DHS/MNsure Glossary


(if applicable)


Affordable Care Act


The Patient Protection and Affordable Care Act was signed into law in March 2012. The ACA calls for states to establish health benefit exchanges to increase access to health insurance.

Advance Premium Tax Credits


Advance Premium Tax Credits limit the amount that low-income individuals and families pay for health insurance premiums. Eligibility for APTCs is based on income.

Basic Health Program


States will have the option to implement a Basic Health Program (BHP) under health reform that gives states 95% of what the federal government would have spent on subsidies for adults between 133% and 200% of the federal poverty level and legal resident immigrants with incomes below 133% who have been in the U.S. for fewer than five years (and therefore do not qualify for Medicaid).

Certified application counselor

Some organizations, such as hospitals, hospital affiliates or HR personnel, who provide consumer assistance in partnership with MNsure will assist with applications, but are not considered navigators or in-person assisters. MNsure does not provide compensation for this consumer assistance service.

Cost sharing

A feature of health plans where beneficiaries are required to pay a portion of the costs of their care. Examples of costs include co-payments, coinsurance and annual deductibles.

Cost Sharing Reductions


Cost Sharing Reductions limit the amount that low-income individuals and families pay for out of pocket costs such as deductibles and copayments after they enroll in a health plan and receive covered medical services. Eligibility for CSRs is based on income.

In-person assister


In-Person Assisters will be paid $70 per individual enrolled in a Qualified Health Plan (QHP) by MNsure. Up to $7 million has been allocated to support the In-Person Assister Program. Payments will be made until funding runs out or through December 2014, whichever comes first.

Insurance Affordability Program


Insurance Affordability Programs are the public insurance programs (such as Medicaid and Child Health Plus) and federal subsidies (including Advance Premium Tax Credits and Cost Sharing Reductions) that make insurance more affordable to low-income individuals and families.

Modified Adjusted Gross Income


A definition of income from the tax system that will be used under the Affordable Care Act to determine eligibility for Medicaid in all states and for tax credits available to people buying insurance in exchanges. The income calculations will take into account family size and income from all family members.

Minnesota Community Application Agent


Community organizations statewide that have partnered with DHS and counties to help people enroll in Minnesota Health Care Programs. It is through partnerships with these community organizations that the state can be most effective in identifying the uninsured and assisting those who are eligible for public programs get the coverage they need. Many MNCAA organizations assist people through the application process. Individuals can go to any participating site that serves residents of the county where the applicant lives.


Minnesota’s new, online marketplace where individuals, families and small businesses will go to get quality, affordable health coverage that will fit their budgets. The marketplace will offer an easy-to-use website where Minnesotans can search and compare plans, a contact center for users to talk with someone about their options, and places where individuals can sign up in their own communities.


Navigators will be paid $25 per individual enrolled in a Minnesota Health Care Program (including Medical Assistance and MinnesotaCare) by the Minnesota Department of Human Services, pursuant 2012 Minnesota Statute Section 256.962, subdivision 5.

Insurance producer


Insurance agent or broker.

Qualified Health Plan


Certified health insurance coverage, provided by licensed health insurance issuers, that is purchased by eligible individuals or small group employers through the MNsure marketplace.

Reasonable compatibility

The standards under which states determine when income information provided by an individual can be considered reasonably compatible with information obtained through verification data sources. Reasonable compatibility standards provide critical flexibility to operationalize eligibility decision-making by allowing states to accept some deviations in income data from different sources.


A verbal or written statement provided by an individual, which affirmatively states what that individual believes to be true.

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