Minnesota Small Business
Health Insurance Plans 2021

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MN Small Business Health Insurance Plans

Minnesota Small Business Health Insurance Plans

Minnesota Small Business Health Insurance Plans 2021. The following is an overview of the rules that govern small group health insurance plans in the State of Minnesota.

The information that is discussed below includes the laws that have been mandated by the Affordable Care Act (ACA or "Obamacare"), as well as the laws that are required by Minnesota State government.

If you own and operate a MN small business and you already offer small group health insurance or you're thinking about offering small group health insurance - this guide can help you better understand the regulations, requirements and available Minnesota small business health insurance plans available.

Learn how to get Minnesota small business health insurance plans for 1 to 50 employees. The best small business health insurance providers in MN offer affordable rates, flexible coverage options and access to a large network of medical providers.

Below are some answers to commonly asked MN small business health insurance plan questions:


How Much Does Minnesota Small Business Health Insurance Cost?

The average price of a standard Minnesota small business health insurance policy ranges from around $583 to over $1706 per employee per month based on; single or family, location, coverages offered, deductibles and more.

What Are The Small Business Health Insurance Regulations In Minnesota?

Minnesota Small Business Health Insurance Plans

In the State of Minnesota, there are specific laws that pertain to small group health insurance. Companies that sell small group health insurance must provide any qualifying small business with health insurance policies.

Additionally, small businesses that employ more than 2 but less than 50 must be offered the same small group health insurance policies that are sold to all other Minnesota small businesses.

If you're a qualifying small business owner, it is legal for health insurance companies to mandate specific requirements. This includes a minimum participation requirement that is established by the health insurance company and requires that a minimum amount of your employees must participate in the policy, otherwise the policy can be terminated.

Additionally, if employers are not willing to pay for a portion of their employees' premiums, health insurance companies are not required to sell Minnesota small business health insurance plans.

With the above said, health insurance companies must offer small businesses the same policies that all other small businesses are offered, and those policies must offer similar benefits.

With that said, however, the price the company charges may be higher, as it is legal for health insurance companies in Minnesota to base premiums on the health status and risk of the group they are insuring; however, there are limits on the increased amount the health insurance company can charge.

It is illegal for health insurance companies to cancel active policies if a member of the group falls ill or becomes injured and requires medical care.

According to Minnesota Management and Budget website, The Affordable Care Act (ACA) resulted in many reforms to healthcare and the health insurance industry. This comprehensive law is comprised of 10 titles, and some provisions in the ACA may affect State employees and the State of Minnesota as an employer.

Title I of the ACA sets forth employer responsibilities, including automatic enrollment for employees of large employers and shared responsibility for employers. Please review the materials below related to the ACA, and do not hesitate to contact MMB if you have any questions or concerns.

Does Minnesota Participate In The Affordable Care Act?

Affordable Care Act Minnesota

In 2010, the Affordable Care Act (ACA or "ObamaCare") was passed by the United States Congress and was signed into law by Obama. Following its passage, provisions of the law have continued to be phased in, and as of January 1, 2014, the majority of American citizens and legal residents of the United States are required, by law, to have qualifying health care coverage.

If they fail to have coverage, they are responsible for paying an annual tax penalty for each month they aren't insured, which is known as the "individual mandate".

The cost of the penalty for failure to have qualifying coverage is $95 per adult and $47.50 per child, or 1% of your total taxable income; whichever amount is higher - as much as $285 per family. In 2017, the penalty increased, and has continued to increase thereafter.

Qualifying Exemptions For The Individual Mandate

Individuals who meet one of the following are exempt from the individual mandate and the associated tax penalties in MN:

  • Illegal aliens
  • Jailed individuals
  • Religious objections
  • The cost of health insurance coverage is higher than 8% of your household income
  • Those who aren't covered for less than three months during the calendar year
  • Those who have hardship waivers
  • Your income level is blow the 100% poverty level

What Are The Affordable Care Act Requirements For Minnesota Small Businesses?

Minnesota Small Business Health Insurance Plans Claim Form

If you're a small business owner in Minnesota, you must provide your employees with insurance. This is a requirement that was put into place by the Affordable Care Act.

Referred to as the Employer Shared Responsibility provision, all employers must offer their employees at least one of the ACA-compliant Minnesota small business health insurance plans, otherwise then can face fines of up to $2,000 per employee.

Minnesota small business owners can purchase coverage for their employees through the state's Small Health Option Program (SHOP) exchange, or from a private insurance agent or broker.

Affordable Care Act Standardized Essential Health Benefits

As per the ACA, all qualifying health insurance plans must offer 10 standardized essential benefits.

Depending on the state, additional benefits may also be required. The 10 ACA standardized essential benefits are as follows:

  1. Ambulatory patient services (medical care that is offered without being admitted to a hospital)
  2. Emergency services
  3. Hospitalizations, such as overnight stays and surgical procedures
  4. Lab services
  5. Mental health and substance abuse disorder services, including behavioral health treatments, such as psychotherapy and counseling
  6. Pediatric health care services, including vision and oral care; however, adult vision and dental coverage aren't essential health benefits under ACA
  7. Pregnancy, maternity, and newborn care, including before and after birth
  8. Prescription pharmaceuticals
  9. Preventative and wellness services, as well as management for chronic diseases
  10. Rehabilitative and habilitative services and devices, including services and devices for injuries, disabilities, and chronic health conditions

Additional Health Benefits Mandated In Minnesota

In addition to the ACA's 10 essential health benefits, health insurance policies offered in MN must also include the following benefits, as required by state law:

  • Bariatric surgery
  • Chiropractic care
  • Clinical trials
  • Congenital anomaly, cleft lip/palate
  • Cosmetic surgery for complications from breast implants
  • Diabetes care management
  • Durable medical equipment scalp-hair prostheses for alopecia areata
  • Family therapy
  • Hospice services
  • In-home treatment for children with emotional disabilities
  • Lyme disease treatment
  • Non-formulary antipsychotic drugs
  • Off-label prescription pharmaceuticals
  • Oral surgery
  • Outpatient rehab
  • Oxygen
  • Port-wine stain removal
  • Routine adult eye exams
  • Second surgical opinions
  • Skilled nursing facilities
  • TMJ disorder treatment
  • Ventilator-dependent services

Standardized Minnesota Small Business Health Insurance Plans
ACA Metal Levels

In order to make it easier to compare costs and benefits, the Affordable Care Act has designated all qualifying Minnesota small business health insurance plans to be one of four metal colors, including Bronze, Silver, Gold, and Platinum.

Each of these designations is based on the average amount of health care costs that the plan will cover, which is illustrates at percentages of how much the insurance company will cover for health care, as well as the amount the insured will have to pay out-of-pocket.

All insurance companies that are participating in the federal or state health care exchange program must offer at least the Silver and Gold Minnesota small business health insurance plans.

All four of the metal plans have a shared maximum out-of-pocked amount that the insured can be charged during any calendar year. The following table illustrates this information:

Metal Plan Insurer Pays / Insured Pays
Bronze60% / 40%
Silver70% / 30%
Gold80% / 20%
Platinum90% / 10%


Guaranteed Issue

As per the ACA, individuals cannot be denied coverage or charged higher premiums because of their past health history, or their gender.

Additionally, look-back and waiting periods cannot be imposed. Additionally, policies are effective when they are issued and all coverage is renewable if the individual chooses to renew the policy.

However, plans can be canceled if the individual fails to pay their premiums or commits fraud.

How Are MN Health Insurance Premiums Determined?

A premium is the amount the insured must pay out-of-pocket in order to maintain their health insurance policy. The premiums that are charged for any of the qualifying metal plans can be based on the following:

  • Age of the individual
  • Whether or not the individual uses tobacco
  • Where the individual lives, based on a rating area
  • The number of family members who will be enrolling

What Types Of Health Insurance Plans Are Available For Minnesota Small Businesses?

Health Insurance Plan Types

While there are several types of health insurance plans to choose from, the following plans are the most popular among MN small business owners:

Health Maintenance Organization - Simply known as an "HMO", this type of plan offers a variety of health-related services via a network of health care providers and hospitals that exclusively contract with the HMO, or who agree to offer their services to members of the HMO. Employees who participate in this type of plan usually have to choose a primary care physician (PCP), and receive most of their care from this physician. If a specialist is needed, the PCP will recommend one that is affiliated with the HMO.

Preferred Provider Organization - More commonly referred to simply as "PPO", this type of health insurance plan is the most common among Minnesota small business owners. The insurance company provides a preferred list of health care providers, and employees must receive their medical care from the doctors and hospitals on that list for their claims to be paid at the highest level possible - but they also have the flexibility to see any other provider anywhere in or out of state.

Point-of-Service Plan - Known as a (POS), this type of health insurance plan provides access to health care services at a lower overall cost, but with fewer choices. Members can access care from in-network or out-of-network providers and facilities, but coverage is better when you stay in-network. POS plans may vary, but generally, plans are considered a blend of HMO and PPO plans - offering more flexibility than HMOs, but less than PPOs.

Health Savings Account - A health savings account (HSA) is a special type of bank account that allows participants in the insurance plan to save money that can be used specifically for the medical care they require in the future. HSA-qualified health insurance plans are usually PPO plans that are specifically designed to be used with an HSA.

Indemnity Health Insurance - This type of health insurance plan allows members to control their own health care and to visit any doctor or hospital they choose. The insurance company would then pay a pre-determined percentage of the total charges for the services that were rendered. Employees may have to pay for some types of services up-front and then they can submit a request for reimbursement with the insurance company.

Minnesota Small Business Health Insurance Plans - The Bottom Line

We strongly advise business owners to speak with a CPA and a MN health insurance broker before jumping in and getting any type of the Minnesota small business health insurance plans available.

Make sure that you know exactly what each option can do for your company and the potential drawbacks associated with it.

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Also find Minnesota insurance agents & brokers and learn about Minnesota small business insurance requirements for general liability, business property, commercial auto & workers compensation including MN business insurance costs. Call us (612) 808-9866.

Small Business Health Insurance Plans By State

You can find more state specific small business health insurance information including requirments and coverage by clicking on the state below:


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