These example cases include some of the common issues that are decided in an appeal.
In some cases, the judge or hearing officer agreed with the person filing the appeal (called the appellant) and "reversed" MNsure's initial decision or action. In other cases the judge "affirmed" (agreed with) MNsure's initial decision or action.
198205: Did MNsure correctly determine the end date for the consumer’s APTC.
Decision: Affirmed.
204032: Did MNsure correctly determine the amount of the consumer’s APTC.
Decision: Reversed.
207286: Was the consumer ineligible for APTC because she would not be filing a joint tax return.
Decision: Affirmed.
207571: Was the consumer ineligible for APTC because she did not give MNsure permission to access her federal tax information.
Decision: Affirmed.
208862: Was the consumer ineligible for APTC because he did not give MNsure permission to access his federal tax information.
Decision: Affirmed.
210197: Did MNsure correctly determine the end date for the consumer’s qualified health plan, and did MNsure properly end the consumer’s APTC.
Decision: Affirmed.
207472: Did MNsure properly allow a health insurer to terminate a qualified health plan for non-payment of premiums and with whom should the consumer remedy the billing dispute for non-payment of plan premiums.
Decision: Affirmed.
177892: Did MNsure correctly determine the start date of the consumer’s qualified health plan coverage.
Decision: Affirmed.
203508: Did MNsure correctly determine the start date of the consumer’s qualified health plan coverage.
Decision: Reversed.
185786: Did MNsure accurately determine that the employer does not provide minimum essential coverage through an employer-sponsored plan to the employee.
Decision: Affirmed.
186787: Did MNsure accurately determine that the employer does not provide minimum essential coverage through an employer-sponsored plan to the employee.
Decision: Reversed.
185880: Did MNsure properly determine the employee was not eligible for employer-sponsored insurance.
Decision: Affirmed.
208564: Did MNsure properly determine that the consumers did not qualify for a special enrollment period because they did not enroll in a qualified health plan within 60 days after their qualifying life event.
Decision: Reversed.
209842: Did MNsure properly determine that the consumer did not qualify for a special enrollment period.
Decision: Affirmed.
206138: Did MNsure properly determine the end date for the consumer’s qualified health plan.
Decision: Affirmed.
210267: Did MNsure correctly determine that the consumer was not eligible for retroactive termination of qualified health plan coverage and correctly terminate the coverage.
Decision: Affirmed.
211006: Did MNsure properly determine the end date for the consumer’s qualified health plan.
Decision: Affirmed.
