Frequently Asked Questions

Q: I only have one employee. Do I still qualify?

A: Yes, as long as they are a documented W-2 employee.

Q: I already have coverage for my full-time employees, but not my part time. Can I enroll only my part-time employees in the program?

A: Yes. You have the freedom to establish different employee groups within your business. As long as they have not been offered coverage for the last 12 months, they work at least 15.5 hours per week, and their median wage is $12.50/hour or less (increasing to $18.22 effective August 1, 2010), they are eligible.

Q: I already have existing health coverage for my employees. Can I drop my current health coverage and enroll in HealthShare?

A: No. HealthShare is for small businesses who currently do not offer health coverage. You cannot have offered health coverage for 12 months prior to enrolling in HealthShare.

Q: Are employees with pre-existing conditions eligible for the HealthShare Program?

A: Yes. Through our Wellness Option, your employee will meet with HealthShare's Care Manager and establish a health goal plan. The HealthShare staff will also help your employees research and enroll in any other state or federal programs they may qualify for.

Q: What's the catch? How can this be done so inexpensively?

A: There is no catch. HealthShare is a unique community-based health coverage program that actively coordinates community services to make health coverage affordable. There are only a handful of programs like this throughout the country. Costs for the program are shared by the employer, the employee, and the community. By keeping the costs within the community and utilizing our local network of providers, HealthShare is able to offer affordable health coverage to small businesses.

Q: Am I obligated to cover dependents?

A: Yes. However, you are not required to contribute toward the dependents' monthly cost. You may contribute any amount or percent if you choose, but if you do for one employee's dependents, then you must for all.

Q: Will you collect the monthly costs from my employees?

A: No. It is the employer's responsibility to collect monthly costs from employees. Payments are due on the 15th of the month prior to the month of coverage. (Example: Payment for December 1 coverage is due by November 15.

Q: Is hospitalization and emergency care covered?

A: Yes. HealthShare is designed to provide hospitalization and ER services when appropriate.  However, part of what makes HealthShare affordable is utilization of preventive care. Each member will be required to choose a primary care clinic and we encourage members to become active participants in their healthcare through our Wellness Option.

Q: Does HealthShare offer prescription coverage?

A: Yes. Like most prescription plans, HealthShare has a listing of covered drugs (generic and branded) with varying co-pays.

Q: Will HealthShare cover pregnancy?

A: HealthShare will work with your employees to find programs they are eligible for. In the case of pregnancy, it is usually more cost effective for the employee to utilize a state or federal funded program. If you have an employee that is pregnant, or becomes pregnant, we will work with them to attain the best care available and assist them in enrollment of services. Once they no longer qualify for federal and state programs, they can return to utilizing the HealthShare program.

Q: If I or my employees enroll in the Wellness Option, do we absolutely have to participate in educational wellness courses or health-related activities?

A: Yes. However, it is the member's choice to enroll in either the Standard or Wellness Option. The Standard Option does not require members to meet with HealthShare's Care Manager (unless they have an existing chronic condition) or participate in wellness courses/healthy activities (two wellness courses or health-related activities per year).

Q: What if I am out of the Duluth area and need to utilize medical services. Will HealthShare cover the costs?

A: No. All members enrolled in HealthShare need to utilize the services of local participating providers (PDF).

Q: Can I offer to pay the employee portion of HealthShare coverage?

A: Yes. You can pay the employee portion. However, if you offer to pay for one employee, you must offer to pay for all employees within that group.

Q: If I offer my employees HealthShare coverage, do they all have to enroll for my business to be eligible?

A: No. Only those employees interested and eligible need to participate in the HealthShare Program. However, if an existing employee declines coverage, they will need to wait until the group's annual renewal period before they can opt to enroll again.

Q: What if I have an employee that carries their own private health insurance. Can they discontinue their private insurance and enroll in HealthShare?

A: Typically HealthShare requires an individual to be uninsured at least four months before they may enroll. However, there are a few exceptions to this rule:

1. Qualifying Events (Life-Changing Events) - In order to waive the four-month rule due to a qualifying event, employee must provide documented proof of the event (such as a letter of coverage termination from their previous health coverage entity), and notify HealthShare within 30 days of the event to enroll. If notification is received beyond 30 days from the qualifying event, the employee must wait until the group's next open enrollment period to enroll. Qualifying events include:
   - An employee who loses health cover age through a spouse's, or parent's, health coverage policy through no fault of their own such as voluntary termination or termination due to non-payment of premiums.
   - An employee who loses health coverage through their spouse due to divorce or death.
2. COBRA Continuation - Employees who currently have or have had health coverage under a COBRA Continuation policy within the last four months may drop this coverage to enroll in HealthShare.
3. Individual Catastrophic Policies - Employees who currently have or have had an individual catastrophic health policy within the last four months may enroll in HealthShare. They are not required to drop their Individual Catastrophic Policy. HealthShare defines an Individual Catastrophic Policy as a policy purchased and maintained by an individual, not through an employer, that has deductible limits equal to or in excess of $3,000 for an individual and $5,000 for families and does not provide for preventative care, office visits, or pharmacy benefits.
4. Minnesota Care - Employees who currently have or have had coverage through Minnesota Care may choose to drop Minnesota Care coverage and enroll in HealthShare if they decide that HealthShare is a better choice for them.

Q: Once I enter into an agreement with HealthShare, how long am I obligated to participate in the program?

A: The initial term of the agreement is one year commencing on the effective date of coverage. If you decide to not renew, you must notify HealthShare 30 days prior to the one-year anniversary of your coverage taking effect. Example: If your coverage became effective on December 1, 2009, you must notify HealthShare by November 1, 2010, that you wish to discontinue coverage. See employer contract for further details if there is a change in business ownership.

Q: What if I terminate an employee or they quit?

A: Notice of any change in covered employee's status must be received by HealthShare no later than the fifth day of the month preceding the following month's coverage. Example: If an employee quits on November 1, the employer must notify HealthShare by November 5 to avoid being charged for December.

Q: Can I or my employees have pre-tax dollars deducted to pay for HealthShare coverage.

A: Yes. Consult with your HealthShare Employer Representative for guidance on how to accomplish this.

Q: What if I have an employee that is injured at work. Will HealthShare cover the costs?

A: No. worker's compensation will need to be utilized to cover any medical costs for injuries occurring at work.

Q: Can domestic partners qualify as dependents under HealthShare?