HF 2290

as introduced - 87th Legislature (2011 - 2012) Posted on 02/15/2012 01:58pm

A bill for an act
relating to commerce; establishing the Minnesota Insurance Marketplace;
prescribing its powers and duties; appropriating money; proposing coding for
new law as Minnesota Statutes, chapter 62V.

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

Section 1.

new text begin [62V.01] TITLE.
new text end

new text begin This chapter may be cited as the "Minnesota Insurance Marketplace Act."
new text end

Sec. 2.

new text begin [62V.02] DEFINITIONS.
new text end

new text begin Subdivision 1. new text end

new text begin Scope. new text end

new text begin For the purposes of this chapter, the following terms have
the meanings given.
new text end

new text begin Subd. 2. new text end

new text begin Board. new text end

new text begin "Board" means the board of directors specified in section 62V.04.
new text end

new text begin Subd. 3. new text end

new text begin Health benefit plan. new text end

new text begin "Health benefit plan" means a policy, contract,
certificate, or agreement defined in section 62A.011, subdivision 3, and a dental plan
defined in section 62Q.76, subdivision 3.
new text end

new text begin Subd. 4. new text end

new text begin Health care program. new text end

new text begin "Health care program" means any public health
care program administered by the commissioner of human services, including those
defined in chapters 256B and 256L.
new text end

new text begin Subd. 5. new text end

new text begin Health carrier. new text end

new text begin "Health carrier" has the meaning defined in section
62A.011.
new text end

new text begin Subd. 6. new text end

new text begin Individual market. new text end

new text begin "Individual market" means the market for health
insurance coverage offered to individuals.
new text end

new text begin Subd. 7. new text end

new text begin Marketplace. new text end

new text begin "Marketplace" means the Minnesota Insurance Marketplace.
new text end

new text begin Subd. 8. new text end

new text begin Navigator. new text end

new text begin "Navigator" means an entity determined by the marketplace
as qualified to:
new text end

new text begin (1) conduct public education activities to raise awareness of the availability of
health benefit plans;
new text end

new text begin (2) distribute information concerning enrollment in health benefit plans and the
availability of health care programs, small business health insurance tax credits, premium
assistance tax credits, and cost-sharing reductions;
new text end

new text begin (3) facilitate enrollment in health care programs and health benefit plans through the
marketplace without receiving compensation from a carrier for such enrollment;
new text end

new text begin (4) provide referrals to any applicable office of health insurance consumer assistance
or health insurance ombudsman established under section 2793 of the Public Health
Service Act, or any other appropriate state agency or agencies, for any enrollee with a
grievance, complaint, or question regarding the enrollee's health benefit plan or coverage,
or a determination under that plan or coverage; and
new text end

new text begin (5) provide information in a manner that is culturally and linguistically appropriate
to the needs of the population being served by the marketplace.
new text end

new text begin Subd. 9. new text end

new text begin Small group market. new text end

new text begin "Small group market" means the market for health
insurance coverage offered to small employers as defined in section 62L.02, subdivision
26.
new text end

Sec. 3.

new text begin [62V.03] MINNESOTA INSURANCE MARKETPLACE;
ESTABLISHMENT.
new text end

new text begin Subdivision 1. new text end

new text begin Creation. new text end

new text begin The Minnesota Insurance Marketplace is created as a
board under section 15.012, paragraph (a), and shall have as its duties to:
new text end

new text begin (1) promote innovation, competition, value, market participation, affordability,
meaningful choices, health improvement, care management, and portability of health
benefit plans in the individual and small group markets;
new text end

new text begin (2) facilitate and simplify the comparison, choice, enrollment, and purchase of
health benefit plans for individuals purchasing in the individual market and for employees
and employers purchasing in the small group markets; and
new text end

new text begin (3) assist employers with access to small business health insurance tax credits and
to assist individuals with access to health care programs and premium assistance tax
credits and cost-sharing reductions.
new text end

new text begin Subd. 2. new text end

new text begin Application of other law. new text end

new text begin (a) The marketplace is subject to review by
the legislative auditor under section 3.971.
new text end

new text begin (b) Board members of the marketplace are subject to section 10A.07 and the
employees of the marketplace are subject to section 10A.071.
new text end

new text begin (c) Data on individuals and employees of employers utilizing the marketplace that
are collected or generated by the marketplace are private data on individuals as defined
in section 13.02, subdivision 12. Data on employers utilizing the marketplace that are
collected or generated by the marketplace are nonpublic data as defined in section
13.02, subdivision 9. Notwithstanding the definition of summary data in section 13.02,
subdivision 19, summary data prepared under this subdivision may be derived from
nonpublic data.
new text end

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

new text begin (1) meetings regarding labor negotiations may be closed at the discretion of the
board;
new text end

new text begin (2) meetings regarding contract negotiations may be closed at the discretion of
the board; and
new text end

new text begin (3) meetings regarding private, not public, nonpublic, or trade secret information
are closed to the public.
new text end

new text begin (e) The marketplace and provisions specified under this chapter are exempt from
chapters 14, including section 14.386; 16C, with the exception of section 16C.16; and 16E.
new text end

Sec. 4.

new text begin [62V.04] GOVERNANCE.
new text end

new text begin Subdivision 1. new text end

new text begin Board. new text end

new text begin The marketplace is governed by a board of directors with
19 members.
new text end

new text begin Subd. 2. new text end

new text begin Appointments. new text end

new text begin (a) Subsequent to the initial staggered appointment periods
under subdivision 3, board membership of the marketplace consists of the following:
new text end

new text begin (1) four members representing the interests of individual consumers served by the
marketplace. Members are appointed by the governor to serve four-year terms following
the initial staggered term lot determination;
new text end

new text begin (2) four members representing the interests of individual consumers, employees, and
small employers that reflect the cultural diversity and geography of Minnesota and the
population served by the marketplace; members are appointed to serve four-year terms
following the initial staggered term lot determination, whereas the Subcommittee on
Committees of the Committee on Rules and Administration of the senate appoints one
member recommended by the majority and one member recommended by the minority
and the speaker of the house appoints one member recommended by the majority and one
member recommended by the minority;
new text end

new text begin (3) two members representing the interests of individual consumers and small
employers served by the marketplace; members shall be appointed to serve four-year
terms by the board after consideration of a list supplied by board members serving on a
nominating committee;
new text end

new text begin (4) four members with demonstrated expertise, leadership, and innovation in the
areas of health benefits administration, health care finance, health plan purchasing, the
health care delivery system; and practitioners, public health, health disparities, or health
policy issues related to the small group and individual markets and the uninsured that
represent the cultural diversity and geography of Minnesota and the population served
by the marketplace. Members are appointed to serve four-year terms following the
initial staggered term lot determination, whereas the Subcommittee on Committees
of the Committee on Rules and Administration of the senate appoints one member
recommended by the majority and one member recommended by the minority and the
speaker of the house appoints one member recommended by the majority and one member
recommended by the minority;
new text end

new text begin (5) two members representing health care providers, health carriers, insurance
producers, organizations with experience assisting people with health care coverage, or
other organizations that may provide services to or through the marketplace; members
shall be appointed to serve four-year terms by the board after consideration of a list
supplied by board members serving on a nominating committee;
new text end

new text begin (6) the commissioner of commerce;
new text end

new text begin (7) the commissioner of health; and
new text end

new text begin (8) the commissioner of human services.
new text end

new text begin (b) Section 15.0597 shall apply to all appointments, except the commissioners.
new text end

new text begin Subd. 3. new text end

new text begin Terms. new text end

new text begin (a) Board members may serve no more than two consecutive
terms, except that commissioners shall serve until replaced.
new text end

new text begin (b) 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 with the exception of subdivision 4.
new text end

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

new text begin (d) Initial appointments under subdivision 2, paragraph (a), clauses (1), (2), and (4),
must be appointed and convene the first meeting of the board within 90 days of enactment.
Initial appointments under subdivision 2, paragraph (a), clauses (3) and (5), shall be
made after consideration of a list supplied by board members serving on a nominating
committee, but within 135 days of enactment.
new text end

new text begin (e) The appointed members under subdivision 2, paragraph (a), clauses (1), (2), and
(4), have an initial term of three, four, or five years, determined by lot by the secretary of
state.
new text end

new text begin Subd. 4. new text end

new text begin Conflicts of interest. new text end

new 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), (2), and (4), shall not be employed by, be a member of the board of directors
of, or otherwise be a representative of a health carrier, health care provider, navigator, or
other entity in the business of or potentially in the business of selling items or services of
significant value to or through the marketplace. A conflict of interest is cause for removal
from the board. Members with a conflict of interest appointed under subdivision 2,
paragraph (a), clauses (1), (2), and (4), shall be removed by the board following notice,
hearing, and a two-thirds vote of the board.
new text end

new text begin (b) No more than three of the members appointed under subdivision 2, paragraph
(a), clauses (3) and (5), may have a conflict of interest.
new text end

new text begin (c) All board members are subject to section 10A.07.
new text end

new text begin Subd. 5. new text end

new text begin Officers. new text end

new text begin Officers of the board are elected by members of the board and
serve for one year, except that one of the governor's appointments described in subdivision
2, paragraph (a), clause (1), shall be designated by the governor as acting chair until a
chair is elected by a majority of the board, but in no case shall the designated chair act as
chair for longer than 135 days after the date of enactment of this act.
new text end

new text begin Subd. 6. new text end

new text begin Vacancies. new text end

new text begin If a vacancy occurs for a board seat, appointment by the entity
specified in subdivision 2 shall occur within 90 days, and the newly appointed member
shall serve the remainder of the term. If a vacancy exists by reason of death, resignation,
or otherwise, a majority of the remaining board members constitutes a quorum.
new text end

new text begin Subd. 7. new text end

new text begin Compensation. new text end

new text begin Board members may be compensated in accordance
with section 15.0575.
new text end

new text begin Subd. 8. new text end

new text begin Assets and personnel. new text end

new text begin (a) Existing assets and personnel managed by the
commissioner of commerce for the design and development of the marketplace shall be
transferred to the board within 60 days of the convening of the first board meeting.
new text end

new text begin (b) The board shall designate a director that:
new text end

new text begin (1) must not have been employed by, a member of the board of directors of, or
otherwise a representative of a health carrier, health care provider, navigator, or other
entity in the business of or potentially in the business of selling items or services of
significant value to or through the marketplace for at least one year prior to appointment;
new text end

new text begin (2) is a full-time employee of the marketplace in the unclassified service whose
compensation is governed by a 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), does not apply;
new text end

new text begin (3) shall administer all of the powers and responsibilities of the marketplace; and
new text end

new text begin (4) shall hire and supervise the staff of the marketplace, including managerial staff in
the unclassified service whose compensation is governed by a 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) does not apply.
new text end

Sec. 5.

new text begin [62V.05] RESPONSIBILITIES AND POWERS OF THE
MARKETPLACE.
new text end

new text begin (a) The marketplace board shall implement and operate the marketplace in
accordance with this chapter and take all actions necessary to ensure that the marketplace
is determined under federal law to be ready to operate no later than January 1, 2014. The
marketplace board shall establish bylaws and procedures governing the operations of the
marketplace, including processes to gather public comment, provide public notice in the
State Register, and procure goods and services.
new text end

new text begin (b) The marketplace may:
new text end

new text begin (1) contract with eligible entities as necessary to provide services needed to
implement and operate the marketplace;
new text end

new text begin (2) enter into information-sharing agreements with federal and state agencies and
other entities provided such 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;
new text end

new text begin (3) seek and receive money from government agencies, philanthropic organizations,
and public and private sources, to fund the costs of implementing and operating the
marketplace and risk adjustment;
new text end

new text begin (4) establish a navigator program that:
new text end

new text begin (i) creates different categories of navigators, with appropriate responsibilities,
designed to address the specific needs of the populations served by the marketplace, in
particular, those experiencing the highest levels of uninsurance and health disparities;
new text end

new text begin (ii) ensures that each category of navigator meets training and certification
requirements that align with the level of service provided;
new text end

new text begin (iii) provides compensation to navigators that aligns with the level of service
provided; and
new text end

new text begin (iv) allows for performance-based compensation; and
new text end

new text begin (5) take other actions reasonably required to implement the provisions of this chapter.
new text end

new text begin (c) Funds received by the marketplace must be deposited in a dedicated fund and
are appropriated to the marketplace for the purpose for which they were received. Funds
appropriated do not cancel and are available until expended.
new text end

new text begin (d) The marketplace shall submit a progress report to the legislature by March 15,
2013, on the progress of establishing the marketplace in accordance with this chapter,
and an annual report by January 15 of each year thereafter, that includes a report on the
performance of the marketplace operations and on meeting the marketplace duties, and an
accounting of the marketplace budget activities.
new text end

Sec. 6.

new text begin [62V.06] PROTECTING INSURANCE MARKET COMPETITION.
new text end

new text begin Subdivision 1. new text end

new text begin Supervision. new text end

new text begin The commissioner of commerce shall supervise the
establishment of the marketplace for up to 60 days after the convening of the first board
meeting.
new text end

new text begin Subd. 2. new text end

new text begin Evaluation of coverage levels. new text end

new text begin The commissioner of commerce shall
evaluate the actuarial value level for all health benefit plans offered by health carriers in
the individual and small group markets.
new text end

new text begin Subd. 3. new text end

new text begin Promote fair competition. new text end

new text begin (a) Standards and certification requirements
under state and federal laws, regulations, and rules shall apply uniformly to all health
benefit plans offered inside and outside the marketplace, except grandfathered plans as
defined under federal law.
new text end

new text begin (b) All health carriers that issue health benefit plans in the individual market shall
offer at least one health benefit plan at each actuarial value level.
new text end

new text begin (c) All health carriers that issue health benefit plans in the small group market shall
offer at least one health benefit plan at each actuarial value level.
new text end

new text begin (d) All health carriers that issue health benefit plans in the individual market or
small group market shall make available to the marketplace each health benefit plan it
offers outside the marketplace.
new text end

new text begin (e) The marketplace shall monitor the stability of risk pools, risk-sharing, and
premium variability in the individual market and the small group market.
new text end

new text begin Subd. 4. new text end

new text begin Protection of data. new text end

new text begin All applicable state and federal laws, regulations,
and rules apply with respect to the confidentiality, integrity, and classification of the
government data received by the marketplace. Notwithstanding any law to the contrary,
the marketplace has access to private and nonpublic data on providers, health carriers,
and third-party administrators that are maintained by the commissioners of health and
commerce and needed by the marketplace for risk adjustment, monitoring adverse
selection, and health plan quality. The definitions in section 13.02 apply to this section.
new text end

Sec. 7. new text begin EFFECTIVE DATE.
new text end

new text begin This act is effective the day following final enactment. Health benefit plan coverage
is available through the marketplace for coverage to be effective January 1, 2014.
new text end