More than two dozen call center operators took their places in neat rows of private cubicles Tuesday, providing the first official link between consumers and the state's new health insurance exchange.

The phone lines in the exchange's downtown St. Paul headquarters were ringing. Operators took more than 200 calls in the first five hours, each lasting about four minutes, officials said.

Executive director April Todd-Malmlov said the call center's opening was "an important milestone" toward the Oct. 1 launch, a key date in preparing for full implementation of the federal health care law next year. "It's very exciting to see something up and running after all the planning," said Todd-Malmlov, who spent the day monitoring the center. Known as MNsure, the exchange is expected to be a gateway for more than 1 million Minnesotans to buy health coverage, using an online site that is supposed to make it easier than ever to comparison shop among options.

There were no notable glitches at the call center in the first hours, Todd-Malmlov said, and the average wait time was 7 seconds. The most common questions had to with eligibility, benefit plan details and costs, she said. While eligibility rules are fairly straightforward to answer, the state won't be releasing information on the health plan choices or the premium rates until Friday.

Customer service is one of several key points to making sure people use the exchanges, according to observers, and the state will spend more than $4 million in outreach efforts in the first year to train brokers, community organizations, libraries and medical clinics so they can work with people to sign them up.

The call center is one of those links in providing assistance.

"For this thing to work, you have to engage people and set up institutional structures that make it simple," said George John, a marketing professor at the University of Minnesota's Carlson School of Management. "The success or failure is not going to turn on some clever ad campaign."

The exchange is aimed at helping individuals who are uninsured or don't get insurance at work, as well as small-business owners and those enrolled in public plans, such as MinnesotaCare and Medical Assistance. Those whose incomes qualify them for discounts to make insurance premiums more affordable will use the MNsure exchange website to access tax credits.

Those with workplace health care benefits and seniors enrolled in Medicare won't need to use the exchange.

City workers spent the Labor Day weekend completing the final build-out on the second floor of MNsure headquarters so call center staff members would be ready to start taking calls by 7:30 a.m. Tuesday.

Nine insurance companies have applied to sell plans on the MNsure exchange, but the Minnesota Department of Commerce must approve all offerings first.

Todd-Malmlov said the MNsure call center also serves as the "front door" to other call centers, and MNsure staff will connect callers who need more specific information to resources at insurance companies, county offices or the Department of Human Services, which manages public health programs. Call operators can speak or provide interpreters for more than 140 languages.

The exchanges, which will open in all states next month, will be an important gateway to roll out key provisions of the federal health law in 2014, when everyone will be required to buy insurance or pay a penalty.

Insurance companies no longer will be able to deny people coverage because they have a preexisting condition and will be limited in how much they can raise premiums based on age. Additionally, all health insurance plans, whether purchased through the exchange, from a broker or directly from a health insurer, will be required to offer a core set of essential benefits will include preventive services, maternity care, prescription drugs and mental health care.

The state recently rolled out its $9 million marketing plan, using Paul Bunyan and Babe the Blue Ox to get the word out about MNsure.

Jackie Crosby • 612-673-7335