Minnesota is bucking the national trend with growing HMO enrollment while at the same time defying a national movement to significant growth in self-insured products. Market leader Blue Cross and Blue Shield of Minnesota has introduced a new product, called SureBlue, which offers a three-year rate guarantee to fully insured businesses with 51 to 249 members. The consumer-driven movement, which is already strong in Minnesota, is likely to get a boost with a decision by Gov. Tim Pawlenty to offer a $250 health reimbursement arrangement to state employees. On the disease management front, the Minnesota Blue plan made a significant decision to bring its DM services in house as part of a new internal effort combining wellness and disease management. Meanwhile, HealthPartners is taking its homegrown wellness program nationwide.