Updated: 10/30/2013 5:00 PM KSTP.com By: Scott Theisen
People in parts of southeastern Minnesota who found they lacked choices and faced unexpectedly high premiums when the state's new health insurance exchange went live will soon have more coverage options, state officials announced Wednesday.
Seven additional health plans - all from Minnetonka-based insurer Medica - will become available to residents of parts of Olmsted and Dodge counties, including the cities of Rochester and Hayfield, where they weren't available when open enrollment began Oct. 1. Residents of those communities previously had only once choice via MNsure, a Blue Cross Blue Shield silver-level plan, though residents in the rest of those counties had more choices.
Some of the new Medica plans will be cheaper than what's currently on offer, said Dannette Coleman, vice president and general manager of individual and family business at the Minnetonka-based insurer.
"We are really excited we were able to find this solution," Coleman said. "It was challenging for us not to be able to provide coverage in the totality of these counties."
The Mayo Clinic's dominance in the Rochester region has made it a tough market for insurers to enter. That's one reason premiums for MNsure plans in the area have been among the highest in a state that has some of the lowest overall rates in the country for coverage offered on the online marketplaces, which are a core component of the Obama administration's health care overhaul.
Exactly when the new plans will open for enrollment isn't clear yet. MNsure's executive director, April Todd-Malmlov, said in a statement that officials there have begun making the technical changes needed to add the plans to the website "as soon as possible."
Coleman said Medica didn't initially offer plans in the affected areas because it didn't think it could under regulations that require adequate access to providers in an insurer's network. While the broad Mayo Health System clinics in southeastern Minnesota are in Medica's network, she said, Medica doesn't have a contract with Mayo in Rochester itself.
"It wasn't for a lack of desire to be there," she said. "It was more an interpretation of the requirements for the network."
Once the problem came to light, the state commerce and health departments worked with Medica to resolve the regulatory questions, commerce spokeswoman Anne O'Connor said.
The new plans include two gold-level and two silver-level plans. They also include two bronze-level plans and a catastrophic coverage option for individuals under 30 that will carry lower premiums than the currently available plan, Coleman said. The new offerings also include six corresponding plans for children.
Premium rates vary considerably depending on the patient's age and whether he or she opts to pay their copayments out of pocket or create a tax-free Health Savings Account to go with the plan.
But Commerce Department papers show that a 40-year-old person in Olmsted County would have to pay $326 a month for the silver Blue Cross Blue Shield plan. The comparable Medica silver plans are priced about $5 to $21 less for a 40-year-old. Premiums for the Medica bronze plans range from about $200 for a 25-year-old up to $546 for a 60-year-old, while Medica's gold plans range from $271 to $820 depending on age.
Todd Malmlov said mid-year changes to the offerings on MNsure generally won't be permitted in the future.
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