SF 810

as introduced - 89th Legislature (2015 - 2016) Posted on 02/13/2015 09:17am

A bill for an act
relating to health; establishing MNsure as a nonprofit corporation; amending
Minnesota Statutes 2014, sections 62V.03; 62V.04; 62V.05; 62V.06, subdivision
1; 62V.08; proposing coding for new law in Minnesota Statutes, chapter 62V;
repealing Minnesota Statutes 2014, sections 62V.07; 62V.09; 62V.11.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

Section 1.

Minnesota Statutes 2014, section 62V.03, is amended to read:

62V.03 MNSURE; ESTABLISHMENT.

Subdivision 1.

Creation.

new text begin (a) new text end MNsure is created as a deleted text begin board under section 15.012,
paragraph (a), deleted text end new text begin nonprofit corporation pursuant to the Minnesota Nonprofit Corporation
Act, sections 317A.001 to 317A.909, new text end to:

(1) promote informed consumer choice, innovation, competition, quality, value,
market participation, affordability, suitable and meaningful choices, health improvement,
care management, reduction of health disparities, and portability of health plans;

(2) facilitate and simplify the comparison, choice, enrollment, and purchase of
health plans for individuals purchasing in the individual market through MNsure and for
employees and employers purchasing in the small group market through MNsure;

(3) assist small employers with access to small business health insurance tax credits
new text begin and inform individuals of eligibility requirements to public health care programs, new text end and
deleted text begin to deleted text end assist individuals with deleted text begin access to public health care programs, deleted text end premium assistance
tax credits and cost-sharing reductions, and certificates of exemption from individual
responsibility requirements; new text begin and
new text end

deleted text begin (4) facilitate the integration and transition of individuals between public health care
programs and health plans in the individual or group market and develop processes that, to
the maximum extent possible, provide for continuous coverage; and
deleted text end

deleted text begin (5) deleted text end new text begin (4) new text end establish and modify as necessary a name and brand for MNsure based
on market studies that show maximum effectiveness in attracting the uninsured and
motivating them to take action.

new text begin (b) If any provision of the Minnesota Nonprofit Corporation Act conflicts with any
provision of this chapter, the provisions of this chapter apply.
new text end

Subd. 2.

Application of other law.

(a) deleted text begin MNsure must be reviewed by the legislative
auditor under section 3.971. The legislative auditor shall audit the books, accounts, and
affairs of MNsure once each year or less frequently as the legislative auditor's funds and
personnel permit. Upon the audit of the financial accounts and affairs of MNsure, MNsure
is liable to the state for the total cost and expenses of the audit, including the salaries paid
to the examiners while actually engaged in making the examination. The legislative
auditor may bill MNsure either monthly or at the completion of the audit. All collections
received for the audits must be deposited in the general fund and are appropriated to
the legislative auditor. Pursuant to section 3.97, subdivision 3a, the Legislative Audit
Commission is requested to direct the legislative auditor to report by March 1, 2014, to
the legislature on any duplication of services that occurs within state government as a
result of the creation of MNsure. The legislative auditor may make recommendations on
consolidating or eliminating any services deemed duplicative. The board shall reimburse
the legislative auditor for any costs incurred in the creation of this report.
deleted text end

deleted text begin (b) deleted text end Board members of MNsure are subject to sections 10A.07 and 10A.09. Board
members and the personnel of MNsure are subject to section 10A.071.

deleted text begin (c) deleted text end new text begin (b) new text end All meetings of the board shall comply with the open meeting law in chapter
13D, except that:

(1) meetings, or portions of meetings, regarding compensation negotiations with the
director or managerial staff may be closed in the same manner and according to the same
procedures identified in section 13D.03;

(2) meetings regarding contract negotiation strategy may be closed in the same
manner and according to the same procedures identified in section 13D.05, subdivision 3,
paragraph (c); and

(3) meetings, or portions of meetings, regarding not public data described in section
62V.06, subdivision 3, and regarding trade secret information as defined in section 13.37,
subdivision 1, paragraph (b), are closed to the public, but must otherwise comply with
the procedures identified in chapter 13D.

deleted text begin (d) MNsure and provisions specified under this chapter are exempt from:
deleted text end

deleted text begin (1) chapter 14, including section 14.386, except as specified in section 62V.05; and
deleted text end

deleted text begin (2) chapters 16B and 16C, with the exception of sections 16C.08, subdivision 2,
paragraph (b), clauses (1) to (8); 16C.086; 16C.09, paragraph (a), clauses (1) and (3),
paragraph (b), and paragraph (c); and section 16C.16. However, MNsure, in consultation
with the commissioner of administration, shall implement policies and procedures to
establish an open and competitive procurement process for MNsure that, to the extent
practicable, conforms to the principles and procedures contained in chapters 16B and 16C.
In addition, MNsure may enter into an agreement with the commissioner of administration
for other services.
deleted text end

deleted text begin (e) deleted text end new text begin (c) new text end The board and the Web site are deleted text begin exempt from deleted text end new text begin not subject to new text end chapter 60K. Any
employee of MNsure who sells, solicits, or negotiates insurance to individuals or small
employers must be licensed as an insurance producer under chapter 60K.

deleted text begin (f) deleted text end new text begin (d) new text end Section 3.3005 applies to any federal funds received by MNsure.

deleted text begin (g) MNsure is exempt from the following sections in chapter 16E: 16E.01,
subdivision 3, paragraph (b); 16E.03, subdivisions 3 and 4; 16E.04, subdivision 1,
subdivision 2, paragraph (c), and subdivision 3, paragraph (b); 16E.0465; 16E.055;
16E.145; 16E.15; 16E.16; 16E.17; 16E.18; and 16E.22.
deleted text end

deleted text begin (h) A MNsure decision that requires a vote of the board, other than a decision that
applies only to hiring of employees or other internal management of MNsure, is an
"administrative action" under section 10A.01, subdivision 2.
deleted text end

Subd. 3.

Continued operation of a private marketplace.

(a) Nothing in this
chapter shall be construed to prohibit: (1) a health carrier from offering outside of MNsure
a health plan to a qualified individual or qualified employer; and (2) a qualified individual
from enrolling in, or a qualified employer from selecting for its employees, a health plan
offered outside of MNsure.

(b) Nothing in this chapter shall be construed to restrict the choice of a qualified
individual to enroll or not enroll in a qualified health plan or to participate in MNsure.
Nothing in this chapter shall be construed to compel an individual to enroll in a qualified
health plan or to participate in MNsure.

(c) For purposes of this subdivision, "qualified individual" and "qualified employer"
have the meanings given in section 1312 of the Affordable Care Act, Public Law 111-148,
and further defined through amendments to the act and regulations issued under the act.

Sec. 2.

Minnesota Statutes 2014, section 62V.04, is amended to read:

62V.04 GOVERNANCE.

Subdivision 1.

Board.

MNsure is governed by a board of directors with deleted text begin seven deleted text end new text begin 11 new text end
members.

Subd. 2.

Appointment.

(a) Board membership of MNsure consists of the following:

deleted text begin (1) three members appointed by the governor with the advice and consent of both the
senate and the house of representatives acting separately in accordance with paragraph (d),
with one member representing the interests of individual consumers eligible for individual
market coverage, one member representing individual consumers eligible for public health
care program coverage, and one member representing small employers. Members are
appointed to serve four-year terms following the initial staggered-term lot determination;
deleted text end

deleted text begin (2) three members appointed by the governor with the advice and consent of both the
senate and the house of representatives acting separately in accordance with paragraph (d)
who have demonstrated expertise, leadership, and innovation in the following areas: one
member representing the areas of health administration, health care finance, health plan
purchasing, and health care delivery systems; one member representing the areas of public
health, health disparities, public health care programs, and the uninsured; and one member
representing health policy issues related to the small group and individual markets.
Members are appointed to serve four-year terms following the initial staggered-term lot
determination; and
deleted text end

deleted text begin (3) the commissioner of human services or a designee.
deleted text end

deleted text begin (b) Section 15.0597 shall apply to all appointments, except for the commissioner.
deleted text end

deleted text begin (c) The governor shall make appointments to the board that are consistent with
federal law and regulations regarding its composition and structure. All board members
appointed by the governor must be legal residents of Minnesota.
deleted text end

deleted text begin (d) Upon appointment by the governor, a board member shall exercise duties of
office immediately. If both the house of representatives and the senate vote not to confirm
an appointment, the appointment terminates on the day following the vote not to confirm
in the second body to vote.
deleted text end

deleted text begin (e) Initial appointments shall be made by April 30, 2013.
deleted text end

deleted text begin (f) One of the six members appointed under paragraph (a), clause (1) or (2), must
have experience in representing the needs of vulnerable populations and persons with
disabilities.
deleted text end

deleted text begin (g) Membership on the board must include representation from outside the
seven-county metropolitan area, as defined in section 473.121, subdivision 2.
deleted text end

new text begin (1) six members representing the interests of individual consumers, employees, and
small employers served by MNsure that reflect the cultural diversity and geography of
Minnesota and the population served by MNsure;
new text end

new text begin (2) five members representing health care providers, health carriers, and producers;
new text end

new text begin (3) the commissioner of management and budget;
new text end

new text begin (4) the commissioner of commerce;
new text end

new text begin (5) the commissioner of health; and
new text end

new text begin (6) the commissioner of human services.
new text end

new text begin (b) The commissioners shall serve as ex-officio nonvoting members.
new text end

new text begin (c) Appointments under this subdivision shall be made by June 30, 2015, and the
appointed members shall begin to exercise the duties of office beginning July 1, 2015.
new text end

Subd. 3.

Terms.

(a) Board members may serve no more than two consecutive
terms, except for the commissioner or the commissioner's designee, who shall serve
until replaced by the governor.

(b) A board member may resign at any time by giving written notice to the board.

(c) The appointed members under subdivision 2, paragraph (a), clauses (1) and (2),
shall have an initial term of two, three, or four years, determined by lot by the secretary of
state.

deleted text begin Subd. 4. deleted text end

deleted text begin Conflicts of interest. deleted text end

deleted text begin (a) Within one year prior to or at any time during
their appointed term, board members appointed under subdivision 2, paragraph (a),
clauses (1) and (2), shall not be employed by, be a member of the board of directors of, or
otherwise be a representative of a health carrier, institutional health care provider or other
entity providing health care, navigator, insurance producer, or other entity in the business
of selling items or services of significant value to or through MNsure. For purposes of this
paragraph, "health care provider or entity" does not include an academic institution.
deleted text end

deleted text begin (b) Board members must recuse themselves from discussion of and voting on an
official matter if the board member has a conflict of interest. A conflict of interest means
an association including a financial or personal association that has the potential to bias or
have the appearance of biasing a board member's decisions in matters related to MNsure
or the conduct of activities under this chapter.
deleted text end

deleted text begin (c) No board member shall have a spouse who is an executive of a health carrier.
deleted text end

deleted text begin (d) No member of the board may currently serve as a lobbyist, as defined under
section 10A.01, subdivision 21.
deleted text end

new text begin Subd. 4a. new text end

new text begin Conflict of interest. new text end

new text begin Members of the board must recuse themselves from
discussion of and voting on an official matter if the member has a conflict of interest. A
conflict of interest means an association, including a financial or personal association, that
has the potential to bias or have the appearance of biasing a member's decisions in matters
related to the exchange or the conduct of activities under this chapter.
new text end

deleted text begin Subd. 5. deleted text end

deleted text begin Acting chair; first meeting; supervision. deleted text end

deleted text begin (a) The governor shall designate
as acting chair one of the appointees described in subdivision 2.
deleted text end

deleted text begin (b) The board shall hold its first meeting within 60 days of enactment.
deleted text end

deleted text begin (c) The board shall elect a chair to replace the acting chair at the first meeting.
deleted text end

deleted text begin Subd. 6. deleted text end

deleted text begin Chair. deleted text end

deleted text begin The board shall have a chair, elected by a majority of members.
The chair shall serve for one year.
deleted text end

deleted text begin Subd. 7. deleted text end

deleted text begin Officers. deleted text end

deleted text begin The members of the board shall elect officers by a majority of
members. The officers shall serve for one year.
deleted text end

deleted text begin Subd. 8. deleted text end

deleted text begin Vacancies. deleted text end

deleted text begin If a vacancy occurs, the governor shall appoint a new member
within 90 days, and the newly appointed member shall be subject to the same confirmation
process described in subdivision 2.
deleted text end

deleted text begin Subd. 9. deleted text end

deleted text begin Removal. deleted text end

deleted text begin (a) A board member may be removed by the appointing
authority and a majority vote of the board following notice and hearing before the board.
For purposes of this subdivision, the appointing authority or a designee of the appointing
authority shall be a voting member of the board for purposes of constituting a quorum.
deleted text end

deleted text begin (b) A conflict of interest as defined in subdivision 4, shall be cause for removal
from the board.
deleted text end

Subd. 10.

Meetings.

The board shall meet at least quarterly.

deleted text begin Subd. 11. deleted text end

deleted text begin Quorum. deleted text end

deleted text begin A majority of the members of the board constitutes a quorum,
and the affirmative vote of a majority of members of the board is necessary and sufficient
for action taken by the board.
deleted text end

deleted text begin Subd. 12. deleted text end

deleted text begin Compensation. deleted text end

deleted text begin (a) The board members shall be paid a salary not to
exceed the salary limits established under section 15A.0815, subdivision 4. The salary for
board members shall be set in accordance with this subdivision and section 15A.0815,
subdivision 5. This paragraph expires December 31, 2015.
deleted text end

deleted text begin (b) Beginning January 1, 2016, the board members may be compensated in
accordance with section 15.0575.
deleted text end

Subd. 13.

Advisory committees.

(a) The board shall establish and maintain
advisory committees to provide insurance producers, health care providers, the health care
industry, consumers, and other stakeholders with the opportunity to advise the board
regarding the operation of MNsure as required under section 1311(d)(6) of the Affordable
Care Act, Public Law 111-148. The board shall regularly consult with the advisory
committees. The advisory committees established under this paragraph shall not expire.

(b) The board may establish additional advisory committees, as necessary, to gather
and provide information to the board in order to facilitate the operation of MNsure. The
advisory committees established under this paragraph shall not expire, except by action of
the board.

(c) Section 15.0597 shall not apply to any advisory committee established by the
board under this subdivision.

(d) The board may provide compensation and expense reimbursement under section
15.059, subdivision 3, to members of the advisory committees.

Sec. 3.

Minnesota Statutes 2014, section 62V.05, is amended to read:

62V.05 RESPONSIBILITIES AND POWERS OF MNSURE.

Subdivision 1.

General.

(a) The board shall operate MNsure according to this
chapter and applicable state and federal law.

(b) The board has the power to:

(1) employ personnel and delegate administrative, operational, and other
responsibilities to the director and other personnel as deemed appropriate by the board.
deleted text begin This authority is subject to chapters 43A and 179A. The director and managerial staff of
MNsure shall serve in the unclassified service and shall be governed by a compensation
plan prepared by the board, submitted to the commissioner of management and budget
for review and comment within 14 days of its receipt, and approved by the Legislative
Coordinating Commission and the legislature under section 3.855, except that section
15A.0815, subdivision 5, paragraph (e), shall not apply deleted text end new text begin MNsure employees are not state
employees and are not subject to any state civil service regulations new text end ;

(2) establish deleted text begin the deleted text end new text begin a new text end budget of MNsure;

(3) seek and accept money, grants, loans, donations, materials, services, or
advertising revenue from government agencies, philanthropic organizations, and public
and private sources to fund the operation of MNsure. No health carrier or insurance
producer shall advertise on MNsure;

(4) contract for the receipt and provision of goods and services;

(5) enter into information-sharing agreements with federal and state agencies and
other entities, provided the agreements include adequate protections with respect to
the confidentiality and integrity of the information to be shared, and comply with all
applicable state and federal laws, regulations, and rules, including the requirements of
section 62V.06; and

(6) exercise all powers reasonably necessary to implement and administer the
requirements of this chapter and the Affordable Care Act, Public Law 111-148.

(c) The board shall establish policies and procedures to gather public comment and
provide public notice in the State Register.

(d) deleted text begin Within 180 days of enactment, deleted text end The board shall establish bylaws, policies, and
procedures governing the operations of MNsure in accordance with this chapter.

Subd. 2.

Operations funding.

deleted text begin (a) Prior to January 1, 2015, MNsure shall retain or
collect up to 1.5 percent of total premiums for individual and small group market health
plans and dental plans sold through MNsure to fund the cash reserves of MNsure, but
the amount collected shall not exceed a dollar amount equal to 25 percent of the funds
collected under section 62E.11, subdivision 6, for calendar year 2012.
deleted text end

deleted text begin (b) deleted text end new text begin (a) new text end Beginning January 1, 2015, MNsure shall retain or collect up to 3.5 percent
of total premiums for individual and small group market health plans and dental plans
sold through MNsure to fund the operations of MNsure, but the amount collected shall not
exceed a dollar amount equal to 50 percent of the funds collected under section 62E.11,
subdivision 6, for calendar year 2012.

deleted text begin (c) deleted text end new text begin (b) new text end Beginning January 1, 2016, MNsure shall retain or collect up to deleted text begin 3.5 deleted text end new text begin 2.0 new text end
percent of total premiums for individual and small group market health plans and dental
plans sold through MNsure to fund the operations of MNsure deleted text begin , but the amount collected
may never exceed a dollar amount greater than 100 percent of the funds collected under
section 62E.11, subdivision 6, for calendar year 2012 deleted text end .

deleted text begin (d) deleted text end new text begin (c) new text end For fiscal years 2014 and 2015, the commissioner of management and
budget is authorized to provide cash flow assistance of up to $20,000,000 from the
special revenue fund or the statutory general fund under section 16A.671, subdivision 3,
paragraph (a), to MNsure. Any funds provided under this paragraph shall be repaid,
with interest, by June 30, 2015.

deleted text begin (e) Funding for the operations of MNsure shall cover any compensation provided to
navigators participating in the navigator program.
deleted text end

Subd. 3.

Insurance producers.

(a) deleted text begin By April 30, 2013, deleted text end The board, in consultation
with the commissioner of commerce, shall establish certification requirements that must
be met by insurance producers in order to assist individuals and small employers with
purchasing coverage through MNsure. deleted text begin Prior to January 1, 2015, the board may amend the
requirements, only if necessary, due to a change in federal rules.
deleted text end

(b) Certification requirements shall not exceed the requirements established
under Code of Federal Regulations, title 45, part 155.220. Certification shall include
training on health plans available through MNsure, available tax credits and cost-sharing
arrangements, compliance with privacy and security standards, eligibility verification
processes, online enrollment tools, and basic information on available public health care
programs. Training required for certification under this subdivision shall qualify for
continuing education requirements for insurance producers required under chapter 60K,
and must comply with course approval requirements under chapter 45.

(c) Producer compensation shall be established by health carriers that provide health
plans through MNsure. The structure of compensation to insurance producers must be
similar for health plans sold through MNsure and outside MNsure.

(d) Any insurance producer compensation structure established by a health carrier
for the small group market must include compensation for defined contribution plans that
involve multiple health carriers. The compensation offered must be commensurate with
other small group market defined health plans.

(e) Any insurance producer assisting an individual or small employer with purchasing
coverage through MNsure must disclose, orally and in writing, to the individual or small
employer at the time of the first solicitation with the prospective purchaser the following:

(1) the health carriers and qualified health plans offered through MNsure that the
producer is authorized to sell, and that the producer may not be authorized to sell all the
qualified health plans offered through MNsure;

(2) that the producer may be receiving compensation from a health carrier for
enrolling the individual or small employer into a particular health plan; and

(3) that information on all qualified health plans offered through MNsure is available
through the MNsure Web site.

For purposes of this paragraph, "solicitation" means any contact by a producer, or any
person acting on behalf of a producer made for the purpose of selling or attempting to sell
coverage through MNsure. If the first solicitation is made by telephone, the disclosures
required under this paragraph need not be made in writing, but the fact that disclosure
has been made must be acknowledged on the application.

deleted text begin (f) Beginning January 15, 2015, each health carrier that offers or sells qualified
health plans through MNsure shall report in writing to the board and the commissioner
of commerce the compensation and other incentives it offers or provides to insurance
producers with regard to each type of health plan the health carrier offers or sells both inside
and outside of MNsure. Each health carrier shall submit a report annually and upon any
change to the compensation or other incentives offered or provided to insurance producers.
deleted text end

deleted text begin (g) deleted text end new text begin (f) new text end Nothing in this chapter shall prohibit an insurance producer from offering
professional advice and recommendations to a small group purchaser based upon
information provided to the producer.

deleted text begin (h) deleted text end new text begin (g) new text end An insurance producer that offers health plans in the small group market
shall notify each small group purchaser of which group health plans qualify for Internal
Revenue Service approved section 125 tax benefits. The insurance producer shall also
notify small group purchasers of state law provisions that benefit small group plans when
the employer agrees to pay 50 percent or more of its employees' premium. Individuals
who are eligible for cost-effective medical assistance will count toward the 75 percent
participation requirement in section 62L.03, subdivision 3.

deleted text begin (i) deleted text end new text begin (h) new text end Nothing in this subdivision shall be construed to limit the licensure
requirements or regulatory functions of the commissioner of commerce under chapter 60K.

Subd. 4.

Navigator; in-person assisters; call center.

(a) The board shall
establish policies and procedures for the ongoing operation of a navigator program,
in-person assister program, call center, and customer service provisions for MNsure deleted text begin to be
implemented beginning January 1, 2015 deleted text end .

deleted text begin (b) Until the implementation of the policies and procedures described in paragraph
(a), the following shall be in effect:
deleted text end

deleted text begin (1) the navigator program shall be met by section 256.962;
deleted text end

deleted text begin (2) entities eligible to be navigators, including entities defined in Code of Federal
Regulations, title 45, part 155.210 (c)(2), may serve as in-person assisters;
deleted text end

deleted text begin (3) the board shall establish requirements and compensation for the navigator
program and the in-person assister program by April 30, 2013. Compensation for
navigators and in-person assisters must take into account any other compensation received
by the navigator or in-person assister for conducting the same or similar services; and
deleted text end

deleted text begin (4) call center operations shall utilize existing state resources and personnel,
including referrals to counties for medical assistance.
deleted text end

deleted text begin (c) deleted text end new text begin (b) new text end The board shall establish a toll-free number for MNsure and may hire and
contract for additional resources as deemed necessary.

deleted text begin (d) deleted text end new text begin (c) new text end The navigator program and in-person assister program must meet the
requirements of section 1311(i) of the Affordable Care Act, Public Law 111-148. In
establishing training standards for the navigators and in-person assisters, the board must
ensure that all entities and individuals carrying out navigator and in-person assister
functions have training in the needs of underserved and vulnerable populations; eligibility
and enrollment rules and procedures; the range of available public health care programs
and qualified health plan options offered through MNsure; and privacy and security
standards. deleted text begin For calendar year 2014, the commissioner of human services shall ensure that
the navigator program under section 256.962 provides application assistance for both
qualified health plans offered through MNsure and public health care programs.
deleted text end

deleted text begin (e) The board must ensure that any information provided by navigators, in-person
assisters, the call center, or other customer assistance portals be accessible to persons
with disabilities and that information provided on public health care programs include
information on other coverage options available to persons with disabilities.
deleted text end

Subd. 5.

Health carrier and health plan requirements; participation.

deleted text begin (a)
Beginning January 1, 2015, the board may establish certification requirements for health
carriers and health plans to be offered through MNsure that satisfy federal requirements
under section 1311(c)(1) of the Affordable Care Act, Public Law 111-148.
deleted text end

deleted text begin (b) Paragraph (a) does not apply if by June 1, 2013, the legislature enacts regulatory
requirements that:
deleted text end

deleted text begin (1) apply uniformly to all health carriers and health plans in the individual market;
deleted text end

deleted text begin (2) apply uniformly to all health carriers and health plans in the small group market;
and
deleted text end

deleted text begin (3) satisfy minimum federal certification requirements under section 1311(c)(1) of
the Affordable Care Act, Public Law 111-148.
deleted text end

deleted text begin (c) In accordance with section 1311(e) of the Affordable Care Act, Public Law
111-148, the board shall establish policies and procedures for certification and selection
of health plans to be offered as qualified health plans through MNsure. The board shall
certify and select a health plan as a qualified health plan to be offered through MNsure, if:
deleted text end

deleted text begin (1) the health plan meets the minimum certification requirements established in
paragraph (a) or the market regulatory requirements in paragraph (b);
deleted text end

deleted text begin (2) the board determines that making the health plan available through MNsure is in
the interest of qualified individuals and qualified employers;
deleted text end

deleted text begin (3) the health carrier applying to offer the health plan through MNsure also applies
to offer health plans at each actuarial value level and service area that the health carrier
currently offers in the individual and small group markets; and
deleted text end

deleted text begin (4) the health carrier does not apply to offer health plans in the individual and
small group markets through MNsure under a separate license of a parent organization
or holding company under section 60D.15, that is different from what the health carrier
offers in the individual and small group markets outside MNsure.
deleted text end

deleted text begin (d) In determining the interests of qualified individuals and employers under
paragraph (c), clause (2), the board may not exclude a health plan for any reason specified
under section 1311(e)(1)(B) of the Affordable Care Act, Public Law 111-148. The board
may consider:
deleted text end

deleted text begin (1) affordability;
deleted text end

deleted text begin (2) quality and value of health plans;
deleted text end

deleted text begin (3) promotion of prevention and wellness;
deleted text end

deleted text begin (4) promotion of initiatives to reduce health disparities;
deleted text end

deleted text begin (5) market stability and adverse selection;
deleted text end

deleted text begin (6) meaningful choices and access;
deleted text end

deleted text begin (7) alignment and coordination with state agency and private sector purchasing
strategies and payment reform efforts; and
deleted text end

deleted text begin (8) other criteria that the board determines appropriate.
deleted text end

deleted text begin (e) For qualified health plans offered through MNsure on or after January 1, 2015,
the board shall establish policies and procedures under paragraphs (c) and (d) for selection
of health plans to be offered as qualified health plans through MNsure by February 1
of each year, beginning February 1, 2014. The board shall consistently and uniformly
apply all policies and procedures and any requirements, standards, or criteria to all health
carriers and health plans. For any policies, procedures, requirements, standards, or criteria
that are defined as rules under section 14.02, subdivision 4, the board may use the process
described in subdivision 9.
deleted text end

deleted text begin (f) For 2014, the board shall not have the power to select health carriers and health
plans for participation in MNsure. deleted text end new text begin (a) new text end The board shall permit all health plans that meet the
certification requirements under section 1311(c)(1) of the Affordable Care Act, Public
Law 111-148, to be offered through MNsure.

deleted text begin (g) Under this subdivision, deleted text end new text begin (b) new text end The board shall have the power to verify that health
carriers and health plans are properly certified to be eligible for participation in MNsure.

deleted text begin (h) deleted text end new text begin (c) new text end The board has the authority to decertify health carriers and health plans that
fail to maintain compliance with section 1311(c)(1) of the Affordable Care Act, Public
Law 111-148.

deleted text begin (i) For qualified health plans offered through MNsure beginning January 1, 2015, deleted text end new text begin
(d) new text end Health carriers must use the most current addendum for Indian health care providers
approved by the Centers for Medicare and Medicaid Services and the tribes as part of their
contracts with Indian health care providers. MNsure shall comply with all future changes
in federal law with regard to health coverage for the tribes.

Subd. 6.

Appeals.

(a) The board may conduct hearings, appoint hearing officers,
and recommend final orders related to appeals of any MNsure determinations deleted text begin , except for
those determinations identified in paragraph (d) deleted text end . deleted text begin An appeal by a health carrier regarding
a specific certification or selection determination made by MNsure under subdivision 5
must be conducted as a contested case proceeding under chapter 14, with the report or
order of the administrative law judge constituting the final decision in the case, subject to
judicial review under sections 14.63 to 14.69. deleted text end For other appeals, the board shall establish
hearing processes which provide for a reasonable opportunity to be heard and timely
resolution of the appeal and which are consistent with the requirements of federal law and
guidance. An appealing party may be represented by legal counsel at these hearings, but
this is not a requirement.

(b) deleted text begin MNsure deleted text end new text begin The board new text end may establish service-level agreements with state agencies
to conduct hearings for appeals. Notwithstanding section 471.59, subdivision 1, a state
agency is authorized to enter into service-level agreements for this purpose with MNsure.

deleted text begin (c) For proceedings under this subdivision, MNsure may be represented by an
attorney who is an employee of MNsure.
deleted text end

deleted text begin (d) This subdivision does not apply to appeals of determinations where a state
agency hearing is available under section 256.045.
deleted text end

Subd. 7.

Agreements; consultation.

(a) The board shall deleted text begin :
deleted text end

deleted text begin (1) establish and maintain an agreement with the chief information officer of the
Office of MN.IT Services for information technology services that ensures coordination
with public health care programs. The board may establish and maintain agreements
with the chief information officer of the Office of MN.IT Services for other information
technology services, including an agreement that would permit MNsure to administer
eligibility for additional health care and public assistance programs under the authority
of the commissioner of human services;
deleted text end

deleted text begin (2) establish and maintain an agreement with the commissioner of human services
for cost allocation and services regarding eligibility determinations and enrollment for
public health care programs that use a modified adjusted gross income standard to
determine program eligibility. The board may establish and maintain an agreement with
the commissioner of human services for other services;
deleted text end

deleted text begin (3) deleted text end establish and maintain an agreement with the commissioners of commerce and
health for services regarding enforcement of MNsure certification requirements for health
plans and dental plans offered through MNsure. The board may establish and maintain
agreements with the commissioners of commerce and health for other services deleted text begin ; and
deleted text end

deleted text begin (4) establish interagency agreements to transfer funds to other state agencies for
their costs related to implementing and operating MNsure, excluding medical assistance
allocatable costs deleted text end .

(b) The board shall deleted text begin consult with the commissioners of commerce and health
regarding the operations of MNsure deleted text end new text begin provide eligibility requirements for public health care
programs on the MNsure Web site, and shall provide contact information on its Web site
regarding enrollment in public health care programs for individuals who believe they may
be eligible for a public health care program new text end .

(c) The board shall consult with Indian tribes and organizations regarding the
operation of MNsure.

deleted text begin (d) Beginning March 15, 2014, and each March 15 thereafter, the board shall submit a
report to the chairs and ranking minority members of the committees in the senate and house
of representatives with primary jurisdiction over commerce, health, and human services on
all the agreements entered into with the chief information officer of the Office of MN.IT
Services, or the commissioners of human services, health, or commerce in accordance with
this subdivision. The report shall include the agency in which the agreement is with; the
time period of the agreement; the purpose of the agreement; and a summary of the terms
of the agreement. A copy of the agreement must be submitted to the extent practicable.
deleted text end

deleted text begin Subd. 8. deleted text end

deleted text begin Rulemaking. deleted text end

deleted text begin (a) If the board's policies, procedures, or other statements are
rules, as defined in section 14.02, subdivision 4, the requirements in either paragraph (b)
or (c) apply, as applicable.
deleted text end

deleted text begin (b) Effective upon enactment until January 1, 2015:
deleted text end

deleted text begin (1) the board shall publish notice of proposed rules in the State Register after
complying with section 14.07, subdivision 2;
deleted text end

deleted text begin (2) interested parties have 21 days to comment on the proposed rules. The board
must consider comments it receives. After the board has considered all comments and
has complied with section 14.07, subdivision 2, the board shall publish notice of the
final rule in the State Register;
deleted text end

deleted text begin (3) if the adopted rules are the same as the proposed rules, the notice shall state that
the rules have been adopted as proposed and shall cite the prior publication. If the adopted
rules differ from the proposed rules, the portions of the adopted rules that differ from the
proposed rules shall be included in the notice of adoption, together with a citation to the
prior State Register that contained the notice of the proposed rules; and
deleted text end

deleted text begin (4) rules published in the State Register before January 1, 2014, take effect upon
publication of the notice. Rules published in the State Register on and after January 1,
2014, take effect 30 days after publication of the notice.
deleted text end

deleted text begin (c) Beginning January 1, 2015, the board may adopt rules to implement any
provisions in this chapter using the expedited rulemaking process in section 14.389.
deleted text end

deleted text begin (d) The notice of proposed rules required in paragraph (b) must provide information
as to where the public may obtain a copy of the rules. The board shall post the proposed
rules on the MNsure Web site at the same time the notice is published in the State Register.
deleted text end

Subd. 9.

Dental plans.

(a) The provisions of this section that apply to health plans
shall apply to dental plans offered as stand-alone dental plans through MNsure, to the
extent practicable.

(b) A stand-alone dental plan offered through MNsure must meet all certification
requirements under section 1311(c)(1) of the Affordable Care Act, Public Law 111-148,
that are applicable to health plans, except for certification requirements that cannot be met
because the dental plan only covers dental benefits.

Subd. 10.

Limitations; risk-bearing.

deleted text begin (a) deleted text end The board shall not bear insurance risk or
enter into any agreement with health care providers to pay claims.

deleted text begin (b) Nothing in this subdivision shall prevent MNsure from providing insurance
for its employees.
deleted text end

Sec. 4.

Minnesota Statutes 2014, section 62V.06, subdivision 1, is amended to read:

Subdivision 1.

Applicability.

MNsure is deleted text begin a state agency for purposes of the
Minnesota Government Data Practices Act and is deleted text end subject to all provisions of chapter 13,
in addition to the requirements contained in this section.

Sec. 5.

Minnesota Statutes 2014, section 62V.08, is amended to read:

62V.08 REPORTS.

(a) MNsure shall submit a report to the legislature by January 15, deleted text begin 2015 deleted text end new text begin 2016 new text end , and
each January 15 thereafter, on: (1) the performance of MNsure operations; (2) meeting
MNsure responsibilities; new text begin and new text end (3) an accounting of MNsure budget activities deleted text begin ; (4) practices
and procedures that have been implemented to ensure compliance with data practices
laws, and a description of any violations of data practices laws or procedures; and (5)
the effectiveness of the outreach and implementation activities of MNsure in reducing
the rate of uninsurance deleted text end .

(b) MNsure must publish its administrative and operational costs on deleted text begin a deleted text end new text begin its new text end Web site
to educate consumers on those costs. The information published must include: (1) the
amount of premiums and federal premium subsidies collected; (2) the amount and source
of revenue received under section deleted text begin 62V.05, subdivision 1, paragraph (b), clause (3) deleted text end new text begin 62V.12 new text end ; new text begin
and new text end (3) the amount and source of any other fees collected for purposes of supporting
operations deleted text begin ; and (4) any misuse of funds as identified in accordance with section 3.975 deleted text end .
The Web site must be updated at least annually.

Sec. 6.

new text begin [62V.12] ACCOUNTS; AUDITS.
new text end

new text begin (a) The board shall provide for and pay the cost of an independent annual audit of
MNsure's books, accounts, and affairs by the legislative auditor subject to sections 3.971
and 3.972. A copy of the audit shall be filed with the secretary of state.
new text end

new text begin (b) The board may establish funds and accounts that it finds necessary.
new text end

new text begin (c) The board may accept and use gifts, grants, or contributions from any public or
private source, to the extent permitted under this chapter. Unless otherwise restricted,
the board may sell, exchange, or otherwise dispose of and invest or reinvest the money,
securities, or property given or bequested it. The principal of these funds, the income from
them, and all other revenues received by it from any nonstate source, including the premium
amounts retained or collected under section 62V.05, subdivision 2, must be placed in the
depositories the board determines, and is subject to expenditures for the board's purposes.
new text end

Sec. 7. new text begin FEDERAL WAIVER REQUEST.
new text end

new text begin (a) The commissioner of human services, in consultation with the Board of Directors
of MNsure, shall develop a proposal that:
new text end

new text begin (1) requires the Department of Human Services to determine eligibility and to enroll
eligible individuals and families into applicable state public health care programs; and
new text end

new text begin (2) requires MNsure to assist qualified individuals in determining premium tax
credits and cost-sharing reductions; provide through a Web site, standardized comparative
information on qualified health plans offered through the Web site; make available through
the Web site to qualified individuals and employers the opportunity to enroll in qualified
health plans; and provide information on the Web site informing individuals of eligibility
requirements for state public health programs.
new text end

new text begin (b) The commissioner shall seek all federal waivers and approvals necessary to
implement this proposal and notify the Board of Directors of MNsure of any federal
decision or action related to the requested waiver and proposal.
new text end

Sec. 8. new text begin REPEALER.
new text end

new text begin Minnesota Statutes 2014, sections 62V.07; 62V.09; and 62V.11, new text end new text begin are repealed.
new text end

Sec. 9. new text begin EFFECTIVE DATE.
new text end

new text begin Sections 1 to 6 and 8 are effective 90 days after the approval of the waiver request
described in section 7, or July 1, 2016, whichever is earlier. Section 7 is effective the
day following final enactment.
new text end