid tax penalty

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3/12/2015 10:14:43 AM

For Immediate Release:

SAINT PAUL, MN – The Department of Commerce issued a consumer alert today to remind Minnesotans that Open Enrollment will be ending on March 31, 2014 and if you have put off purchasing health insurance, now is the time to explore your options and purchase coverage. Open enrollment is the specific time of the year that someone can buy or change their insurance coverage, the next open enrollment period will begin on November 15, 2014. Buying a plan during open enrollment is the best way to ensure that you have coverage if you get sick and to protect yourself or your family financially. 

Minnesotans need to know that after March 31, 2014, the “individual responsibility requirement” of the Affordable Care Act, also known as the individual mandate will begin. This is the requirement that every person must have health insurance of some kind. If someone doesn’t have insurance that qualifies as “minimum essential coverage”, they may be subject to a fee at the end of the year when they file their taxes. In the first year, the fine is $95 per adult or 1% of family income, whichever is greater. In subsequent years, the penalty goes up. 

In general, if someone already has health insurance coverage, they do not need to buy a new plan. “Minimum essential coverage” includes government-program coverage like Medicare, Medicaid/Medical Assistance, the Children’s Health Insurance Program (CHIP), veteran’s coverage and TRICARE, and it also includes employer-sponsored coverage or individually purchased coverage someone already has. It does not include plans that have limited benefits, like vision or dental plans, disability policies, or worker’s compensation plans. And beginning in 2015, high risk pool coverage and certain self-insured student plans will no longer qualify as “minimum essential coverage”.

For Minnesotans who do not have minimum essential coverage, open enrollment is the time to find a new health insurance plan. For the first time, Minnesotans with pre-existing conditions who could not receive coverage now have the choice to shop around for coverage that fits their financial and health needs. Many customers of insurance agents and brokers across the state have signed up for new coverage during open enrollment. This is in addition to the over 118,000 Minnesotans MNsure has reported that have enrolled in coverage through MNsure, noting that an additional one thousand Minnesotans continue to enroll daily.

What do I need to know when looking for health insurance coverage?

During open enrollment, companies cannot turn you down for coverage if you have a pre-existing condition. Even if someone does not want to buy coverage through MNsure, they can purchase a policy directly from the health insurance company during open enrollment. Once open enrollment ends, it will be harder to get coverage. This is because health plans are not required to accept people applying for individual policies year-round. You cannot wait until you get sick to buy coverage because you might not be able to find it when that happens. 

There are some opportunities to buy coverage outside of open enrollment, during “special enrollment periods.” Special enrollment periods occur after a “qualifying life event,” which include getting married or divorced, having a new baby, losing coverage through your job, or moving to a new state. If one of these events happens you will have a certain amount of time afterward to buy new coverage or change your health plan (usually 30 days). 

Help is Available for You to Find and Enroll in Coverage

If you have never bought health insurance on your own or you want to change your plan, knowing who you can rely on to help you is the first step to enroll in coverage. There are many resources available to help you choose and enroll in a health plan, including brokers (also called agents) and navigators. Brokers and navigators provide different types of assistance.

How Can a Broker or Agent Help? 

A broker or agent can help you or your small business decide on the right plan at the right price. Brokers and agents can give you advice on a specific plan based on your needs. They are paid by the insurance company or companies they represent, and can help you buy a health plan even if you do not choose to enroll through MNsure (Minnesota’s online health insurance marketplace). 

How Can a Navigator Help? 

A navigator can only provide you with application and enrollment help if you buy your coverage through MNsure. They can provide impartial information about the health plans available to you, but they cannot recommend a specific health plan. If you need help deciding on the right plan, they may refer you to a broker or agent.

Before contacting an agent or navigator to help you find the right coverage, visit the Commerce Department’s health insurance glossary to help you brush up on everything health insurance and rate review related. The Commerce Department urges all consumers to use our license lookup tool to make sure the company or individual you are, or will be, working with is licensed to sell insurance in Minnesota. Do not purchase insurance with any agents, brokers, or companies that are not licensed to sell insurance in our state.

Don’t forget: Open Enrollment ends on March 31, 2014. This is the last day to enroll in health insurance inside or outside of MNsure without facing a tax penalty. This deadline does not apply to Medical Assistance or MinnesotaCare recipients or participants in the Small Business Health Options Program (SHOP).

The Minnesota Department of Commerce is here to help. 

Call our Consumer Response Team at 651-539-1600 or toll-free at 1-800-657-3602 (in Greater Minnesota) if you have any questions about your insurance or if you believe you have been a victim of a scam or Questions about the program can be directed to the Department of Commerce Energy Information Line: 651-539-1886 or toll free at 1-800-657-3710.

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