An Association Health Plan (AHP) is a health plan offered by a group of employers within an association. MSBA is a bona fide pre-rule industry-based Association Health Plan (AHP). Being an AHP allows member firms to band together to manage and purchase coverages at a manageable price.

One primary owner of the law firm must be a member in good standing with MSBA, but not all attorneys must be members of the MSBA. Law Firm must have a minimum of two W2 employees and one non-owner taking coverage. The law firm also must be domiciled in Minnesota. Available to full-time attorneys, staff and family members. Seasonal and temporary employees are not eligible.

Plan	Waiting Period New Hire	Coverage Effective Date New Hire	Coverage Termination
Medical	30 days	1st of month following	Last Day of the Month of Termination

Participation requirements: At least 75% of eligible employees who are not enrolled in another health plan and a minimum of 50% of the total number of eligible employees (regardless of waivers) must participate in this plan.

Example 1:  Law firm has 20 total employees. 15 of their 20 employees have valid waivers through their coverage elsewhere. This firm would not meet the participation requirements as they would need at least 10 of the 20 enrolling to meet the 50% of total eligible employee requirement.

Example 2:  Law firm has 20 total employees.  6 of their 20 employees have valid waivers through coverage elsewhere. 10 employees are intending to enroll. This company would not be eligible to participate as their enrollment is 71% after valid waivers (10 out of 14) not meeting the 75% requirement.  

Example 3:  Law firm has 20 total employees.  8 of their 20 employees have valid waivers through coverage elsewhere. 12 employees are intending to enroll. This company would meet the participation requirements as they have more than 50% of their total eligible enrolling and greater than 75% after valid waivers.

A valid waiver is when an employee waives coverage for one of the following reasons: enrollment in a spouse’s plan, employee has coverage as a dependent on his/her parent’s plan, Medicare or Medicaid eligibility or TRICARE eligibility.

Contribution requirements: An employer must contribute a minimum contribution to all employees equal to 50% of the employee-only cost of the lowest cost plan offered by the employer.

120 days from when quote is provided.

Rates are guaranteed for a period of 12 months. However for the initial launch in 2020, Groups with an Oct 1 – Dec 1 effective dates will receive rates guaranteed until Jan 1, 2022.

No, this is required to be an exclusive product offering. This plan is exclusive for medical coverage, but you are able to offer other benefits such as dental and vision.

You can elect the plans that make the most sense for your firm. Please note that there are limits on the number of plans/networks you can offer depending on the number of employees enrolled in your plan. The rules are as follows:

Allowed number of plans/networks:

a.  5 or fewer enrolled employees – 1 plan/network

b.  6-20 enrolled employees – up to 6 plans/networks

c.  21-100+ enrolled employees - up to 12 plans/networks

An ACO includes a more localized network of coordinated health care and coverage and a truly integrated experience. By working together, Medica and the provider networks can actually raise the level of care, while lowering the cost. Therefore, premium costs could be significantly lower with an ACO.

An ACO offers the advantages of an insurer and provider working together on your behalf to keep you healthy. They integrate information and resources to deliver a more personalized experience at a lower cost.

When you compare your options within Minnesota, an ACO offers you the lowest premiums.

No. When enrolling in an ACO offering, you will need to stay in that ACO for the year unless you move out of the ACO service area or have a qualifying event.

No. When enrolling in an ACO offering, you will need to choose one ACO for the entire family. 

All of Minnesota State Bar Association’s (MSBA) medical plans offered include out-of-network benefits. Keep in mind that the amount you pay for your care may be significantly higher when accessing providers that are not affiliated with your selected ACO network. ACO networks contain an established network of primary care and specialty care providers. In the event the services you need are not available within your ACO network and your network provider specifically directs you to a non-network provider, your provider can submit a care direction form indicating that you can receive certain eligible health services from a non-network provider. For in-network benefits to apply, the care direction form must be submitted by your network provider prior to your appointment with the out-of-network provider.

If your college student lives outside your selected ACO service area, but within Medica’s service area of Minnesota, North Dakota, South Dakota and western Wisconsin, emergency and urgent care services will be covered at the in-network benefit level. However, for other health care services, they will need to access care from your selected ACO network provider for in-network benefits to apply. Depending on your student’s health care needs, you may want to consider the other MSBA medical plans available to you which may include providers throughout Medica’s service area and nationwide. If you choose an ACO and are traveling outside Medica’s service area and need care, Medica’s Travel Program would include access to a national network of providers and in-network coverage for many types of medical care. Some services, including chiropractic care and e-visits, are not part of the Travel Program. Your out-of-network benefit will apply for these services.

The plan’s Governing Committee will manage MSBA’s fully insured medical plans with the support of Mercer and Medica.

As a Minnesota based not-for-profit health plan with over 45 years of experience, Medica is proud to be recognized as the trusted health plan of choice to the nearly one million members in throughout Minnesota, Iowa, Kansas, Missouri, Nebraska, North Dakota, Oklahoma, South Dakota and Wisconsin. 

Medica has a long-standing history of offering innovative solutions and partnering with providers to deliver cost saving network solutions such as our ACOs. In 2012, Medica was the first health plan in the country to align with a major health care system in the development of an ACO, a first step toward the reengineering of provider collaboration and health care delivery. Today, Medica continues to transform health care delivery through collaboration with leading care systems.

Mercer, a business of Marsh & McLennan (NYSE: MMC), is a global leader in redefining the world of work, reshaping retirement and investment outcomes, and unlocking real health and well-being. The MSBA and Mercer have partnered for over 25 years to provide insurance solutions to members and their families.

With more than 65 years of experience in the industry, Mercer creates and manages insurance programs for some of the largest, most prestigious associations, including affinity, alumni, health care, education, unions, military, professional occupations and other membership organizations. Mercer-designed and -administered programs encompass customer service, marketing, program management, carrier relations and implementation. Through Mercer, clients can meet the challenges and complexities of today’s evolving market.