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Probate & Trust Law Section Conference Manual ... - Minnesota CLE

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Each state must have a transparent, competitive health insurance<br />

marketplace (an Affordable Insurance Exchange) where individuals and<br />

small businesses can purchase affordable qualified insurance. 39 <strong>Minnesota</strong><br />

has elected to sponsor its own marketplace, which shall be known as<br />

“MNsure.” Enrollment must begin on October 1, 2013. The statutes that<br />

authorize and govern MNsure are found in Minn. Stat. Ch. 62V.<br />

The health insurance plans offered in the individual and small business<br />

market, both inside and outside of the Exchange, must offer a<br />

comprehensive package of items and services, known as essential health<br />

benefits. Essential health benefits must include services within at least ten<br />

core categories, ambulatory patient services; emergency services;<br />

hospitalization; maternity and newborn care; mental health and substance<br />

use disorder services, including behavioral health treatment; prescription<br />

drugs; rehabilitative and habilitative services and devices; laboratory<br />

services; preventive and wellness services and chronic disease<br />

management; and pediatric services, including oral and vision care.<br />

Insurance policies must cover these benefits in order to be certified and<br />

offered in Exchanges, and all Medicaid state plans must cover these<br />

services by 2014.<br />

Small businesses and individuals, including self-employed individuals, may<br />

be eligible for a tax credit that can be used to lower what the individual<br />

pays for monthly health plan premiums. Individuals who qualify can take<br />

the premium tax credit in the form of advance payments to lower their<br />

monthly health plan premiums. The value of the tax credit will depend on<br />

family income. The tax credit will be determined as part of the application<br />

for a health care plan. The tax credit will be sent directly to the insurance<br />

company and applied to the premium, so the individual will pay less out of<br />

pocket.<br />

The tax credit is sent directly to your insurance company and applied to<br />

your premium, so you pay less out of your own pocket.<br />

ACA requires a standard application form to be used to apply for plans<br />

offered through the Exchange. CMS has promulgated a five-page<br />

application form. The application form will also be the starting point to<br />

apply for all health care programs, including state medical assistance<br />

39 For a summary of ACA requirements, see 7 Key Terms in the Affordable Care Act that<br />

Small Businesses Should Know available at: http://www.healthcare.gov/law/timeline/full.html<br />

40

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