Pete Frank, Information Technology Director, MNSure


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A presentation to the May 2013 Minnesota Broadband Task Force meeting.

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Pete Frank, Information Technology Director, MNSure

  1. 1. About MNSUREMinnesota’s health insurance marketplacePresentation to the Broadband Task ForceMay 14, 2013Pete Frank, Mnsure IT Director
  2. 2. OverviewWhat is MNsureWhat’s been done to dateWhat’s next2
  3. 3. What is MNsure?A new marketplace where Minnesotans can find,compare, choose, and get quality health carecoverage that best fits your needs and your budget.3
  4. 4. Why MNsure?Subject of ongoing dialogue inMinnesota since 2006Provision within the federalAffordable Care Act (ACA)enacted in March 2010State-based marketplace signedinto law by Governor Dayton inMarch 20134
  5. 5. Why MNsure?One place to search, select and enroll. Lessadministration for small employers.Simple One-StopShopMore ChoiceLower CostsQuality RatingsConsumer has many plans to pick from andcan pick a quality plan that best fits theirneeds.Financial assistance and greater marketincentives for competition on quality & cost.Consumers can find easy to use, comparableinformation on plans and providers5
  6. 6. How will MNsure work?6CommerceFederalHubOtherDHSMDHInsurersNavigators,Agents,BrokersIndividualsEmployers/EmployeesMNsureMarketplaceCommerce
  7. 7. How will MNsure work? One process to determine eligibility for Qualified Health Plan Financial assistance/tax credits to lower premiums Medicaid Children’s Health Insurance Program (CHIP) Reduced cost sharing Offers choice of plans and levels of coverage Insurance companies compete for your business7
  8. 8. Who will MNsure serve?Over 1 million MinnesotansIndividual Consumers –450,000Small Businesses andEmployees – 155,000Medical AssistanceEnrollees – 690,0008
  9. 9. Who can use MNsure?Live inservice areaBe a U.S. citizenNot beincarcerated9
  10. 10. When can you enroll? Initial open enrollment starts October 1, 2013 and ends March 31,2014 Annual open enrollment periods after that run October 15 throughDecember 7 Special enrollment periods available in certain circumstancesduring the year Members of federally-recognized tribes may enroll or change plandesignations one time per month Small employers can enroll/renew throughout the year at one timeof their choosing Individuals may apply and be eligible for Medicaid throughout theyear10
  11. 11. What’s BeenDone to Date11
  12. 12. Grant FundingFederal Grant of$1 MFebruary 2011Federal Grant of$4.2 MAugust 2011Federal Grant of$23 MFebruary 2012Federal Grant of$42.5 MAugust 2012Federal Grant of$39.3 MJanuary 2013• Planning• Development• Technical Infrastructure• StakeholderConsultations• Market Research• Technical Infrastructure• Program Integration• Operations• Outreach• Branding12
  13. 13. Stakeholder EngagementAdvisory Task Force15 membersProvides guidance on issues related tothe development of a health insurancemarketplace for Minnesota.Technical Work Groups185 membersDevelop, discuss, and provide technicalassistance on options to the AdvisoryTask Force• Adverse Selection• Finance• Governance• Individual Eligibility• IT and Operations• Measurement and Reporting• Navigators and Agents/Brokers• Outreach, Communications & Marketing• Plan Certification• Small Employers and Employees• Tribal Consultation13
  14. 14. System Development14
  15. 15. MNsure Functionality and Interactions15
  16. 16. The User ExperienceHelps to design a user experience that is responsive topeople’s different needs, desires and expectations.16
  17. 17. How might MNsure look?17
  18. 18. Federal Planning LandmarksDesign ReviewApril 2012Assessed progress on IT and operational functionsBlueprint Certification ApplicationNovember 2012Described readiness to perform exchange activities and functions for statesseeking approval to operate a state-based exchangeConditional Approval ReceivedDecember 20Certification Documents and Approval Notification
  19. 19. MNsure LegislationHF5 / SF1 introducedJanuary 10, 2013Heard andpassed in 18House andSenatecommitteesMore than100amendmentsofferedOver 100hours ofdebateSigned into law March 20, 201319
  20. 20. MNsure GovernanceBoard MembersCommissioner of DHS6 appointed to represent interests of consumers, smallemployers, uninsured, health care systemBoard appoints advisory committees ofstakeholders20
  21. 21. MNsure Funding• May withhold up to1.5% of policypremiums• No more than 25% of2012 MCHAassessment• Up to $20 million loan2014• May withhold up to3.5% of policypremiums• No more than 50% of2012 MCHAassessment2015 • May withhold up to3.5% of policypremiums• No more than 100% of2012 MCHAassessment201621
  22. 22. Qualified Health PlansAll plans meetingrequirementsallowed in 2014;Board may selectbest starting in 2015Plansubmissions bymid-MayPlans must meetminimum“certification”requirementsCertification Criteria:
  23. 23. Plan Levels of CoverageLevels ofCoveragePlan Pays onAverageEnrollees Pay onAverage* (inaddition to themonthly plan premium)Bronze 60 % 40 %Silver 70 % 30 %Gold 80 % 20 %Platinum 90 % 10 %23
  24. 24. Consumer Assistance ServicesEligible OrganizationsHave existing, or could readily establish, relationships with consumers inMinnesota, including uninsured and underinsured, likely to be eligible toenroll through MNsure• Community and consumer non-profit focused groups• Trade, industry and professional organizations• Farming organizations• Religious organizations• Chamber of Commerce• Agents/Brokers• Coalitions and collaborative efforts• Tribal organizations• State and local human services24
  25. 25. Consumer Assistance ServicesCompensationIn-Person Assister Infrastructure and outreach grants – competitive solicitation process Payment per enrollment (until funds are depleted) Pay-for-performance paymentsCertified Application Counselors Do not receive payment from MNsure or health carriersAgent/Brokers Continued commission from carriers25
  26. 26. What’s Next26
  27. 27. Next Steps• Customer Service/Call Center• Navigators/In-Person Assisters/Brokers• Plan Certification and Comparison Info• Eligibility and Enrollment• Premium ProcessingBusiness Operations• Hardware/Software• Federal Hub• Privacy/Security• System and Software Integration• TestingTechnology• Messaging• Outreach – grassroots within communities• Public Awareness – TV, radio, social media,etc.Outreach27
  28. 28. Upcoming Key DatesMay:MNsureBoardappointedand meetingMay: Healthinsuranceplans filedwith DOC &MDHSummer:Systemtesting;ConsumerAssistancetraining;MNsure atState FairSeptember:Call CenteropensOctober 1:Enrollmentbegins28
  29. 29. Public Education Website29
  30. 30. Questions? FrankInformation Technolgy