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Scenarios

QHP Eligibility

Annual Eligibility Renewal: Consumers who are re-determined eligible for a qualified health plan (QHP) in the next coverage year.

Renewal with No APTC: Sent to consumers who are re-determined eligible for a QHP in the next coverage year but do not qualify for an advanced premium tax credits (APTC) due to various reasons.

QHP to Public Program: Sent to consumers whose QHP eligibility cannot be automatically updated because they are projected to be eligible for Medical Assistance or MinnesotaCare.

No Eligibility: Sent to consumers currently enrolled in a health insurance plan through MNsure but do not have eligibility for the next coverage year.

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 be sent.

Enrolled in QHP: Sent to consumers enrolled in a QHP through MNsure, confirming what plan the household will be enrolled in for the coming year.

Public Program Eligibility

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.

Need to Renew Notice (NTR)

Mixed Eligibility Household

Members of mixed-eligibility households may have different renewal dates based on there type of coverage. They will get separate renewal notices from both MNsure and DHS which may come at different times of the year.

Example scenario:

  • Adults in the household are QHP-eligible and are re-determined to be QHP-eligible during MNsure’s renewal period. They will receive the annual eligibility renewal notice.
  • The child in the household is MA-eligible and will receive a notification from DHS when their renewal is up and the steps to take to renew their membership.

TIP: Look for the agency logo on a notice to quickly identify the servicing agency or agencies for the renewal.

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