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Rights and Responsibilities - Qualified Health Plans (Private Health Plans)

These rights and responsibilities apply to qualified health plans with or without advanced premium tax credit or cost-sharing reductions.

Reporting Changes

You must report changes within 30 days of a change happening if you have an advanced premium tax credit, cost-sharing reduction or a private health plan (qualified health plan). Use an online form or call MNsure at 1-855-366-7873 (1-855-3MNSURE) to report any changes. If you do not report changes, you may have to pay money back to the state or federal government for benefits that you received but were not eligible for.

If you are not sure whether to report a change, call us at the above number and explain what is happening. Examples of changes you need to report include the following:

Income changes when you

  • Start a new job, change jobs or stop a job
  • Start to get, or receive changes in the amount of, other income like Social Security, other retirement income, child support, unemployment or workers' compensation

Residence changes when you

  • Sell your home
  • Move to a new address

Life changes in your household when someone

  • Starts or stops other health insurance or Medicare
  • Becomes pregnant or has a baby
  • Moves in or out of your home
  • Changes tax filing status
  • Loses Minnesota residency
  • Changes citizenship or lawful presence status
  • Changes incarceration status
  • Dies, gets married or gets a divorce
  • Becomes disabled
  • Starts or stops school

Filing Taxes

If you purchased a private health plan (qualified health plan) through MNsure and are receiving advanced premium tax credits or wish to claim the Premium Tax Credit (PTC), you must file taxes with the Internal Revenue Service (IRS).

At the end of the tax year, MNsure will issue a 1095-A form for you to use with reporting health insurance coverage to the IRS. Find more information about tax filing here and on the Tax FAQ section.

You Have the Right to Ask for a Hearing

If you feel your health care eligibility or benefits are wrong or your application was not processed correctly, you may ask for an appeal hearing. By requesting an appeal hearing, you are requesting a fair review of your case. You can represent yourself or use an attorney, advocate, authorized representative, relative, friend or another person. Find specific appeal instructions on all eligibility notices that you receive. Learn more about the appeals process and how to ask for a hearing.

Nondiscrimination Notice

Discrimination is against the law. See MNsure and the Minnesota Department of Human Services (DHS) nondiscrimination notice.

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