Health Plan Information - Minnesota Plan Listings
Health Maintenance Organizations in Minnesota

In Minnesota, an HMO is either a non-profit corporation or a local government unit. An HMO provides comprehensive health maintenance services, or arranges for the provision of these services, to enrollees on the basis of a fixed prepaid sum without regard to the frequency or extent of services furnished to any particular enrollee.

Minnesota HMOs are licensed pursuant to Minnesota Statutes, chapter 62D and Minnesota Rules, part 4685.

• Allina Health and Aetna Health
  Allina Information | Allina Reports
• Blue Plus
  Blue Plus Information | Blue Plus Reports
• Group Health (license ended 2024)
  Group Health Information | Group Health Reports
• HealthPartners
  HealthPartners Information | HealthPartners Reports
• Hennepin Health (formerly Metropolitan Health Plan)
  Hennepin Health Information | Hennepin Health Reports
• Humana, Inc.
  Humana Information | Humana Reports
• Medica
  Medica Information | Medica Reports
• Medica Community Health Plan
  Medica Community Health Plan Information | Medica Community Health Plan Reports
• Quartz
  Quartz Information | Quartz Reports
• Sanford HealthPlan of Minnesota
  Sanford Information | Sanford Reports
• UCare
  UCare Information | UCare Reports
• UCare Community Health Plan (formerly PreferredOne)
  UCare CHP Information | UCare CHP Reports
• UnitedHealthcare of Illinois
  UnitedHealthcare of Illinois Information | UnitedHealthcare of Illinois Reports

Health Plan Information - County Based Purchasing

County Based Purchasing (CBP) is a health plan operated by a county or group of counties. The CBP entity purchases health care services for certain residents enrolled in Medical Assistance, Prepaid Assistance Medical Program, and MinnesotaCare. The participating counties are primarily rural.

Generally, counties propose arrangements that add value to public programs by:

• Assuring improved access to providers and community resources
• Improving coordination of health and human services
• Stabilizing and supporting existing community provider networks

CBP is authorized by Minnesota Statutes, section 256B.692, permitting counties to elect this purchasing system. CBP entities must meet the same requirements as HMOs or Community Integrated Service Networks (CISNs), as provided for under Minnesota Statutes, chapters 62D and 62N. Requirements are also set out in portions of Minnesota Statutes, chapters 62A, 62J, 62M, 62Q, and 72A.; and in Minn. Rules Part 4685.These requirements include standards for access, quality and financial solvency.

Implementing CBP Arrangements

CBP entities submit proposals and documentation to the Minnesota Department of Human Services (DHS) and the Minnesota Department of Health (MDH), the regulatory authority for HMOs. MDH reviews the proposals to assure that all consumer protections provided by law are reflected in the county-based purchasing arrangements. MDH makes a recommendation to DHS regarding the county-based purchasing proposal. DHS typically initiates competitive procurement and requests approval for a change in its agreement with the federal Centers for Medicaid and Medicare Services (CMS). Once operational, a county-based purchasing entity is subject to a contractual agreement with DHS and ongoing regulatory oversight by MDH.

Status of CBPs

Currently, three entities, representing 20 counties and over 26,000 enrollees, are operational. These entities are:

• Itasca Medical Care - IM Care Information | IM Care Report Summary
• PrimeWest - PrimeWest Information | PrimeWest Report Summary
• South Country Health Alliance - SCHA Information | SCHA Report Summary

For more information, email health.mcs@state.mn.us.