HF 425

as introduced - 90th Legislature (2017 - 2018) Posted on 01/27/2017 11:18am

A bill for an act
relating to health; eliminating the MNsure Board; designating MNsure as a state
agency; changing rulemaking provisions; amending Minnesota Statutes 2016,
sections 15.01; 15A.0815, subdivision 2; 62V.02, subdivisions 2, 11; 62V.03;
62V.04; 62V.05; 62V.06; 62V.07; 62V.08; 62V.09; repealing Minnesota Statutes
2016, section 62V.11.

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

Section 1.

Minnesota Statutes 2016, section 15.01, is amended to read:

15.01 DEPARTMENTS OF THE STATE.

The following agencies are designated as the departments of the state government: the
Department of Administration; the Department of Agriculture; the Department of Commerce;
the Department of Corrections; the Department of Education; the Department of Employment
and Economic Development; the Department of Health; the Department of Human Rights;
the Department of Labor and Industry; the Department of Management and Budget; the
Department of Military Affairs; the Department of Natural Resources; the Department of
Public Safety; the Department of Human Services; the Department of Revenue; the
Department of Transportation; the Department of Veterans Affairs; new text begin the Department of
MNsure; new text end and their successor departments.

Sec. 2.

Minnesota Statutes 2016, section 15A.0815, subdivision 2, is amended to read:

Subd. 2.

Group I salary limits.

The salary for a position listed in this subdivision shall
not exceed 133 percent of the salary of the governor. This limit must be adjusted annually
on January 1. The new limit must equal the limit for the prior year increased by the percentage
increase, if any, in the Consumer Price Index for all urban consumers from October of the
second prior year to October of the immediately prior year. The commissioner of management
and budget must publish the limit on the department's Web site. This subdivision applies
to the following positions:

Commissioner of administration;

Commissioner of agriculture;

Commissioner of education;

Commissioner of commerce;

Commissioner of corrections;

Commissioner of health;

Commissioner, Minnesota Office of Higher Education;

Commissioner, Housing Finance Agency;

Commissioner of human rights;

Commissioner of human services;

Commissioner of labor and industry;

Commissioner of management and budget;

new text begin Commissioner of MNsure;
new text end

Commissioner of natural resources;

Commissioner, Pollution Control Agency;

Commissioner of public safety;

Commissioner of revenue;

Commissioner of employment and economic development;

Commissioner of transportation; and

Commissioner of veterans affairs.

Sec. 3.

Minnesota Statutes 2016, section 62V.02, subdivision 2, is amended to read:

Subd. 2.

deleted text begin Board deleted text end new text begin Commissioner new text end .

deleted text begin "Board" deleted text end new text begin "Commissioner" new text end means the deleted text begin Board of Directors deleted text end new text begin
commissioner new text end of MNsure deleted text begin specified in section 62V.04 deleted text end .

Sec. 4.

Minnesota Statutes 2016, section 62V.02, subdivision 11, is amended to read:

Subd. 11.

Qualified health plan.

"Qualified health plan" means a health plan that meets
the definition in section 1301(a) of the Affordable Care Act, Public Law 111-148, and has
been certified by the deleted text begin board deleted text end new text begin commissioner new text end in accordance with section 62V.05, subdivision
5, to be offered through MNsure.

Sec. 5.

Minnesota Statutes 2016, section 62V.03, is amended to read:

62V.03 MNSURE; ESTABLISHMENT.

Subdivision 1.

Creation.

MNsure is created as a deleted text begin board under section 15.012, paragraph
(a), deleted text end new text begin department of the state government under section 15.01 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 and
to assist individuals with access to public health care programs, premium assistance tax
credits and cost-sharing reductions, and certificates of exemption from individual
responsibility requirements;

(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

(5) 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.

Subd. 2.

Application of other law.

(a) MNsure deleted text begin must be reviewed deleted text end new text begin is subject to audit new text end by
the legislative auditor under section deleted text begin 3.971 deleted text end new text begin 3.972 new text end . deleted text begin 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) 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 end

deleted text begin (c) All meetings of the board and of the Minnesota Eligibility System Executive Steering
Committee established under section 62V.055 shall comply with the open meeting law in
chapter 13D.
deleted text end

deleted text begin (d) The board and deleted text end new text begin (b) new text end The Web site deleted text begin are deleted text end new text begin is new text end exempt from 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 (e) deleted text end new text begin (c) new text end Section 3.3005 applies to any federal funds received by MNsure.

deleted text begin (f) 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. 6.

Minnesota Statutes 2016, section 62V.04, is amended to read:

62V.04 GOVERNANCE.

deleted text begin Subdivision 1. deleted text end

deleted text begin Board. deleted text end

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

deleted text begin Subd. 2. deleted text end

deleted text begin Appointment. deleted text end

deleted text begin (a) Board membership of MNsure consists of the following:
deleted text end

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

deleted text begin Subd. 3. deleted text end

deleted text begin Terms. deleted text end

deleted text begin (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.
deleted text end

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

deleted text begin (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 end

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

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

deleted text begin Subd. 10. deleted text end

deleted text begin Meetings. deleted text end

deleted text begin The board shall meet at least quarterly.
deleted text end

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 deleted text begin board deleted text end new text begin commissioner new text end 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 deleted text begin board deleted text end new text begin
commissioner new text end regarding the operation of MNsure as required under section 1311(d)(6) of
the Affordable Care Act, Public Law 111-148. The deleted text begin board deleted text end new text begin commissioner new text end shall regularly
consult with the advisory committees. The advisory committees established under this
paragraph shall not expire.

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

(c) Section 15.0597 shall not apply to any advisory committee established by the deleted text begin board deleted text end new text begin
commissioner new text end under this subdivision.

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

Sec. 7.

Minnesota Statutes 2016, section 62V.05, is amended to read:

62V.05 RESPONSIBILITIES AND POWERS OF MNSURE.

Subdivision 1.

General.

(a) The deleted text begin board deleted text end new text begin commissioner new text end shall operate MNsure according
to this chapter and applicable state and federal law.

(b) The deleted text begin board deleted text end new text begin commissioner new text end has the power to:

deleted text begin (1) employ personnel and delegate administrative, operational, and other responsibilities
to the director and other personnel as deemed appropriate by the board. 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

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

deleted text begin (3) deleted text end new text begin (1) new text end 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;

deleted text begin (4) deleted text end new text begin (2) new text end contract for the receipt and provision of goods and services;

deleted text begin (5) deleted text end new text begin (3) new text end 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

deleted text begin (6) deleted text end new text begin (4) new text end 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 deleted text begin board deleted text end new text begin commissioner new text end shall establish policies and procedures to gather public
comment and provide public notice in the State Register.

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

Subd. 2.

Operations funding.

(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.

(b) 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.

(c) Beginning January 1, 2016, 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 may never exceed a
dollar amount greater than 100 percent of the funds collected under section 62E.11,
subdivision 6, for calendar year 2012.

(d) 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.

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

Subd. 3.

Insurance producers.

(a) deleted text begin By April 30, 2013, deleted text end The deleted text begin board deleted text end new text begin commissioner new text end , 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.

(f) Beginning January 15, 2015, each health carrier that offers or sells qualified health
plans through MNsure shall report in writing to the deleted text begin board deleted text end new text begin commissioner new text end 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.

(g) 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.

(h) 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.

(i) 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 deleted text begin board deleted text end new text begin commissioner new text end 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 to be implemented
beginning January 1, 2015.

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) deleted text end new text begin (b) new text end The deleted text begin board deleted text end new text begin commissioner new text end shall establish requirements and compensation for the
navigator program and the in-person assister program by April 30, 2013. new text begin 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. new text end Compensation for navigators and in-person
assisters must new text begin be equal to the compensation provided to insurance producers, and must new text end take
into account any other compensation received by the navigator or in-person assister for
conducting the same or similar services deleted text begin ; and deleted text end new text begin .
new text end

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

deleted text begin (c) deleted text end new text begin (d) new text end The deleted text begin board deleted text end new text begin commissioner new text end 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 (e) 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 deleted text begin board deleted text end new text begin commissioner new text end 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) deleted text end new text begin (f) new text end The deleted text begin board deleted text end new text begin commissioner new text end 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.

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

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

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

(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

(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 begin (d) deleted text end new text begin (b) new text end In determining the interests of qualified individuals and employers under paragraph
deleted text begin (c) deleted text end new text begin (a) new text end , clause (2), the deleted text begin board deleted text end new text begin commissioner new text end 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 deleted text begin board deleted text end new text begin commissioner new text end may consider:

(1) affordability;

(2) quality and value of health plans;

(3) promotion of prevention and wellness;

(4) promotion of initiatives to reduce health disparities;

(5) market stability and adverse selection;

(6) meaningful choices and access;

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

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

deleted text begin (e) deleted text end new text begin (c) new text end For qualified health plans offered through MNsure on or after January 1, deleted text begin 2015 deleted text end new text begin
2017 new text end , the deleted text begin board deleted text end new text begin commissioner new text end shall establish policies and procedures deleted text begin under paragraphs (c)
and (d) deleted text end new text begin in accordance with this subdivision new text end for selection of health plans to be offered as
qualified health plans through MNsure by February 1 of each year, beginning February 1,
deleted text begin 2014 deleted text end new text begin 2016 new text end . The deleted text begin board deleted text end new text begin commissioner new text end 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 deleted text begin board deleted text end new text begin commissioner new text end may use the process described
in subdivision deleted text begin 9 deleted text end new text begin 8 new 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. 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 end

deleted text begin (g) deleted text end new text begin (d) new text end Under this subdivision, the deleted text begin board deleted text end new text begin commissioner new text end 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 (e) new text end The deleted text begin board deleted text end new text begin commissioner new text end 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) deleted text end new text begin (f) new text end For qualified health plans offered through MNsure beginning January 1, 2015,
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 deleted text begin board deleted text end new text begin commissioner new text end may conduct hearings, appoint hearing
officers, and recommend final orders related to appeals of any MNsure determinations,
except for those determinations identified in paragraph (d). An appeal by a health carrier
regarding a specific certification or selection determination made by deleted text begin MNsure deleted text end new text begin the
commissioner new text end 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. For other
appeals, the deleted text begin board deleted text end new text begin commissioner new text end 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 commissioner new text end may establish service-level agreements with new text begin other new text end 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 deleted text begin MNsure deleted text end new text begin
the commissioner new text end .

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

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

(e) An appellant aggrieved by an order of MNsure issued in an eligibility appeal, as
defined in Minnesota Rules, part 7700.0101, may appeal the order to the district court of
the appellant's county of residence by serving a written copy of a notice of appeal upon
MNsure and any other adverse party of record within 30 days after the date MNsure issued
the order, the amended order, or order affirming the original order, and by filing the original
notice and proof of service with the court administrator of the district court. Service may
be made personally or by mail; service by mail is complete upon mailing; no filing fee shall
be required by the court administrator in appeals taken pursuant to this subdivision. MNsure
shall furnish all parties to the proceedings with a copy of the decision and a transcript of
any testimony, evidence, or other supporting papers from the hearing held before the appeals
examiner within 45 days after service of the notice of appeal.

(f) Any party aggrieved by the failure of an adverse party to obey an order issued by
MNsure may compel performance according to the order in the manner prescribed in sections
586.01 to 586.12.

(g) Any party may obtain a hearing at a special term of the district court by serving a
written notice of the time and place of the hearing at least ten days prior to the date of the
hearing. The court may consider the matter in or out of chambers, and shall take no new or
additional evidence unless it determines that such evidence is necessary for a more equitable
disposition of the appeal.

(h) Any party aggrieved by the order of the district court may appeal the order as in
other civil cases. No costs or disbursements shall be taxed against any party nor shall any
filing fee or bond be required of any party.

(i) If MNsure or district court orders eligibility for qualified health plan coverage through
MNsure, or eligibility for federal advance payment of premium tax credits or cost-sharing
reductions contingent upon full payment of respective premiums, the premiums must be
paid or provided pending appeal to the district court, Court of Appeals, or Supreme Court.
Provision of eligibility by MNsure pending appeal does not render moot MNsure's position
in a court of law.

Subd. 7.

Agreements; consultation.

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

deleted text begin (1) 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 (2) deleted text end new text begin (1) new 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 deleted text begin board deleted text end new text begin commissioner new text end may establish and
maintain agreements with the commissioners of commerce and health for other services;
and

deleted text begin (3) deleted text end new text begin (2) new text end establish interagency agreements to transfer funds to other state agencies for their
costs related to implementing and operating MNsure, excluding medical assistance allocatable
costs.

new text begin (b) The commissioner shall consult with the Office of MN.IT Services and the
commissioner of human services on all decisions that relate to information technology
services to permit MNsure the ability to administer eligibility for public health care programs
and ensure coordination and compatibility between public health care programs and qualified
health plans.
new text end

deleted text begin (b) deleted text end new text begin (c) new text end The deleted text begin board deleted text end new text begin commissioner new text end shall consult with the commissioners of commerce and
health regarding the operations of MNsure.

deleted text begin (c) deleted text end new text begin (d) new text end The deleted text begin board deleted text end new text begin commissioner new text end shall consult with Indian tribes and organizations
regarding the operation of MNsure.

deleted text begin (d) deleted text end new text begin (e) new text end Beginning March 15, 2016, and each March 15 thereafter, the deleted text begin board deleted text end new text begin commissioner new text end
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.

Subd. 8.

Rulemaking.

The deleted text begin board deleted text end new text begin commissioner new text end may adopt rules to implement any
provisions in this chapter using the expedited rulemaking process in section 14.389.

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) The board deleted text end new text begin MNsure new text end shall not bear insurance
risk deleted text begin or deleted text end new text begin and the commissioner shall not new text end 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

Subd. 11.

Prohibition on other product lines.

MNsure is prohibited from certifying,
selecting, or offering products and policies of coverage that do not meet the definition of
health plan or dental plan as provided in section 62V.02.

Subd. 12.

Reports on interagency agreements and intra-agency transfers.

The
MNsure Board shall provide quarterly reports to the chairs and ranking minority members
of the legislative committees with jurisdiction over health and human services policy and
finance on:

(1) interagency agreements or service-level agreements and any renewals or extensions
of existing interagency or service-level agreements with a state department under section
15.01, state agency under section 15.012, or the Office of MN.IT Services, with a value of
more than $100,000, or related agreements with the same department or agency with a
cumulative value of more than $100,000; and

(2) transfers of appropriations of more than $100,000 between accounts within or between
agencies.

The report must include the statutory citation authorizing the agreement, transfer or dollar
amount, purpose, and effective date of the agreement, the duration of the agreement, and a
copy of the agreement.

Sec. 8.

Minnesota Statutes 2016, section 62V.06, is amended to read:

62V.06 DATA PRACTICES.

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.

Subd. 2.

Definitions.

As used in this section:

(1) "individual" means an individual according to section 13.02, subdivision 8, but does
not include a vendor of services; and

(2) "participating" means that an individual, employee, or employer is seeking, or has
sought an eligibility determination, enrollment processing, or premium processing through
MNsure.

Subd. 3.

General data classifications.

The following data collected, created, or
maintained by MNsure are classified as private data on individuals, as defined in section
13.02, subdivision 12, or nonpublic data, as defined in section 13.02, subdivision 9:

(1) data on any individual participating in MNsure;

(2) data on any individuals participating in MNsure as employees of an employer
participating in MNsure; and

(3) data on employers participating in MNsure.

Subd. 4.

Application and certification data.

(a) Data submitted by an insurance producer
in an application for certification to sell a health plan through MNsure, or submitted by an
applicant seeking permission or a commission to act as a navigator or in-person assister,
are classified as follows:

(1) at the time the application is submitted, all data contained in the application are
private data, as defined in section 13.02, subdivision 12, or nonpublic data as defined in
section 13.02, subdivision 9, except that the name of the applicant is public; and

(2) upon a final determination related to the application for certification by MNsure, all
data contained in the application are public, with the exception of trade secret data as defined
in section 13.37.

(b) Data created or maintained by a government entity as part of the evaluation of an
application are protected nonpublic data, as defined in section 13.02, subdivision 13, until
a final determination as to certification is made and all rights of appeal have been exhausted.
Upon a final determination and exhaustion of all rights of appeal, these data are public, with
the exception of trade secret data as defined in section 13.37 and data subject to
attorney-client privilege or other protection as provided in section 13.393.

(c) If an application is denied, the public data must include the criteria used by the deleted text begin board deleted text end new text begin
commissioner new text end to evaluate the application and the specific reasons for the denial, and these
data must be published on the MNsure Web site.

Subd. 5.

Data sharing.

(a) deleted text begin MNsure deleted text end new text begin The commissioner new text end may share or disseminate data
classified as private or nonpublic in subdivision 3 as follows:

(1) to the subject of the data, as provided in section 13.04;

(2) according to a court order;

(3) according to a state or federal law specifically authorizing access to the data;

(4) with other state or federal agencies, only to the extent necessary to verify the identity
of, determine the eligibility of, process premiums for, process enrollment of, or investigate
fraud related to an individual, employer, or employee participating in MNsure, provided
that deleted text begin MNsure deleted text end new text begin the commissioner new text end must enter into a data-sharing agreement with the agency
prior to sharing data under this clause; and

(5) with a nongovernmental person or entity, only to the extent necessary to verify the
identity of, determine the eligibility of, process premiums for, process enrollment of, or
investigate fraud related to an individual, employer, or employee participating in MNsure,
provided that deleted text begin MNsure deleted text end new text begin the commissioner new text end must enter into a contract with the person or entity,
as provided in section 13.05, subdivision 6 or 11, prior to disseminating data under this
clause.

(b) deleted text begin MNsure deleted text end new text begin The commissioner new text end may share or disseminate data classified as private or
nonpublic in subdivision 4 as follows:

(1) to the subject of the data, as provided in section 13.04;

(2) according to a court order;

(3) according to a state or federal law specifically authorizing access to the data;

(4) with other state or federal agencies, only to the extent necessary to carry out the
functions of MNsure, provided that deleted text begin MNsure deleted text end new text begin the commissioner new text end must enter into a data-sharing
agreement with the agency prior to sharing data under this clause; and

(5) with a nongovernmental person or entity, only to the extent necessary to carry out
the functions of MNsure, provided that deleted text begin MNsure deleted text end new text begin the commissioner new text end must enter a contract
with the person or entity, as provided in section 13.05, subdivision 6 or 11, prior to
disseminating data under this clause.

(c) Sharing or disseminating data outside of MNsure in a manner not authorized by this
subdivision is prohibited. The list of authorized dissemination and sharing contained in this
subdivision must be included in the Tennessen warning required by section 13.04, subdivision
2.

deleted text begin (d) Until July 1, 2014, state agencies must share data classified as private or nonpublic
on individuals, employees, or employers participating in MNsure with MNsure, only to the
extent such data are necessary to verify the identity of, determine the eligibility of, process
premiums for, process enrollment of, or investigate fraud related to a MNsure participant.
The agency must enter into a data-sharing agreement with MNsure prior to sharing any data
under this paragraph.
deleted text end

Subd. 6.

Notice and disclosures.

(a) In addition to the Tennessen warning required by
section 13.04, subdivision 2, deleted text begin MNsure deleted text end new text begin the commissioner new text end must provide any data subject asked
to supply private data with:

(1) a notice of rights related to the handling of genetic information, pursuant to section
13.386; and

(2) a notice of the records retention policy of MNsure, detailing the length of time
MNsure will retain data on the individual and the manner in which it will be destroyed upon
expiration of that time.

(b) All notices required by this subdivision, including the Tennessen warning, must be
provided in an electronic format suitable for downloading or printing.

Subd. 7.

Summary data.

In addition to creation and disclosure of summary data derived
from private data on individuals, as permitted by section 13.05, subdivision 7, deleted text begin MNsure deleted text end new text begin the
commissioner new text end may create and disclose summary data derived from data classified as
nonpublic under this section.

Subd. 8.

Access to data; audit trail.

(a) Only individuals with explicit authorization
from the deleted text begin board deleted text end new text begin commissioner new text end may enter, update, or access not public data collected, created,
or maintained by MNsure. The ability of authorized individuals to enter, update, or access
data must be limited through the use of role-based access that corresponds to the official
duties or training level of the individual, and the statutory authorization that grants access
for that purpose. All queries and responses, and all actions in which data are entered, updated,
accessed, or shared or disseminated outside of MNsure, must be recorded in a data audit
trail. Data contained in the audit trail are public, to the extent that the data are not otherwise
classified by this section.

The deleted text begin board deleted text end new text begin commissioner new text end shall immediately and permanently revoke the authorization
of any individual determined to have willfully entered, updated, accessed, shared, or
disseminated data in violation of this section, or any provision of chapter 13. If an individual
is determined to have willfully gained access to data without explicit authorization from
the deleted text begin board deleted text end new text begin commissioner new text end , the deleted text begin board deleted text end new text begin commissioner new text end shall forward the matter to the county
attorney for prosecution.

(b) This subdivision shall not limit or affect the authority of the legislative auditor to
access data needed to conduct audits, evaluations, or investigations of MNsure or the
obligation of the deleted text begin board deleted text end new text begin commissioner new text end and MNsure employees to comply with section 3.978,
subdivision 2.

(c) This subdivision does not apply to actions taken by a MNsure participant to enter,
update, or access data held by MNsure, if the participant is the subject of the data that is
entered, updated, or accessed.

Subd. 9.

Sale of data prohibited.

deleted text begin MNsure deleted text end new text begin The commissioner new text end may not sell any data
collected, created, or maintained by MNsure, regardless of its classification, for commercial
or any other purposes.

Subd. 10.

Gun and firearm ownership.

deleted text begin MNsure deleted text end new text begin The commissioner new text end shall not collect
information that indicates whether or not an individual owns a gun or has a firearm in the
individual's home.

Sec. 9.

Minnesota Statutes 2016, section 62V.07, is amended to read:

62V.07 FUNDS.

deleted text begin (a) deleted text end The MNsure account is created in the new text begin state government new text end special revenue fund of the
state treasury. All funds received by MNsure shall be deposited in the account. deleted text begin Funds in
the account are appropriated to MNsure for the operation of MNsure. deleted text end Notwithstanding
section 11A.20, all investment income and all investment losses attributable to the investment
of the MNsure account not currently needed, shall be credited to the MNsure account.

deleted text begin (b) The budget submitted to the legislature under section 16A.11 must include budget
information for MNsure.
deleted text end

Sec. 10.

Minnesota Statutes 2016, section 62V.08, is amended to read:

62V.08 REPORTS.

(a) deleted text begin MNsure deleted text end new text begin The commissioner new text end 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; (3) an accounting of MNsure budget activities; (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.

(b) deleted text begin MNsure deleted text end new text begin The commissioner new text end must publish its administrative and operational costs on
a 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 62V.05, subdivision 1, paragraph (b), clause (3);
(3) the amount and source of any other fees collected for purposes of supporting operations;
and (4) any misuse of funds as identified in accordance with section 3.975. The Web site
must be updated at least annually.

Sec. 11.

Minnesota Statutes 2016, section 62V.09, is amended to read:

62V.09 EXPIRATION AND SUNSET EXCLUSION.

Notwithstanding section 15.059, the deleted text begin board and its deleted text end advisory committees new text begin established by
the commissioner under this chapter new text end shall not expire, except as specified in section 62V.04,
subdivision 13. deleted text begin The board and its advisory committees are not subject to review or sunsetting
under chapter 3D.
deleted text end

Sec. 12. new text begin REPEALER.
new text end

new text begin Minnesota Statutes 2016, section 62V.11, new text end new text begin is repealed.
new text end

Sec. 13. new text begin EFFECTIVE DATE.
new text end

new text begin Sections 1 to 12 are effective July 1, 2017.
new text end

APPENDIX

Repealed Minnesota Statutes: 17-0636

62V.11 LEGISLATIVE OVERSIGHT COMMITTEE.

Subdivision 1.

Legislative oversight.

(a) The Legislative Oversight Committee is established to provide oversight to the implementation of this chapter and the operation of MNsure.

(b) The committee shall review the operations of MNsure at least annually and shall recommend necessary changes in policy, implementation, and statutes to the board and to the legislature.

(c) MNsure shall present to the committee the annual report required in section 62V.08, the appeals process under section 62V.05, subdivision 6, and the actions taken regarding the treatment of multiemployer plans.

Subd. 2.

Membership; meetings; compensation.

(a) The Legislative Oversight Committee shall consist of five members of the senate, three members appointed by the majority leader of the senate, and two members appointed by the minority leader of the senate; and five members of the house of representatives, three members appointed by the speaker of the house, and two members appointed by the minority leader of the house of representatives.

(b) Appointed legislative members serve at the pleasure of the appointing authority and shall continue to serve until their successors are appointed.

(c) The first meeting of the committee shall be convened by the chair of the Legislative Coordinating Commission. Members shall elect a chair at the first meeting. The chair must convene at least one meeting annually, and may convene other meetings as deemed necessary.

Subd. 4.

Review of costs.

The board shall submit for review the annual budget of MNsure for the next fiscal year by March 15 of each year, beginning March 15, 2014.

Subd. 5.

Review of Minnesota eligibility system funding and expenditures.

The committee shall review quarterly reports submitted by the Minnesota Eligibility System Executive Steering Committee under section 62V.055, subdivision 3, regarding Minnesota eligibility system funding and expenditures.