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Minnesota health insurance exchange

44K enroll in private plans on MNsure as of Jan. 23

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As of Jan. 23, nearly 106,000 people have signed up for coverage through MNsure. More than 44,100 enrolled in private coverage, about 44,300 enrolled in Medical Assistance (Medicaid), and about 17,500 enrolled in MinnesotaCare (health insurance program for uninsured, working residents).

2015 rates and participating insurers

PreferredOne, which offered the lowest rates in the nation in 2014 and captured a large portion of 2014 enrollees, withdrew from MNsure for 2015. PreferredOne said remaining on the exchange was “not administratively and financially sustainable.” A Star Tribune business writer attributed PreferredOne’s departure as a market dynamics rather than a problem with MNsure.

Consumers who bought a PreferredOne plan through MNsure for 2014 can renew their policies for 2015 by working directly with the insurer. However, PreferredOne rates are going up an average of 63 percent, and consumers won’t qualify for subsidies if they shop outside the exchange.

Five insurers are offering individual and family policies on MNsure for 2015: Blue Cross Blue Shield of Minnesota, Blue Plus, Health Partners, Medica, and UCare. MNsure will offer 84 plans statewide, up from 78 for 2014. Blue Plus is new to the exchange for 2015.

Minnesota officials announced 2015 premiums increased 4.5 percent on average for the four insurers returning to MNsure from 2014. MNsure critics characterized the official announcement as misleading as it fails to take into account low-cost 2014 plans from PreferredOne.

Good enrollment in 2014 despite glitches

Minnesota’s state-run exchange, MNsure, was quite successful at enrolling residents in 2014 — despite considerable technical problems. A study commissioned by MNsure and conducted by the University of Minnesota showed that the state’s uninsured rate dropped from 8.9 percent in the fall of 2013 to just 4.9 percent over the course of the 2014 open enrollment period — the lowest rate in state history. The study’s author called the drop “unprecedented in Minnesota,” and the state now has one of the lowest uninsured rates in the nation.

According to a MNsure press release, 300,085 people obtained health insurance through the exchange as of Aug. 21: 53,770 people enrolled in private health plans, 65,749 enrolled in MinnesotaCare (health insurance program for uninsured, working residents), and 180,566 enrolled in Medical Assistance (Medicaid).

Fixing MNsure

In April, MNsure hired Deloitte Consulting to audit MNsure’s technology and improve the website to make enrolling in coverage and updating life events easier and more streamlined. Deloitte has been involved in successful state-run marketplaces for Connecticut, Kentucky, Rhode Island and Washington.

Software upgrades were installed in August, and system testing continued right up until the start of open enrollment. These upgrades delivered greatly improved performance on Day 1 of 2015 open enrollment, with about 200 signing up for coverage. The MNsure site had no downtime. More than 11,500 unique users visited the website and about 1,500 people called the call center.

To reduce wait times for consumers and insurance professionals, MNsure increased its call center and support staff and launched a dedicated service line for agents and brokers. These measures delivered greatly improved performance in the early days of the second open enrollment period, with wait times of about five minutes. However, wait times were averaging about 20 minutes in mid-December.

More in-person assisters are available in Minnesota for the 2015 open enrollment period. MNsure encourages residents to utilize the exchange’s assister directory to find local navigators and brokers who can help with the enrollment process.

MNsure background

Four insurers offered individual policies through the marketplace for 2014: Blue Cross Blue Shield of Minnesota, HealthPartners, Medica, PreferredOne, and UCare. Kaiser Health News reported that Minnesota offered some of the lowest premiums for silver (mid-level) plans in the U.S. Four of Minnesota’s nine regions made Kaiser’s list of the 10 least expensive places to buy health insurance.

While low premiums are good for consumers, they raise financial concerns for the marketplace. Beginning in 2015, MNsure’s operating costs will be funded with a 3.5 percent withhold of premiums. Low premiums mean that less money will be collected through the withhold.

Low enrollment in private health plans compounds the financial problem. While Minnesota far exceeded its 2014 goal of 135,000 signups — which was set in October 2013 — for overall enrollment, the mix is much different than expected. Enrollment in Medical Assistance was much higher than expected, while enrollment in private health insurance was much lower.

At a December 2014 board meeting, MNsure released lower enrollment targets and a revised budget. MNsure reduced projected enrollment in private health plans from 100,000 to 67,000 for calendar year 2015. The drop reduces projected revenue from private health plan enrollment by $4.7 million for fiscal year 2015.

Given MNsure’s difficult launch, the state is conducting a series of audits and reviews.

The first audit reviewed how MNsure spent state and federal money. Auditors concluded that the exchange has generally adequate internal controls and found no fraud or abuse. The review was conducted by the state Office of the Legislative Auditor, and the report was published in October 2014.

Another audit, also conducted by the Office of the Legislative Auditor and released in November 2014, found that the MNsure system in some cases incorrectly determined who qualified for public health benefits. The errors occurred during the first open enrollment period, before a series of system fixes were implemented. The audit did not quantify the total financial impact of the errors. The state Human Services commissioner said a consultant working on technical fixes to MNsure concluded that the eligibility functionality was working correctly by June 2014.

Minnesota health insurance exchange links

855-3MNSURE (855-366-7873)

State Exchange Profile: Minnesota
The Henry J. Kaiser Family Foundation overview of Minnesota’s progress toward creating a state health insurance exchange.