Local meeting on health insurance marketplace
provides information, but not all the answers
Wednesday, October 30, 2013 3:49 AM
Understanding the new Minnesota health insurance marketplace MNsure and the impact of the implementation of the Patient Protection and Affordable Care Act, also termed Obamacare, has proven to be a mental marathon for many Americans.
Around 20 people from the area attended an Oct. 23 MNsure information session at Wheeler’s Bar and Grill sponsored by the Harmony Insurance Group. ANTON ADAMEK/NEWS-RECORD
Blue Cross and Blue Shield of Minnesota broker Charles Moline led a presentation and question and answer session at Wheeler's Bar and Grill on Oct. 23. Though held at 9 a.m., over 20 Harmony and area residents and small business owners attended the event to find out more information about changes in the world of insurance.
The informational meeting was sponsored by the Harmony Insurance Group.
Moline gave a brief summary of the recent history of the United States insurance market reforms. He noted changes to insurance access began in 2010, which included the expansion of Medicaid and implementation of new small business tax credits. Reforms in the market and changes in benefits were also briefly summarized.
In referring to changes indicated by the 2014 reforms, Moline said anyone will now be able to buy healthcare and not worry about preexisting conditions denying them coverage. Insurance companies will be able to exercise rating restrictions based on age, tobacco use, family size and area.
Pointing to a regional rate map of Minnesota, Moline noted that the 10 southeast Minnesota counties had the highest area factor for health insurance rates, at 1.249. He said this was because Mayo Clinic is the most expensive provider in the state. The area pays higher premiums because of that fact.
He said some in the region may even pay nine percent more just because of where they live. The healthcare reforms will also require people to pay for a broader benefits package, even if they do not have need for benefits in pediatric, maternity, chronic disease management and several others. Moline said this would affect cost to families up to $24 per child per month up to three children.
Speaking frankly, Moline said the new rules, benefits and taxes would increase costs for almost everyone who is currently insured. "I haven't seen one person who is paying less for their insurance," he shared.
One meeting attendee shared that her premium cost would double for the same plan.
Other changes to the health insurance market will create a single risk pool. Moline said this helped determine the future of the Minnesota Comprehensive Health Association, which is the state's current high-risk pool and which will be closing on Dec. 31, 2014. More information on this aspect of health coverage can be found on mchamn.com.
The definition for the MinnesotaCare program was expanding to recognize individuals up to 200 percent above the poverty level. Moline said people could find financial assistance based on their income. People can find out if they qualify for a premium tax credit by creating an account on the MNsure website and plugging in their personal income information.
In answering a question about underestimating their income, Moline said people would be required to pay back any overcompensation. In the event of overestimating the actual income, a person could see a tax credit on their premium.
Moline also explained that financial assistance would be structured differently through a new system of taxes and tax credits. Everyone will see a premium tax in 2014 of 1.5 percent and that will go up to 3.5 percent in 2015. The current taxes and assessments to premiums is at 13.11 percent. Any changes in taxation will be determined by the seven-person board of directors for MNsure.
Small employer tax credits are available for employers with less than 25 employees with a sub-$50,000 average wage. The credit can be up to 50 percent of the employer-paid portion of a premium for employers that contribute at least 50 percent. That tax credit will be available for two years. Sole proprietors are considered to be individuals in the market
"Most of this just affects individuals and small employers," he shared, while also adding that the definition of a small employer was being changed in 2016. Any business that provides insurance to over 100 people will be defined as a large employer.
Beginning Oct. 1, open enrollment through MNsure commenced. Enrollment will remain open until Mach 31, 2014, and subsequent enrollment opportunities will occur from Oct. 1 through Dec. 31 every year. People may be able to switch plans if they have a qualifying event take place in their life such as a marriage, death, birth or a move from their current coverage area.
Those who do not obtain health insurance will be penalized $95 per person or one percent of their taxable household income, whichever is greater. This penalty increases each year that insurance is not obtained.
Moline explained that depending on where you live, you may not have as many options for health insurance that the exchange originally claimed to be able to provide.
There are 14 individual and family plans available in Fillmore County, with Medica and BlueCross the only providers. Moline suggested people research the different networks within the state.
As the meeting wound down, Jim Lutes from Harmony Insurance Group explained that they didn't "have all the answers."
Moline encouraged people to go online to MNsure.org or go to their insurance agent to find out more.