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MNsure Announces Implementation of Retroactive Coverage, Tax Credits and Cost-Sharing Reductions

4/29/2014 10:14:43 AM


CONTACT: Jenni Bowring-McDonough
Media Relations Coordinator

ST. PAUL, Minn. - Today, MNsure announced implementation procedures for consumers eligible for a qualified health plan to obtain retroactive coverage, tax credits and cost-sharing reductions. The procedures are in response to a federal government bulletin published February 27, 2014, that allows state-based marketplaces, like MNsure, flexibility in addressing consumers with "exceptional circumstances." These guidelines apply to people who:

  • Have not been continuously enrolled in coverage since January 1, 2014, or
  • Enrolled in coverage outside of MNsure but are eligible for tax credits and/or cost-sharing reductions.

If a consumer has not been continuously enrolled in coverage since January 1, 2014, and either has record of some activity in the MNsure system, or can credibly document failed attempts to enroll in coverage because of technical issues, he or she may qualify for retroactive coverage. The consumer may be eligible to obtain retroactive coverage back to the first effective date available after a first enrollment attempt was made, with the earliest date being January 1, 2014. Consumers must pay premiums for all months back to the effective date of retroactive coverage.

If a consumer enrolled in a qualifying individual market plan outside of MNsure, but believes he or she is eligible for an advanced premium tax credit, he or she must contact MNsure. Consumers must have purchased a qualifying individual market plan from a health insurance company that offers products through MNsure in order to be eligible to participate. The consumer will need to enroll through MNsure and must keep the same insurance company and policy they purchased outside of MNsure (if the same plan is offered through MNsure). Retroactive advanced premium tax credit or cost-sharing reductions will be applied by the insurance carrier. The consumer's effective date of coverage will stay the same. The consumer will also be eligible for a special enrollment period to choose a different plan going forward if needed. Consumers are reminded that tax credits are available to consumers within defined income limits. Consumers with employer-sponsored coverage are generally not eligible for tax credits.

Minnesotans who believe they fall into either of these two categories must call the MNsure Contact Center at 1-855-366-7873 by May 15, 2014, to report their case and start the process. These retroactive options will not be available to those that report after this date. Consumers must also act promptly as MNsure works with them to process their enrollment.

Due to potentially high call volumes, Minnesotans who are eligible for these categories are urged to report their case immediately.

This does not apply to those consumers determined eligible for Medical Assistance or MinnesotaCare.

The 2014 open enrollment period ended on March 31. Most Minnesotans who did not enroll in coverage must now wait until the next open enrollment begins on November 15, 2014, and may be subject to a tax penalty. The only consumers who can currently enroll in health insurance - inside or outside of MNsure - are those who experience a qualifying life event, those who are eligible for Medical Assistance or MinnesotaCare, members of federally recognized Indian tribes, or participants in the Small Business Health Options Program (SHOP).

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