Bill Text: MN SF1 | 2013-2014 | 88th Legislature | Engrossed
NOTE: There are more recent revisions of this legislation. Read Latest Draft
Bill Title: Minnesota Insurance Marketplace Act (MNsure)
Sponsorship: Slight Partisan Bill (Democrat 3-1)
Status: (Introduced - Dead) 2013-03-06 - HF substituted on General Orders HF5 [SF1 Detail]
Download: Minnesota-2013-SF1-Engrossed.html
Bill Title: Minnesota Insurance Marketplace Act (MNsure)
Sponsorship: Slight Partisan Bill (Democrat 3-1)
Status: (Introduced - Dead) 2013-03-06 - HF substituted on General Orders HF5 [SF1 Detail]
Download: Minnesota-2013-SF1-Engrossed.html
1.2relating to commerce; establishing the Minnesota Insurance Marketplace;
1.3prescribing its powers and duties; authorizing rulemaking; appropriating money;
1.4amending Minnesota Statutes 2012, sections 13.7191, by adding a subdivision;
1.513D.08, by adding a subdivision; proposing coding for new law as Minnesota
1.6Statutes, chapter 62V.
1.7BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
1.8 Section 1. Minnesota Statutes 2012, section 13.7191, is amended by adding a
1.9subdivision to read:
1.10 Subd. 14a. Minnesota Insurance Marketplace. Classification and sharing of data
1.11of the Minnesota Insurance Marketplace is governed by section 62V.06.
1.12 Sec. 2. Minnesota Statutes 2012, section 13D.08, is amended by adding a subdivision
1.13to read:
1.14 Subd. 5a. Minnesota Insurance Marketplace. Meetings of the Minnesota
1.15Insurance Marketplace are governed by section 62V.03, subdivision 2.
1.16 Sec. 3. [62V.01] TITLE.
1.17This chapter may be cited as the "Minnesota Insurance Marketplace Act."
1.18 Sec. 4. [62V.02] DEFINITIONS.
1.19 Subdivision 1. Scope. For the purposes of this chapter, the following terms have
1.20the meanings given.
1.21 Subd. 2. Board. "Board" means the board of directors specified in section 62V.04.
2.1 Subd. 3. Health benefit plan. "Health benefit plan" means a policy, contract,
2.2certificate, or agreement defined in section 62A.011, subdivision 3, and a dental plan
2.3defined in section 62Q.76, subdivision 3.
2.4 Subd. 4. Health carrier. "Health carrier" has the meaning defined in section
2.562A.011.
2.6 Subd. 5. Individual market. "Individual market" means the market for health
2.7insurance coverage offered to individuals.
2.8 Subd. 6. Insurance producer. "Insurance producer" has the meaning defined
2.9in section 60K.31.
2.10 Subd. 7. Minnesota Insurance Marketplace. "Minnesota Insurance Marketplace"
2.11means the Minnesota Insurance Marketplace created as a state health benefit exchange
2.12as described in section 1311 of the federal Patient Protection and Affordable Care Act
2.13(Public Law 111-148), and further defined through amendments to the act and regulations
2.14issued under the act.
2.15 Subd. 8. Navigator. "Navigator" has the meaning described in section 1311(i) of
2.16the federal Patient Protection and Affordable Care Act (Public Law 111-148), and further
2.17defined through amendments to the act and regulations issued under the act.
2.18 Subd. 9. Public health care program. "Public health care program" means any
2.19public health care program administered by the commissioner of human services whereby
2.20eligibility for the program is determined according to a modified adjusted gross income
2.21standard.
2.22 Subd. 10. Small group market. "Small group market" means the market for health
2.23insurance coverage offered to small employers as defined in section 62L.02, subdivision 26.
2.24 Sec. 5. [62V.03] MINNESOTA INSURANCE MARKETPLACE;
2.25ESTABLISHMENT.
2.26 Subdivision 1. Creation. The Minnesota Insurance Marketplace is created as a
2.27board under section 15.012, paragraph (a), to:
2.28(1) promote innovation, competition, quality, value, market participation,
2.29affordability, meaningful choices, health improvement, care management, reduction of
2.30health disparities, and portability of health benefit plans;
2.31(2) facilitate and simplify the comparison, choice, enrollment, and purchase of health
2.32benefit plans for individuals purchasing in the individual market through the Minnesota
2.33Insurance Marketplace and for employees and employers purchasing in the small group
2.34market through the Minnesota Insurance Marketplace;
3.1(3) assist small employers with access to small business health insurance tax credits
3.2and to assist individuals with access to public health care programs, premium assistance
3.3tax credits and cost-sharing reductions, and certificates of exemption from individual
3.4responsibility requirements; and
3.5(4) facilitate the integration and transition of individuals between public health care
3.6programs and health benefit plans in the individual market.
3.7 Subd. 2. Application of other law. (a) The Minnesota Insurance Marketplace is
3.8subject to review by the legislative auditor under section 3.971.
3.9(b) Board members of the Minnesota Insurance Marketplace are subject to section
3.1010A.07. Board members and the personnel of the Minnesota Insurance Marketplace
3.11are subject to section 10A.071.
3.12(c) All meetings of the board shall comply with the open meeting law in chapter
3.1313D, except that:
3.14(1) meetings regarding personnel negotiations may be closed at the discretion of
3.15the board;
3.16(2) meetings regarding contract negotiations may be closed at the discretion of
3.17the board; and
3.18(3) meetings or portions of meetings where not public data, as defined in section
3.1913.02, subdivision 8a, or trade secret information, as defined in section 13.37, subdivision
3.201, are closed to the public.
3.21(d) Except as specified in section 62V.05, subdivisions 7 and 9, the Minnesota
3.22Insurance Marketplace and provisions specified under this chapter must be exempt from
3.23chapter 14, including section 14.386. To set fees identified in section 62V.05, subdivisions
3.242 and 3, the board is exempt from section 16A.1283.
3.25 Sec. 6. [62V.04] GOVERNANCE.
3.26 Subdivision 1. Board. The Minnesota Insurance Marketplace is governed by a
3.27board of directors with seven members.
3.28 Subd. 2. Appointment. (a) Board membership of the Minnesota Insurance
3.29Marketplace consists of the following:
3.30(1) three members appointed by the governor and confirmed by the senate, with
3.31one member representing the interests of individual consumers eligible for individual
3.32market coverage, one member representing individual consumers eligible for public health
3.33care program coverage, and one member representing small employers. Members are
3.34appointed to serve a four-year term following the initial staggered-term lot determination;
4.1(2) three members appointed by the governor and confirmed by the senate, who have
4.2demonstrated expertise, leadership, and innovation in the following areas: one member
4.3representing the areas of health administration, health care finance, health plan purchasing,
4.4and health care delivery systems; one member representing the areas of public health, health
4.5disparities, public health care programs, and the uninsured; and one member representing
4.6health policy issues related to the small group and individual markets. Members are
4.7appointed to serve a four-year term following the initial staggered term lot determination;
4.8(3) the commissioner of human services or a designee; and
4.9(4) the governor shall make appointments to the board that are consistent with
4.10federal law and regulations regarding its composition and structure.
4.11(b) Section 15.0597 shall apply to all appointments, except for the commissioner
4.12and initial appointments.
4.13(c) Initial appointments shall be made within 30 days of enactment.
4.14 Subd. 3. Terms. (a) Board members may serve no more than two consecutive
4.15terms, except for the commissioner or the commissioner's designee, who shall serve
4.16until replaced by the governor.
4.17(b) A board member may resign at any time by giving written notice to the board.
4.18(c) The appointed members under subdivision 2, paragraph (a), clauses (1) and (2),
4.19shall have an initial term of two, three, or four years, determined by lot by the secretary of
4.20state.
4.21 Subd. 4. Conflicts of interest. Within one year prior to or at any time during their
4.22appointed term, board members appointed under subdivision 2, paragraph (a), clauses (1)
4.23and (2), shall not be employed by, be a member of the board of directors of, or otherwise
4.24be a representative of a health carrier, health care provider, navigator, insurance producer,
4.25or other entity in the business of selling items or services of significant value to or through
4.26the Minnesota Insurance Marketplace.
4.27 Subd. 5. Acting chair; first meeting; supervision. (a) The governor shall designate
4.28as acting chair one of the appointees described in subdivision 2.
4.29(b) The board shall hold its first meeting within 60 days of enactment.
4.30(c) The board shall elect a chair to replace the acting chair at the first meeting.
4.31 Subd. 6. Chair. The board shall have a chair, elected by a majority of members.
4.32The chair shall serve for one year.
4.33 Subd. 7. Officers. The members of the board shall elect officers by a majority of
4.34members. The officers shall serve for one year.
5.1 Subd. 8. Vacancies. If a vacancy occurs for a board seat that was appointed by the
5.2governor, the governor shall appoint a new member within 90 days to serve the remainder
5.3of the term.
5.4 Subd. 9. Removal. A board member may be removed by the board only for cause,
5.5following notice, hearing, and a two-thirds vote of the board. A conflict of interest as
5.6defined in subdivision 4 shall be cause for removal from the board.
5.7 Subd. 10. Meetings. The board shall meet at least quarterly.
5.8 Subd. 11. Quorum. A majority of the members of the board constitutes a quorum,
5.9and the affirmative vote of a majority of members of the board is necessary and sufficient
5.10for action taken by the board.
5.11 Subd. 12. Compensation. The board members shall be paid a salary not to exceed
5.12the salary limits established under section 15A.0815, subdivision 4. The salary for
5.13board members shall be set in accordance with this subdivision and section 15A.0815,
5.14subdivision 5.
5.15 Subd. 13. Advisory committees. (a) The board may establish, as necessary,
5.16advisory committees to gather information related to the operation of the Minnesota
5.17Insurance Marketplace.
5.18(b) Section 15.0597 shall not apply to any advisory committee established by the
5.19board.
5.20 Sec. 7. [62V.05] RESPONSIBILITIES AND POWERS OF THE MINNESOTA
5.21INSURANCE MARKETPLACE.
5.22 Subdivision 1. General. (a) The board shall operate the Minnesota Insurance
5.23Marketplace according to this chapter and applicable state and federal law.
5.24(b) The board has the power to:
5.25(1) employ personnel and delegate administrative, operational, and other
5.26responsibilities to the director and other personnel as deemed appropriate by the board.
5.27The director and managerial staff of the Minnesota Insurance Marketplace shall serve in
5.28the unclassified service and shall be governed by a compensation plan prepared by the
5.29board, submitted to the commissioner of management and budget for review and comment
5.30within 14 days of its receipt, and approved by the Legislative Coordinating Commission
5.31and the legislature under section 3.855, subdivision 3, except that section 15A.0815,
5.32subdivision 5, paragraph (e), shall not apply;
5.33(2) establish the budget of the Minnesota Insurance Marketplace;
6.1(3) seek and accept money, grants, loans, donations, materials, services, or
6.2advertising revenue from government agencies, philanthropic organizations, and public
6.3and private sources to fund the operation of the Minnesota Insurance Marketplace;
6.4(4) contract for the receipt and provision of goods and services;
6.5(5) enter into information-sharing agreements with federal and state agencies and
6.6other entities as authorized under section 62V.06; and
6.7(6) take any other actions reasonably required to implement and administer its
6.8responsibilities.
6.9(c) Within 180 days of enactment, the board shall establish bylaws, policies,
6.10and procedures governing the operations of the Minnesota Insurance Marketplace in
6.11accordance with this chapter.
6.12 Subd. 2. Operations funding. (a) Beginning January 1, 2015, the board may
6.13retain or collect up to 3.5 percent of premiums for individual market and small group
6.14market health benefit plans sold through the Minnesota Insurance Marketplace to fund
6.15the operations of the Minnesota Insurance Marketplace.
6.16(b) Prior to January 1, 2015, the Minnesota Insurance Marketplace shall retain or
6.17collect 3.5 percent of total premiums for individual market and small group market health
6.18benefit plans sold through the Minnesota Insurance Marketplace to fund the operations
6.19of the Minnesota Insurance Marketplace.
6.20(c) Funds collected for the operations of the Minnesota Insurance Marketplace
6.21under this subdivision shall cover any compensation provided to navigators participating
6.22in the navigator program.
6.23 Subd. 3. Compensation; insurance producers. (a) The board may establish
6.24requirements and compensation structure for insurance producers assisting individuals and
6.25small employers with coverage through the Minnesota Insurance Marketplace.
6.26(b) Within 30 days of enactment, the commissioner of management and budget shall
6.27establish requirements and compensation for insurance producers assisting individuals
6.28and small employers with coverage through the Minnesota Insurance Marketplace. The
6.29requirements and compensation structure established under this paragraph shall remain in
6.30effect until the implementation of the requirements and compensation structure established
6.31under paragraph (a).
6.32(c) Beginning January 1, 2015, the board may collect a percentage of premiums
6.33for individual market and small group market health benefit plans sold through the
6.34Minnesota Insurance Marketplace to fund the compensation of insurance producers
6.35assisting individuals and small employers with coverage through the Minnesota Insurance
6.36Marketplace. The percentage collected shall not exceed the percentage of premium paid to
7.1insurance producers in the fully insured individual and small group markets in Minnesota
7.2for the most recent available year as identified in the I-SITE maintained by the National
7.3Association of Insurance Commissioners (NAIC).
7.4(d) Prior to January 1, 2015, the Minnesota Insurance Marketplace shall collect a
7.5percentage of premiums for individual market and small group market health benefit plans
7.6sold through the Minnesota Insurance Marketplace to fund the compensation of insurance
7.7producers assisting individuals and small employers with coverage through the Minnesota
7.8Insurance Marketplace. The percentage collected shall equal the percentage of premium
7.9paid to insurance producers in the fully insured individual and small group markets in
7.10Minnesota for 2012 as identified in the I-SITE maintained by the NAIC.
7.11 Subd. 4. Navigator; in-person assisters; call center. (a) The board may establish
7.12policies and procedures for the ongoing operation of a navigator program, in-person
7.13assister program, call center, and customer service provisions for the Minnesota Insurance
7.14Marketplace to be implemented beginning January 1, 2015.
7.15(b) Until the implementation of the policies and procedures described in paragraph
7.16(a), the following shall be in effect:
7.17(1) the navigator program shall be met by section 256.962;
7.18(2) entities eligible to be navigators may serve as in-person assisters;
7.19(3) the commissioner of management and budget shall establish requirements
7.20and compensation for the navigator program and the in-person assister program within
7.2130 days of enactment. Compensation for navigators and in-person assisters must take
7.22into account any other compensation received by the in-person assister for conducting
7.23the same or similar services; and
7.24(4) call center operations shall utilize existing state resources and personnel,
7.25including referrals to counties for medical assistance.
7.26(c) The commissioner of management and budget shall establish a toll-free number
7.27for the Minnesota Insurance Marketplace and may hire and contract for additional
7.28resources as deemed necessary.
7.29 Subd. 5. Health carrier requirements; participation. (a) Beginning January 1,
7.302015, the board shall have the power to establish certification requirements for health
7.31carriers and health benefit plans offered through the Minnesota Insurance Marketplace
7.32unless by June 1, 2013, the legislature enacts regulatory requirements that:
7.33(1) apply uniformly to all health carriers and health benefit plans in the individual
7.34market;
7.35(2) apply uniformly to all health carriers and health benefit plans in the small
7.36group market; and
8.1(3) satisfy federal certification requirements for the Minnesota Insurance
8.2Marketplace.
8.3(b) The board has the power to select health carriers and health benefit plans for
8.4participation in the Minnesota Insurance Marketplace from the health carriers and health
8.5benefit plans that have met certification requirements. Selection must be determined in the
8.6interests of the individual consumers and employers and within federal requirements.
8.7(c) For health benefit plans offered through the Minnesota Insurance Marketplace
8.8beginning January 1, 2015, health carriers must use the most current addendum for Indian
8.9health care providers approved by Centers for Medicare and Medicaid Services and the
8.10tribes as part of their contracts with Indian health care providers.
8.11 Subd. 6. Appeals process; eligibility determinations. (a) The board shall establish
8.12a process for appeal of individual or employer eligibility determinations of the Minnesota
8.13Insurance Marketplace. The process must provide for a reasonable opportunity to be
8.14heard and timely resolution of the appeal, consistent with the requirements of federal
8.15law and regulations.
8.16(b) The Minnesota Insurance Marketplace may establish service-level agreements
8.17with state agencies to conduct hearings for appeals. Notwithstanding section 471.59,
8.18subdivision 1, a state agency is authorized to enter into service-level agreements for this
8.19purpose with the Minnesota Insurance Marketplace.
8.20(c) For proceedings under this subdivision and subdivision 7, the Minnesota
8.21Insurance Marketplace may be represented by an attorney who is an employee of the
8.22Minnesota Insurance Marketplace.
8.23(d) This subdivision does not apply to appeals of determinations where a state
8.24agency hearing is available under section 256.045.
8.25 Subd. 7. Contested case proceeding; health carrier determinations. A health
8.26carrier that is aggrieved by a decision of the board regarding its compliance with
8.27certification requirements or participation in the Minnesota Insurance Marketplace under
8.28subdivision 5, paragraph (a) or (b), is entitled to a contested case proceeding under chapter
8.2914. The report or order of the administrative law judge constitutes the final decision in the
8.30case, subject to judicial review under sections 14.63 to 14.69.
8.31 Subd. 8. Agreements; consultation. (a) The board shall:
8.32(1) establish and maintain an agreement with the chief information officer of
8.33the Office of Enterprise Technology for information technology services that ensures
8.34coordination with public health care programs. The board may establish and maintain
8.35agreements with the chief information officer of the Office of Enterprise Technology for
8.36other information technology services, including an agreement that would permit the
9.1Minnesota Insurance Marketplace to administer eligibility for additional health care and
9.2public assistance programs under the authority of the commissioner of human services;
9.3(2) establish and maintain an agreement with the commissioner of human services
9.4for cost allocation and services regarding eligibility determinations and enrollment for
9.5public health care programs. The board may establish and maintain an agreement with the
9.6commissioner of human services for other services; and
9.7(3) establish and maintain an agreement with the commissioners of commerce
9.8and health for services regarding enforcement of Minnesota Insurance Marketplace
9.9certification requirements for health benefit plans offered through the Minnesota Insurance
9.10Marketplace. The board may establish and maintain agreements with the commissioners
9.11of commerce and health for other services.
9.12(b) The board shall consult with the commissioners of commerce and health
9.13regarding the operations of the Minnesota Insurance Marketplace.
9.14(c) The board shall consult with Indian tribes and organizations regarding the
9.15operation of the Minnesota Insurance Marketplace.
9.16(d) The board shall establish advisory committees to provide the health care industry,
9.17consumers, and other stakeholders with the opportunity to share their perspectives
9.18regarding the operations of the Minnesota Insurance Marketplace.
9.19 Subd. 9. Rulemaking in first year. (a) For a period of one year following
9.20enactment, the Minnesota Insurance Marketplace may adopt rules to implement any
9.21provisions of this chapter following the process in this subdivision.
9.22(b) The Minnesota Insurance Marketplace shall publish proposed rules in the State
9.23Register.
9.24(c) Interested parties have 21 days after publication to comment on the proposed
9.25rules. After the Minnesota Insurance Marketplace has considered all comments, the
9.26Minnesota Insurance Marketplace shall publish notice in the State Register that the rules
9.27have been adopted and the rules shall take effect on publication.
9.28(d) If the adopted rules are the same as the proposed rules, the notice shall state that
9.29the rules have been adopted as proposed and shall cite the prior publication. If the adopted
9.30rules differ from the proposed rules, the portions of the adopted rules that differ from the
9.31proposed rules shall be included in the notice of adoption, together with a citation to the
9.32prior State Register that contained the notice of the proposed rules.
9.33(e) The Minnesota Insurance Marketplace shall seek comments from the Department
9.34of Administration, Information Policy Analysis Division, before adopting any final rules
9.35involving the sharing, use, or disclosure of not public data.
10.1(f) By October 1, 2013, by January 15, 2014, and by May 1, 2014, the board
10.2shall submit a report to the majority leader of the senate, the speaker of the house
10.3of representatives, and the chairs of the committees in the senate and the house of
10.4representatives with primary jurisdiction over commerce, that lists and describes all rules
10.5promulgated under this subdivision.
10.6 Subd. 10. Rulemaking after the first year. Beginning one year after enactment, the
10.7board may adopt rules to implement any provisions in this chapter using the expedited
10.8rulemaking process in section 14.389.
10.9 Sec. 8. [62V.06] DATA.
10.10(a) The definitions in section 13.02 apply to this section.
10.11(b) Government data of the Minnesota Insurance Marketplace on individuals,
10.12employees of employers, and employers using the Minnesota Insurance Marketplace are
10.13private data on individuals or nonpublic data. The Minnesota Insurance Marketplace
10.14may share not public data with state and federal agencies and other entities if the board
10.15determines that the exchange of the data is reasonably necessary to carry out the functions
10.16of the Minnesota Insurance Marketplace. State agencies shall share not public data
10.17with the Minnesota Insurance Marketplace if the board determines that the exchange of
10.18the data is reasonably necessary to carry out the functions of the Minnesota Insurance
10.19Marketplace. Data-sharing agreements must include adequate protections with respect to
10.20the confidentiality and integrity of the data to be shared and comply with applicable law.
10.21Notwithstanding the provisions governing summary data in sections 13.02, subdivision
10.2219, and 13.05, subdivision 7, the Minnesota Insurance Marketplace may derive summary
10.23data from nonpublic data under this section.
10.24 Sec. 9. [62V.07] FUNDS.
10.25All funds received by the Minnesota Insurance Marketplace must be deposited in a
10.26dedicated fund which may earn interest and are appropriated to the Minnesota Insurance
10.27Marketplace for the purpose for which the funds were received. Funds do not cancel
10.28and are available until expended.
10.29 Sec. 10. [62V.08] REPORT.
10.30The Minnesota Insurance Marketplace shall submit a report to the legislature by
10.31January 15, 2015, and each January 15 thereafter, on: (1) the performance of Minnesota
10.32Insurance Marketplace operations; (2) meeting the Minnesota Insurance Marketplace
11.1responsibilities; and (3) an accounting of the Minnesota Insurance Marketplace budget
11.2activities.
11.3 Sec. 11. [62V.09] EXPIRATION AND SUNSET EXCLUSION.
11.4Notwithstanding section 15.059, the board and its advisory committees shall not
11.5expire. The board and its advisory committees are not subject to review or sunsetting
11.6under chapter 3D. Advisory committees established by the board shall not expire except
11.7by action of the board.
11.8 Sec. 12. TRANSITION OF AUTHORITY.
11.9(a) Upon the effective date of this act, the commissioner of management and budget
11.10shall exercise all authorities and responsibilities under Minnesota Statutes, sections 62V.03
11.11and 62V.05 until the board has satisfied the requirements of Minnesota Statutes, section
11.1262V.05, subdivision 1, paragraph (c). In exercising these authorities and responsibilities of
11.13the board, the commissioner of management and budget shall be subject to or exempted
11.14from the same statutory provisions as the board, as identified in Minnesota Statutes,
11.15section 62V.03, subdivision 2.
11.16(b) Upon the establishment of bylaws, policies, and procedures governing the
11.17operations of the Minnesota Insurance Marketplace by the board as required under
11.18Minnesota Statutes, section 62V.05, subdivision 1, paragraph (c), all personnel, assets,
11.19contracts, obligations, and funds managed by the commissioner of management and
11.20budget for the design and development of the Minnesota Insurance Marketplace shall be
11.21transferred to the board. Existing personnel managed by the commissioner of management
11.22and budget for the design and development of the Minnesota Insurance Marketplace shall
11.23staff the board upon enactment.
11.24 Sec. 13. MINNESOTA COMPREHENSIVE HEALTH ASSOCIATION
11.25TERMINATION.
11.26The commissioner of commerce, in consultation with the board of directors of
11.27the Minnesota Comprehensive Health Association, has the authority to develop and
11.28implement the phase out and eventual termination of coverage provided by the Minnesota
11.29Comprehensive Health Association under Minnesota Statutes, chapter 62E. The phase
11.30out of coverage shall begin no sooner than January 1, 2014. The member assessments
11.31established under Minnesota Statutes, section 62E.11, shall take into consideration any
11.32phase out of coverage implemented under this section.
12.1 Sec. 14. REPORT ON APPEALS PROCESS.
12.2By February 1, 2014, and February 1, 2015, the Board of Directors of the Minnesota
12.3Insurance Marketplace shall submit a report to the legislature on the appeals process for
12.4eligibility determinations established under section 7.
12.5 Sec. 15. EFFECTIVE DATE.
12.6Sections 1 to 14 are effective the day following final enactment. Any actions taken
12.7by any state agencies in furtherance of the design, development, and implementation of the
12.8Minnesota Insurance Marketplace prior to the effective date shall be considered actions
12.9taken by the Minnesota Insurance Marketplace and shall be governed by the provisions of
12.10this chapter and state law. Health benefit plan coverage through the Minnesota Insurance
12.11Marketplace is effective January 1, 2014.
1.3prescribing its powers and duties; authorizing rulemaking; appropriating money;
1.4amending Minnesota Statutes 2012, sections 13.7191, by adding a subdivision;
1.513D.08, by adding a subdivision; proposing coding for new law as Minnesota
1.6Statutes, chapter 62V.
1.7BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
1.8 Section 1. Minnesota Statutes 2012, section 13.7191, is amended by adding a
1.9subdivision to read:
1.10 Subd. 14a. Minnesota Insurance Marketplace. Classification and sharing of data
1.11of the Minnesota Insurance Marketplace is governed by section 62V.06.
1.12 Sec. 2. Minnesota Statutes 2012, section 13D.08, is amended by adding a subdivision
1.13to read:
1.14 Subd. 5a. Minnesota Insurance Marketplace. Meetings of the Minnesota
1.15Insurance Marketplace are governed by section 62V.03, subdivision 2.
1.16 Sec. 3. [62V.01] TITLE.
1.17This chapter may be cited as the "Minnesota Insurance Marketplace Act."
1.18 Sec. 4. [62V.02] DEFINITIONS.
1.19 Subdivision 1. Scope. For the purposes of this chapter, the following terms have
1.20the meanings given.
1.21 Subd. 2. Board. "Board" means the board of directors specified in section 62V.04.
2.1 Subd. 3. Health benefit plan. "Health benefit plan" means a policy, contract,
2.2certificate, or agreement defined in section 62A.011, subdivision 3, and a dental plan
2.3defined in section 62Q.76, subdivision 3.
2.4 Subd. 4. Health carrier. "Health carrier" has the meaning defined in section
2.562A.011.
2.6 Subd. 5. Individual market. "Individual market" means the market for health
2.7insurance coverage offered to individuals.
2.8 Subd. 6. Insurance producer. "Insurance producer" has the meaning defined
2.9in section 60K.31.
2.10 Subd. 7. Minnesota Insurance Marketplace. "Minnesota Insurance Marketplace"
2.11means the Minnesota Insurance Marketplace created as a state health benefit exchange
2.12as described in section 1311 of the federal Patient Protection and Affordable Care Act
2.13(Public Law 111-148), and further defined through amendments to the act and regulations
2.14issued under the act.
2.15 Subd. 8. Navigator. "Navigator" has the meaning described in section 1311(i) of
2.16the federal Patient Protection and Affordable Care Act (Public Law 111-148), and further
2.17defined through amendments to the act and regulations issued under the act.
2.18 Subd. 9. Public health care program. "Public health care program" means any
2.19public health care program administered by the commissioner of human services whereby
2.20eligibility for the program is determined according to a modified adjusted gross income
2.21standard.
2.22 Subd. 10. Small group market. "Small group market" means the market for health
2.23insurance coverage offered to small employers as defined in section 62L.02, subdivision 26.
2.24 Sec. 5. [62V.03] MINNESOTA INSURANCE MARKETPLACE;
2.25ESTABLISHMENT.
2.26 Subdivision 1. Creation. The Minnesota Insurance Marketplace is created as a
2.27board under section 15.012, paragraph (a), to:
2.28(1) promote innovation, competition, quality, value, market participation,
2.29affordability, meaningful choices, health improvement, care management, reduction of
2.30health disparities, and portability of health benefit plans;
2.31(2) facilitate and simplify the comparison, choice, enrollment, and purchase of health
2.32benefit plans for individuals purchasing in the individual market through the Minnesota
2.33Insurance Marketplace and for employees and employers purchasing in the small group
2.34market through the Minnesota Insurance Marketplace;
3.1(3) assist small employers with access to small business health insurance tax credits
3.2and to assist individuals with access to public health care programs, premium assistance
3.3tax credits and cost-sharing reductions, and certificates of exemption from individual
3.4responsibility requirements; and
3.5(4) facilitate the integration and transition of individuals between public health care
3.6programs and health benefit plans in the individual market.
3.7 Subd. 2. Application of other law. (a) The Minnesota Insurance Marketplace is
3.8subject to review by the legislative auditor under section 3.971.
3.9(b) Board members of the Minnesota Insurance Marketplace are subject to section
3.1010A.07. Board members and the personnel of the Minnesota Insurance Marketplace
3.11are subject to section 10A.071.
3.12(c) All meetings of the board shall comply with the open meeting law in chapter
3.1313D, except that:
3.14(1) meetings regarding personnel negotiations may be closed at the discretion of
3.15the board;
3.16(2) meetings regarding contract negotiations may be closed at the discretion of
3.17the board; and
3.18(3) meetings or portions of meetings where not public data, as defined in section
3.1913.02, subdivision 8a, or trade secret information, as defined in section 13.37, subdivision
3.201, are closed to the public.
3.21(d) Except as specified in section 62V.05, subdivisions 7 and 9, the Minnesota
3.22Insurance Marketplace and provisions specified under this chapter must be exempt from
3.23chapter 14, including section 14.386. To set fees identified in section 62V.05, subdivisions
3.242 and 3, the board is exempt from section 16A.1283.
3.25 Sec. 6. [62V.04] GOVERNANCE.
3.26 Subdivision 1. Board. The Minnesota Insurance Marketplace is governed by a
3.27board of directors with seven members.
3.28 Subd. 2. Appointment. (a) Board membership of the Minnesota Insurance
3.29Marketplace consists of the following:
3.30(1) three members appointed by the governor and confirmed by the senate, with
3.31one member representing the interests of individual consumers eligible for individual
3.32market coverage, one member representing individual consumers eligible for public health
3.33care program coverage, and one member representing small employers. Members are
3.34appointed to serve a four-year term following the initial staggered-term lot determination;
4.1(2) three members appointed by the governor and confirmed by the senate, who have
4.2demonstrated expertise, leadership, and innovation in the following areas: one member
4.3representing the areas of health administration, health care finance, health plan purchasing,
4.4and health care delivery systems; one member representing the areas of public health, health
4.5disparities, public health care programs, and the uninsured; and one member representing
4.6health policy issues related to the small group and individual markets. Members are
4.7appointed to serve a four-year term following the initial staggered term lot determination;
4.8(3) the commissioner of human services or a designee; and
4.9(4) the governor shall make appointments to the board that are consistent with
4.10federal law and regulations regarding its composition and structure.
4.11(b) Section 15.0597 shall apply to all appointments, except for the commissioner
4.12and initial appointments.
4.13(c) Initial appointments shall be made within 30 days of enactment.
4.14 Subd. 3. Terms. (a) Board members may serve no more than two consecutive
4.15terms, except for the commissioner or the commissioner's designee, who shall serve
4.16until replaced by the governor.
4.17(b) A board member may resign at any time by giving written notice to the board.
4.18(c) The appointed members under subdivision 2, paragraph (a), clauses (1) and (2),
4.19shall have an initial term of two, three, or four years, determined by lot by the secretary of
4.20state.
4.21 Subd. 4. Conflicts of interest. Within one year prior to or at any time during their
4.22appointed term, board members appointed under subdivision 2, paragraph (a), clauses (1)
4.23and (2), shall not be employed by, be a member of the board of directors of, or otherwise
4.24be a representative of a health carrier, health care provider, navigator, insurance producer,
4.25or other entity in the business of selling items or services of significant value to or through
4.26the Minnesota Insurance Marketplace.
4.27 Subd. 5. Acting chair; first meeting; supervision. (a) The governor shall designate
4.28as acting chair one of the appointees described in subdivision 2.
4.29(b) The board shall hold its first meeting within 60 days of enactment.
4.30(c) The board shall elect a chair to replace the acting chair at the first meeting.
4.31 Subd. 6. Chair. The board shall have a chair, elected by a majority of members.
4.32The chair shall serve for one year.
4.33 Subd. 7. Officers. The members of the board shall elect officers by a majority of
4.34members. The officers shall serve for one year.
5.1 Subd. 8. Vacancies. If a vacancy occurs for a board seat that was appointed by the
5.2governor, the governor shall appoint a new member within 90 days to serve the remainder
5.3of the term.
5.4 Subd. 9. Removal. A board member may be removed by the board only for cause,
5.5following notice, hearing, and a two-thirds vote of the board. A conflict of interest as
5.6defined in subdivision 4 shall be cause for removal from the board.
5.7 Subd. 10. Meetings. The board shall meet at least quarterly.
5.8 Subd. 11. Quorum. A majority of the members of the board constitutes a quorum,
5.9and the affirmative vote of a majority of members of the board is necessary and sufficient
5.10for action taken by the board.
5.11 Subd. 12. Compensation. The board members shall be paid a salary not to exceed
5.12the salary limits established under section 15A.0815, subdivision 4. The salary for
5.13board members shall be set in accordance with this subdivision and section 15A.0815,
5.14subdivision 5.
5.15 Subd. 13. Advisory committees. (a) The board may establish, as necessary,
5.16advisory committees to gather information related to the operation of the Minnesota
5.17Insurance Marketplace.
5.18(b) Section 15.0597 shall not apply to any advisory committee established by the
5.19board.
5.20 Sec. 7. [62V.05] RESPONSIBILITIES AND POWERS OF THE MINNESOTA
5.21INSURANCE MARKETPLACE.
5.22 Subdivision 1. General. (a) The board shall operate the Minnesota Insurance
5.23Marketplace according to this chapter and applicable state and federal law.
5.24(b) The board has the power to:
5.25(1) employ personnel and delegate administrative, operational, and other
5.26responsibilities to the director and other personnel as deemed appropriate by the board.
5.27The director and managerial staff of the Minnesota Insurance Marketplace shall serve in
5.28the unclassified service and shall be governed by a compensation plan prepared by the
5.29board, submitted to the commissioner of management and budget for review and comment
5.30within 14 days of its receipt, and approved by the Legislative Coordinating Commission
5.31and the legislature under section 3.855, subdivision 3, except that section 15A.0815,
5.32subdivision 5, paragraph (e), shall not apply;
5.33(2) establish the budget of the Minnesota Insurance Marketplace;
6.1(3) seek and accept money, grants, loans, donations, materials, services, or
6.2advertising revenue from government agencies, philanthropic organizations, and public
6.3and private sources to fund the operation of the Minnesota Insurance Marketplace;
6.4(4) contract for the receipt and provision of goods and services;
6.5(5) enter into information-sharing agreements with federal and state agencies and
6.6other entities as authorized under section 62V.06; and
6.7(6) take any other actions reasonably required to implement and administer its
6.8responsibilities.
6.9(c) Within 180 days of enactment, the board shall establish bylaws, policies,
6.10and procedures governing the operations of the Minnesota Insurance Marketplace in
6.11accordance with this chapter.
6.12 Subd. 2. Operations funding. (a) Beginning January 1, 2015, the board may
6.13retain or collect up to 3.5 percent of premiums for individual market and small group
6.14market health benefit plans sold through the Minnesota Insurance Marketplace to fund
6.15the operations of the Minnesota Insurance Marketplace.
6.16(b) Prior to January 1, 2015, the Minnesota Insurance Marketplace shall retain or
6.17collect 3.5 percent of total premiums for individual market and small group market health
6.18benefit plans sold through the Minnesota Insurance Marketplace to fund the operations
6.19of the Minnesota Insurance Marketplace.
6.20(c) Funds collected for the operations of the Minnesota Insurance Marketplace
6.21under this subdivision shall cover any compensation provided to navigators participating
6.22in the navigator program.
6.23 Subd. 3. Compensation; insurance producers. (a) The board may establish
6.24requirements and compensation structure for insurance producers assisting individuals and
6.25small employers with coverage through the Minnesota Insurance Marketplace.
6.26(b) Within 30 days of enactment, the commissioner of management and budget shall
6.27establish requirements and compensation for insurance producers assisting individuals
6.28and small employers with coverage through the Minnesota Insurance Marketplace. The
6.29requirements and compensation structure established under this paragraph shall remain in
6.30effect until the implementation of the requirements and compensation structure established
6.31under paragraph (a).
6.32(c) Beginning January 1, 2015, the board may collect a percentage of premiums
6.33for individual market and small group market health benefit plans sold through the
6.34Minnesota Insurance Marketplace to fund the compensation of insurance producers
6.35assisting individuals and small employers with coverage through the Minnesota Insurance
6.36Marketplace. The percentage collected shall not exceed the percentage of premium paid to
7.1insurance producers in the fully insured individual and small group markets in Minnesota
7.2for the most recent available year as identified in the I-SITE maintained by the National
7.3Association of Insurance Commissioners (NAIC).
7.4(d) Prior to January 1, 2015, the Minnesota Insurance Marketplace shall collect a
7.5percentage of premiums for individual market and small group market health benefit plans
7.6sold through the Minnesota Insurance Marketplace to fund the compensation of insurance
7.7producers assisting individuals and small employers with coverage through the Minnesota
7.8Insurance Marketplace. The percentage collected shall equal the percentage of premium
7.9paid to insurance producers in the fully insured individual and small group markets in
7.10Minnesota for 2012 as identified in the I-SITE maintained by the NAIC.
7.11 Subd. 4. Navigator; in-person assisters; call center. (a) The board may establish
7.12policies and procedures for the ongoing operation of a navigator program, in-person
7.13assister program, call center, and customer service provisions for the Minnesota Insurance
7.14Marketplace to be implemented beginning January 1, 2015.
7.15(b) Until the implementation of the policies and procedures described in paragraph
7.16(a), the following shall be in effect:
7.17(1) the navigator program shall be met by section 256.962;
7.18(2) entities eligible to be navigators may serve as in-person assisters;
7.19(3) the commissioner of management and budget shall establish requirements
7.20and compensation for the navigator program and the in-person assister program within
7.2130 days of enactment. Compensation for navigators and in-person assisters must take
7.22into account any other compensation received by the in-person assister for conducting
7.23the same or similar services; and
7.24(4) call center operations shall utilize existing state resources and personnel,
7.25including referrals to counties for medical assistance.
7.26(c) The commissioner of management and budget shall establish a toll-free number
7.27for the Minnesota Insurance Marketplace and may hire and contract for additional
7.28resources as deemed necessary.
7.29 Subd. 5. Health carrier requirements; participation. (a) Beginning January 1,
7.302015, the board shall have the power to establish certification requirements for health
7.31carriers and health benefit plans offered through the Minnesota Insurance Marketplace
7.32unless by June 1, 2013, the legislature enacts regulatory requirements that:
7.33(1) apply uniformly to all health carriers and health benefit plans in the individual
7.34market;
7.35(2) apply uniformly to all health carriers and health benefit plans in the small
7.36group market; and
8.1(3) satisfy federal certification requirements for the Minnesota Insurance
8.2Marketplace.
8.3(b) The board has the power to select health carriers and health benefit plans for
8.4participation in the Minnesota Insurance Marketplace from the health carriers and health
8.5benefit plans that have met certification requirements. Selection must be determined in the
8.6interests of the individual consumers and employers and within federal requirements.
8.7(c) For health benefit plans offered through the Minnesota Insurance Marketplace
8.8beginning January 1, 2015, health carriers must use the most current addendum for Indian
8.9health care providers approved by Centers for Medicare and Medicaid Services and the
8.10tribes as part of their contracts with Indian health care providers.
8.11 Subd. 6. Appeals process; eligibility determinations. (a) The board shall establish
8.12a process for appeal of individual or employer eligibility determinations of the Minnesota
8.13Insurance Marketplace. The process must provide for a reasonable opportunity to be
8.14heard and timely resolution of the appeal, consistent with the requirements of federal
8.15law and regulations.
8.16(b) The Minnesota Insurance Marketplace may establish service-level agreements
8.17with state agencies to conduct hearings for appeals. Notwithstanding section 471.59,
8.18subdivision 1, a state agency is authorized to enter into service-level agreements for this
8.19purpose with the Minnesota Insurance Marketplace.
8.20(c) For proceedings under this subdivision and subdivision 7, the Minnesota
8.21Insurance Marketplace may be represented by an attorney who is an employee of the
8.22Minnesota Insurance Marketplace.
8.23(d) This subdivision does not apply to appeals of determinations where a state
8.24agency hearing is available under section 256.045.
8.25 Subd. 7. Contested case proceeding; health carrier determinations. A health
8.26carrier that is aggrieved by a decision of the board regarding its compliance with
8.27certification requirements or participation in the Minnesota Insurance Marketplace under
8.28subdivision 5, paragraph (a) or (b), is entitled to a contested case proceeding under chapter
8.2914. The report or order of the administrative law judge constitutes the final decision in the
8.30case, subject to judicial review under sections 14.63 to 14.69.
8.31 Subd. 8. Agreements; consultation. (a) The board shall:
8.32(1) establish and maintain an agreement with the chief information officer of
8.33the Office of Enterprise Technology for information technology services that ensures
8.34coordination with public health care programs. The board may establish and maintain
8.35agreements with the chief information officer of the Office of Enterprise Technology for
8.36other information technology services, including an agreement that would permit the
9.1Minnesota Insurance Marketplace to administer eligibility for additional health care and
9.2public assistance programs under the authority of the commissioner of human services;
9.3(2) establish and maintain an agreement with the commissioner of human services
9.4for cost allocation and services regarding eligibility determinations and enrollment for
9.5public health care programs. The board may establish and maintain an agreement with the
9.6commissioner of human services for other services; and
9.7(3) establish and maintain an agreement with the commissioners of commerce
9.8and health for services regarding enforcement of Minnesota Insurance Marketplace
9.9certification requirements for health benefit plans offered through the Minnesota Insurance
9.10Marketplace. The board may establish and maintain agreements with the commissioners
9.11of commerce and health for other services.
9.12(b) The board shall consult with the commissioners of commerce and health
9.13regarding the operations of the Minnesota Insurance Marketplace.
9.14(c) The board shall consult with Indian tribes and organizations regarding the
9.15operation of the Minnesota Insurance Marketplace.
9.16(d) The board shall establish advisory committees to provide the health care industry,
9.17consumers, and other stakeholders with the opportunity to share their perspectives
9.18regarding the operations of the Minnesota Insurance Marketplace.
9.19 Subd. 9. Rulemaking in first year. (a) For a period of one year following
9.20enactment, the Minnesota Insurance Marketplace may adopt rules to implement any
9.21provisions of this chapter following the process in this subdivision.
9.22(b) The Minnesota Insurance Marketplace shall publish proposed rules in the State
9.23Register.
9.24(c) Interested parties have 21 days after publication to comment on the proposed
9.25rules. After the Minnesota Insurance Marketplace has considered all comments, the
9.26Minnesota Insurance Marketplace shall publish notice in the State Register that the rules
9.27have been adopted and the rules shall take effect on publication.
9.28(d) If the adopted rules are the same as the proposed rules, the notice shall state that
9.29the rules have been adopted as proposed and shall cite the prior publication. If the adopted
9.30rules differ from the proposed rules, the portions of the adopted rules that differ from the
9.31proposed rules shall be included in the notice of adoption, together with a citation to the
9.32prior State Register that contained the notice of the proposed rules.
9.33(e) The Minnesota Insurance Marketplace shall seek comments from the Department
9.34of Administration, Information Policy Analysis Division, before adopting any final rules
9.35involving the sharing, use, or disclosure of not public data.
10.1(f) By October 1, 2013, by January 15, 2014, and by May 1, 2014, the board
10.2shall submit a report to the majority leader of the senate, the speaker of the house
10.3of representatives, and the chairs of the committees in the senate and the house of
10.4representatives with primary jurisdiction over commerce, that lists and describes all rules
10.5promulgated under this subdivision.
10.6 Subd. 10. Rulemaking after the first year. Beginning one year after enactment, the
10.7board may adopt rules to implement any provisions in this chapter using the expedited
10.8rulemaking process in section 14.389.
10.9 Sec. 8. [62V.06] DATA.
10.10(a) The definitions in section 13.02 apply to this section.
10.11(b) Government data of the Minnesota Insurance Marketplace on individuals,
10.12employees of employers, and employers using the Minnesota Insurance Marketplace are
10.13private data on individuals or nonpublic data. The Minnesota Insurance Marketplace
10.14may share not public data with state and federal agencies and other entities if the board
10.15determines that the exchange of the data is reasonably necessary to carry out the functions
10.16of the Minnesota Insurance Marketplace. State agencies shall share not public data
10.17with the Minnesota Insurance Marketplace if the board determines that the exchange of
10.18the data is reasonably necessary to carry out the functions of the Minnesota Insurance
10.19Marketplace. Data-sharing agreements must include adequate protections with respect to
10.20the confidentiality and integrity of the data to be shared and comply with applicable law.
10.21Notwithstanding the provisions governing summary data in sections 13.02, subdivision
10.2219, and 13.05, subdivision 7, the Minnesota Insurance Marketplace may derive summary
10.23data from nonpublic data under this section.
10.24 Sec. 9. [62V.07] FUNDS.
10.25All funds received by the Minnesota Insurance Marketplace must be deposited in a
10.26dedicated fund which may earn interest and are appropriated to the Minnesota Insurance
10.27Marketplace for the purpose for which the funds were received. Funds do not cancel
10.28and are available until expended.
10.29 Sec. 10. [62V.08] REPORT.
10.30The Minnesota Insurance Marketplace shall submit a report to the legislature by
10.31January 15, 2015, and each January 15 thereafter, on: (1) the performance of Minnesota
10.32Insurance Marketplace operations; (2) meeting the Minnesota Insurance Marketplace
11.1responsibilities; and (3) an accounting of the Minnesota Insurance Marketplace budget
11.2activities.
11.3 Sec. 11. [62V.09] EXPIRATION AND SUNSET EXCLUSION.
11.4Notwithstanding section 15.059, the board and its advisory committees shall not
11.5expire. The board and its advisory committees are not subject to review or sunsetting
11.6under chapter 3D. Advisory committees established by the board shall not expire except
11.7by action of the board.
11.8 Sec. 12. TRANSITION OF AUTHORITY.
11.9(a) Upon the effective date of this act, the commissioner of management and budget
11.10shall exercise all authorities and responsibilities under Minnesota Statutes, sections 62V.03
11.11and 62V.05 until the board has satisfied the requirements of Minnesota Statutes, section
11.1262V.05, subdivision 1, paragraph (c). In exercising these authorities and responsibilities of
11.13the board, the commissioner of management and budget shall be subject to or exempted
11.14from the same statutory provisions as the board, as identified in Minnesota Statutes,
11.15section 62V.03, subdivision 2.
11.16(b) Upon the establishment of bylaws, policies, and procedures governing the
11.17operations of the Minnesota Insurance Marketplace by the board as required under
11.18Minnesota Statutes, section 62V.05, subdivision 1, paragraph (c), all personnel, assets,
11.19contracts, obligations, and funds managed by the commissioner of management and
11.20budget for the design and development of the Minnesota Insurance Marketplace shall be
11.21transferred to the board. Existing personnel managed by the commissioner of management
11.22and budget for the design and development of the Minnesota Insurance Marketplace shall
11.23staff the board upon enactment.
11.24 Sec. 13. MINNESOTA COMPREHENSIVE HEALTH ASSOCIATION
11.25TERMINATION.
11.26The commissioner of commerce, in consultation with the board of directors of
11.27the Minnesota Comprehensive Health Association, has the authority to develop and
11.28implement the phase out and eventual termination of coverage provided by the Minnesota
11.29Comprehensive Health Association under Minnesota Statutes, chapter 62E. The phase
11.30out of coverage shall begin no sooner than January 1, 2014. The member assessments
11.31established under Minnesota Statutes, section 62E.11, shall take into consideration any
11.32phase out of coverage implemented under this section.
12.1 Sec. 14. REPORT ON APPEALS PROCESS.
12.2By February 1, 2014, and February 1, 2015, the Board of Directors of the Minnesota
12.3Insurance Marketplace shall submit a report to the legislature on the appeals process for
12.4eligibility determinations established under section 7.
12.5 Sec. 15. EFFECTIVE DATE.
12.6Sections 1 to 14 are effective the day following final enactment. Any actions taken
12.7by any state agencies in furtherance of the design, development, and implementation of the
12.8Minnesota Insurance Marketplace prior to the effective date shall be considered actions
12.9taken by the Minnesota Insurance Marketplace and shall be governed by the provisions of
12.10this chapter and state law. Health benefit plan coverage through the Minnesota Insurance
12.11Marketplace is effective January 1, 2014.
