Minnesota Health Insurance (MN)

Minnesota (MN)
Individual Health Insurance Regulations

Learn more about Minnesota Individual Health Insurance

Minnesota does not require its individual health insurance policies to be guaranteed issue, which means that the health insurance carrier may medically underwrite any application for health insurance and decline the application for pre-existing medical conditions or past health history. Because individual health insurance plans in Minnesota are not standardized, all health plans will vary in what benefits they offer to the consumer. As a result of being medically underwritten, the insurance carrier may do any one of the following during the application process: 1) deny coverage based upon the information provided in the application regarding health history 2) Offer to provide coverage as specified in the health plan, but apply certain limitations to the health plan, placing limitations or exclusionary periods on pre-existing conditions or 3) offer full and complete coverage as outlined in the requested health plan. Minnesota does permit a 6 month look back and 12 month exclusionary period on pre-existing condition wherein the applicant does not have prior creditable coverage. For those individuals with prior creditable coverage, the state does not allow for the 6 month look back / 12 month exclusionary period. Elimination riders or amendments to the policy which would allow the health insurance carrier to exclude coverage for a specific condition are not permitted under Minnesota State law. Individual health insurance premium rates may be based upon health status, age, occupation or geographic locations. Rates may not be determined by the gender of the applicant.

Minnesota (MN)
Small Group Health Insurance Regulations

In Minnesota, a small employer group is defined as any company with 2 to 50 employees. Small group health insurance in Minnesota is issued on a guarantee issue basis, which provides that no group can be turned away or declined health insurance coverage based on their past or current health history. Guidelines to join the employer-sponsored health plan may require all employees to participate in a waiting period before becoming eligible to join the group health plan. Once the waiting period has been fulfilled and you are eligible to join the health plan, you may not be denied coverage. There is, however, the right of the health insurance carrier to exercise a 6 month look back/12 month exclusionary period on all applicants who may be lacking prior creditable coverage. This provision allows the health insurance carrier an opportunity to ascertain information on pre-existing conditions and to impose a 12 month exclusionary period for which treatment of the pre-existing conditions will not be covered under the health insurance plan. The maximum exclusionary period, under these circumstances, would be no more than 12 months. Minnesota provides for group health insurance rates to be medically underwritten with a rate adjustment factor of 25%.

Minnesota COBRA and Continuation Coverage

The Minnesota state mini-COBRA laws require business of 2-19 employees to provide the same COBRA options as employers with 20 or more employees under federal COBRA regulations. COBRA continuation coverage becomes available upon the happening of a qualifying event which causes you to lose your health insurance benefits under the group plan. COBRA allows you to remain on your previous employer's group health plan and receive the same level of coverage for a period of 18 months. You will be responsible for paying the premium amounts previously paid by your employer, plus a 2% administration fee. Individual conversion plans are available for persons that have exhausted their COBRA option. The state's high-risk health insurance pool provides coverage to all persons that are HIPAA eligible, regardless of their health status.

Additional Minnesota Resources

• Minnesota Comprehensive Health Association - MCHA
  Minnesota's "high risk pool" offering individual health insurance to Minnesota residents who are unable to obtain health insurance in the private market due to past or present health status.
• MinnesotaCare
  Administered by the Minnesota Department of Human Services, the MinnesotaCare program offers comprehensive health care coverage to children of low-income families.
• Minnesota Health Care Programs
  Under the operation of the Minnesota Department of Human Services, provides health care and medical insurance to low-income residents of the state through the Medicaid program.

MN Medical Insurance Statistics

Total Population: 5,129,000
With Health Insurance: 4,699,000 / 91.6%
Without Health Insurance: 431,000 / 8.4%
*According to 2005 CPS Reports / U.S. Census Bureau

Note: The percentage of Minnesota residents without health insurance has decreased by .5% since 2004.

Minnesota Department of Commerce
Phone: 651-297-7161
The Minnesota Department of Commerce regulates the Insurance industry within the state of Minnesota, offering up-to-date information and several useful consumer links.

Minnesota Department of Health
Provides information and resources for Minnesota health care consumers.

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