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Scenarios

QHP Eligible

Standard Renewal: Consumers who are re-determined eligible for a qualified health plan (QHP) in the coming coverage year. Notice: Health Care Eligibility Renewal Notice.

Renewal with No APTC: Consumers who are re-determined eligible for a QHP in the coming coverage year but do not qualify for APTC due to various reasons. Notice: Health Care Eligibility Renewal Notice (with FTI language.)

QHP to Public Program: Consumers whose QHP eligibility cannot be automatically updated because they are projected to be eligible for Medical Assistance or MinnesotaCare. Notice: Health Care Renewal Notice.

No Eligibility: Consumers is currently enrolled in a health insurance plan through MNsure but does not have Insurance Assisted (IA) or unassisted QHP (UQHP) eligibility for the next coverage year. Notice: No Eligibility Cover Letter.

Consumers whose QHP eligibility did not automatically update require follow-up by MNsure or DHS and in some cases, documentation from the consumer. Once the follow-up is completed a Manual Renewal Eligibility Notice will generate.

Enrolled in QHP: Consumer household is notified they will be enrolled in for the coming coverage year. Notice: Plan Enrollment Confirmation Notice.

Public-Program Eligible

Household Eligible for MA and/or MinnesotaCare: These consumers will get notified by the Department of Human Services (DHS) when their renewal is up, and the steps to take to renew their membership.

Mixed-Eligibility Households

Members of mixed-eligibility households may have different renewal dates based on their type of coverage. As a result they will get separate renewal documents from both MNsure and DHS which may come at different times of the year. 

For example: Adults in the household are QHP-eligible and are re-determined to be QHP-eligible during MNsure’s renewal period. They will fall under the Standard Renewal scenario and receive the Health Care Eligibility Renewal Notice. The child in the case is MA-eligible and will fall under the public-program-eligible scenario, and be notified by DHS when their renewal is up and the steps to take to renew their membership. 

TIP: look for the agency logo on the notice to quickly identify the servicing agency for the renewal.

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