Skip to main content Skip to office menu Skip to footer
Minnesota Legislature

Office of the Revisor of Statutes

HF 5

Conference Committee Report - 90th Legislature (2017 - 2018) Posted on 03/29/2017 08:34pm

KEY: stricken = removed, old language.
underscored = added, new language.
1.1CONFERENCE COMMITTEE REPORT ON H. F. No. 5
1.2A bill for an act
1.3relating to insurance; health; regulating certain data practices of the premium
1.4subsidy program; creating a state-operated reinsurance program; appropriating
1.5money;amending Minnesota Statutes 2016, sections 62E.10, subdivision 2; 62E.11,
1.6subdivisions 5, 6; 297I.05, subdivisions 5, 13; Laws 2017, chapter 2, article 1,
1.7section 2, subdivision 4; proposing coding for new law in Minnesota Statutes,
1.8chapter 62E; repealing Laws 2013, chapter 9, section 15.
1.9March 29, 2017
1.10The Honorable Kurt L. Daudt
1.11Speaker of the House of Representatives
1.12The Honorable Michelle L. Fischbach
1.13President of the Senate
1.14We, the undersigned conferees for H. F. No. 5 report that we have agreed upon the items
1.15in dispute and recommend as follows:
1.16That the Senate recede from its amendments and that H. F. No. 5 be further amended
1.17as follows:
1.18Delete everything after the enacting clause and insert:

1.19"ARTICLE 1
1.20MINNESOTA PREMIUM SECURITY PLAN

1.21    Section 1. Minnesota Statutes 2016, section 62E.10, subdivision 2, is amended to read:
1.22    Subd. 2. Board of directors; organization. The board of directors of the association
1.23shall be made up of eleven 13 members as follows: six directors selected by contributing
1.24members, subject to approval by the commissioner, one of which must be a health actuary;
1.25two directors selected by the commissioner of human services, one of whom must represent
1.26hospitals and one of whom must represent health care providers; five public directors selected
1.27by the commissioner, at least two of whom must be plan enrollees, two of whom are covered
1.28under an individual plan subject to assessment under section 62E.11 or group plan offered
2.1by an employer subject to assessment under section 62E.11, enrollees in the individual
2.2market and one of whom must be a licensed insurance agent. At least two of the public
2.3directors must reside outside of the seven-county metropolitan area. In determining voting
2.4rights at members' meetings, each member shall be entitled to vote in person or proxy. The
2.5vote shall be a weighted vote based upon the member's cost of self-insurance, accident and
2.6health insurance premium, subscriber contract charges, health maintenance contract payment,
2.7or community integrated service network payment derived from or on behalf of Minnesota
2.8residents in the previous calendar year, as determined by the commissioner. In approving
2.9directors of the board, the commissioner shall consider, among other things, whether all
2.10types of members are fairly represented. Directors selected by contributing members may
2.11be reimbursed from the money of the association for expenses incurred by them as directors,
2.12but shall not otherwise be compensated by the association for their services. The costs of
2.13conducting meetings of the association and its board of directors shall be borne by members
2.14of the association.

2.15    Sec. 2. [62E.21] DEFINITIONS.
2.16    Subdivision 1. Application. For the purposes of sections 62E.21 to 62E.25, the terms
2.17defined in this section have the meanings given them.
2.18    Subd. 2. Affordable Care Act. "Affordable Care Act" means the federal act as defined
2.19in section 62A.011, subdivision 1a.
2.20    Subd. 3. Attachment point. "Attachment point" means an amount as provided in section
2.2162E.23, subdivision 2, paragraph (b).
2.22    Subd. 4. Benefit year. "Benefit year" means the calendar year for which an eligible
2.23health carrier provides coverage through an individual health plan.
2.24    Subd. 5. Board. "Board" means the board of directors of the Minnesota Comprehensive
2.25Health Association created under section 62E.10.
2.26    Subd. 6. Coinsurance rate. "Coinsurance rate" means the rate as provided in section
2.2762E.23, subdivision 2, paragraph (c).
2.28    Subd. 7. Commissioner. "Commissioner" means the commissioner of commerce.
2.29    Subd. 8. Eligible health carrier. "Eligible health carrier" means all of the following
2.30that offer individual health plans and incur claims costs for an individual enrollee's covered
2.31benefits in the applicable benefit year:
3.1(1) an insurance company licensed under chapter 60A to offer, sell, or issue a policy of
3.2accident and sickness insurance as defined in section 62A.01;
3.3(2) a nonprofit health service plan corporation operating under chapter 62C; or
3.4(3) a health maintenance organization operating under chapter 62D.
3.5    Subd. 9. Individual health plan. "Individual health plan" means a health plan as defined
3.6in section 62A.011, subdivision 4, that is not a grandfathered plan as defined in section
3.762A.011, subdivision 1b.
3.8    Subd. 10. Individual market. "Individual market" has the meaning given in section
3.962A.011, subdivision 5.
3.10    Subd. 11. Minnesota Comprehensive Health Association or association. "Minnesota
3.11Comprehensive Health Association" or "association" has the meaning given in section
3.1262E.02, subdivision 14.
3.13    Subd. 12. Minnesota premium security plan or plan. "Minnesota premium security
3.14plan" or "plan" means the state-based reinsurance program authorized under section 62E.23.
3.15    Subd. 13. Payment parameters. "Payment parameters" means the attachment point,
3.16reinsurance cap, and coinsurance rate for the plan.
3.17    Subd. 14. Reinsurance cap. "Reinsurance cap" means the threshold amount as provided
3.18in section 62E.23, subdivision 2, paragraph (d).
3.19    Subd. 15. Reinsurance payments. "Reinsurance payments" means an amount paid by
3.20the association to an eligible health carrier under the plan.

3.21    Sec. 3. [62E.22] DUTIES OF COMMISSIONER.
3.22The commissioner shall require eligible health carriers to calculate the premium amount
3.23the eligible health carrier would have charged for the benefit year if the Minnesota premium
3.24security plan had not been established. The eligible health carrier must submit this
3.25information as part of its rate filing. The commissioner must consider this information as
3.26part of the rate review.

3.27    Sec. 4. [62E.23] MINNESOTA PREMIUM SECURITY PLAN.
3.28    Subdivision 1. Administration of plan. (a) The association is Minnesota's reinsurance
3.29entity to administer the state-based reinsurance program referred to as the Minnesota premium
3.30security plan.
4.1(b) The association may apply for any available federal funding for the plan. All funds
4.2received by or appropriated to the association shall be deposited in the premium security
4.3plan account in section 62E.25, subdivision 1. The association shall notify the chairs and
4.4ranking minority members of the legislative committees with jurisdiction over health and
4.5human services and insurance within ten days of receiving any federal funds.
4.6(c) The association must collect or access data from an eligible health carrier that are
4.7necessary to determine reinsurance payments, according to the data requirements under
4.8subdivision 5, paragraph (c).
4.9(d) The board must not use any funds allocated to the plan for staff retreats, promotional
4.10giveaways, excessive executive compensation, or promotion of federal or state legislative
4.11or regulatory changes.
4.12(e) For each applicable benefit year, the association must notify eligible health carriers
4.13of reinsurance payments to be made for the applicable benefit year no later than June 30 of
4.14the year following the applicable benefit year.
4.15(f) On a quarterly basis during the applicable benefit year, the association must provide
4.16each eligible health carrier with the calculation of total reinsurance payment requests.
4.17(g) By August 15 of the year following the applicable benefit year, the association must
4.18disburse all applicable reinsurance payments to an eligible health carrier.
4.19    Subd. 2. Payment parameters. (a) The board must design and adjust the payment
4.20parameters to ensure the payment parameters:
4.21(1) will stabilize or reduce premium rates in the individual market;
4.22(2) will increase participation in the individual market;
4.23(3) will improve access to health care providers and services for those in the individual
4.24market;
4.25(4) mitigate the impact high-risk individuals have on premium rates in the individual
4.26market;
4.27(5) take into account any federal funding available for the plan; and
4.28(6) take into account the total amount available to fund the plan.
4.29(b) The attachment point for the plan is the threshold amount for claims costs incurred
4.30by an eligible health carrier for an enrolled individual's covered benefits in a benefit year,
4.31beyond which the claims costs for benefits are eligible for reinsurance payments. The
5.1attachment point shall be set by the board at $50,000 or more, but not exceeding the
5.2reinsurance cap.
5.3(c) The coinsurance rate for the plan is the rate at which the association will reimburse
5.4an eligible health carrier for claims incurred for an enrolled individual's covered benefits
5.5in a benefit year above the attachment point and below the reinsurance cap. The coinsurance
5.6rate shall be set by the board at a rate between 50 and 80 percent.
5.7(d) The reinsurance cap is the threshold amount for claims costs incurred by an eligible
5.8health carrier for an enrolled individual's covered benefits, after which the claims costs for
5.9benefits are no longer eligible for reinsurance payments. The reinsurance cap shall be set
5.10by the board at $250,000 or less.
5.11(e) The board may adjust the payment parameters to the extent necessary to secure
5.12federal approval of the state innovation waiver request in article 1, section 8.
5.13    Subd. 3. Operation. (a) The board shall propose to the commissioner the payment
5.14parameters for the next benefit year by January 15 of the year before the applicable benefit
5.15year. The commissioner shall approve or reject the payment parameters no later than 14
5.16days following the board's proposal. If the commissioner fails to approve or reject the
5.17payment parameters within 14 days following the board's proposal, the proposed payment
5.18parameters are final and effective.
5.19(b) If the amount in the premium security plan account in section 62E.25, subdivision
5.201, is not anticipated to be adequate to fully fund the approved payment parameters as of
5.21July 1 of the year before the applicable benefit year, the board, in consultation with the
5.22commissioner and the commissioner of management and budget, shall propose payment
5.23parameters within the available appropriations. The commissioner must permit an eligible
5.24health carrier to revise an applicable rate filing based on the final payment parameters for
5.25the next benefit year.
5.26    Subd. 4. Calculation of reinsurance payments. (a) Each reinsurance payment must be
5.27calculated with respect to an eligible health carrier's incurred claims costs for an individual
5.28enrollee's covered benefits in the applicable benefit year. If the claims costs do not exceed
5.29the attachment point, the reinsurance payment is $0. If the claims costs exceed the attachment
5.30point, the reinsurance payment shall be calculated as the product of the coinsurance rate
5.31and the lesser of:
5.32(1) the claims costs minus the attachment point; or
5.33(2) the reinsurance cap minus the attachment point.
6.1(b) The board must ensure that reinsurance payments made to eligible health carriers do
6.2not exceed the total amount paid by the eligible health carrier for any eligible claim. "Total
6.3amount paid of an eligible claim" means the amount paid by the eligible health carrier based
6.4upon the allowed amount less any deductible, coinsurance, or co-payment, as of the time
6.5the data are submitted or made accessible under subdivision 5, paragraph (c).
6.6    Subd. 5. Eligible carrier requests for reinsurance payments. (a) An eligible health
6.7carrier may request reinsurance payments from the association when the eligible health
6.8carrier meets the requirements of this subdivision and subdivision 4.
6.9(b) An eligible health carrier must make requests for reinsurance payments in accordance
6.10with any requirements established by the board.
6.11(c) An eligible health carrier must provide the association with access to the data within
6.12the dedicated data environment established by the eligible health carrier under the federal
6.13risk adjustment program under United States Code, title 42, section 18063. Eligible health
6.14carriers must submit an attestation to the board asserting compliance with the dedicated
6.15data environments, data requirements, establishment and usage of masked enrollee
6.16identification numbers, and data submission deadlines.
6.17(d) An eligible health carrier must provide the access described in paragraph (c) for the
6.18applicable benefit year by April 30 of each year of the year following the end of the
6.19applicable benefit year.
6.20(e) An eligible health carrier must maintain documents and records, whether paper,
6.21electronic, or in other media, sufficient to substantiate the requests for reinsurance payments
6.22made pursuant to this section for a period of at least six years. An eligible health carrier
6.23must also make those documents and records available upon request from the commissioner
6.24for purposes of verification, investigation, audit, or other review of reinsurance payment
6.25requests.
6.26(f) An eligible health carrier may follow the appeals procedure under section 62E.10,
6.27subdivision 2a.
6.28(g) The association may have an eligible health carrier audited to assess the health
6.29carrier's compliance with the requirements of this section. The eligible health carrier must
6.30ensure that its contractors, subcontractors, or agents cooperate with any audit under this
6.31section. If an audit results in a proposed finding of material weakness or significant deficiency
6.32with respect to compliance with any requirement of this section, the eligible health carrier
6.33may provide a response to the proposed finding within 30 days. Within 30 days of the
7.1issuance of a final audit report that includes a finding of material weakness or significant
7.2deficiency, the eligible health carrier must:
7.3(1) provide a written corrective action plan to the association for approval;
7.4(2) implement the approved plan; and
7.5(3) provide the association with written documentation of the corrective action once
7.6taken.
7.7    Subd. 6. Data. Government data of the association under this section are private data
7.8on individuals, or nonpublic data, as defined under section 13.02, subdivisions 9 or 12.

7.9    Sec. 5. [62E.24] ACCOUNTING, REPORTS, AND AUDITS OF THE
7.10ASSOCIATION.
7.11    Subdivision 1. Accounting. The board must keep an accounting for each benefit year
7.12of all:
7.13(1) funds appropriated for reinsurance payments and administrative and operational
7.14expenses;
7.15(2) requests for reinsurance payments received from eligible health carriers;
7.16(3) reinsurance payments made to eligible health carriers; and
7.17(4) administrative and operational expenses incurred for the plan.
7.18    Subd. 2. Reports. The board must submit to the commissioner and make available to
7.19the public a report summarizing the plan operations for each benefit year by posting the
7.20summary on the Minnesota Comprehensive Health Association Web site and making the
7.21summary otherwise available by November 1 of the year following the applicable benefit
7.22year or 60 calendar days following the final disbursement of reinsurance payments for the
7.23applicable benefit year, whichever is later.
7.24    Subd. 3. Legislative auditor. The Minnesota premium security plan is subject to audit
7.25by the legislative auditor. The board must ensure that its contractors, subcontractors, or
7.26agents cooperate with the audit.
7.27    Subd. 4. Independent external audit. (a) The board must engage and cooperate with
7.28an independent certified public accountant or CPA firm licensed or permitted under chapter
7.29326A to perform an audit for each benefit year of the plan, in accordance with generally
7.30accepted auditing standards. The audit must at a minimum:
7.31(1) assess compliance with the requirements of sections 62E.21 to 62E.25; and
8.1(2) identify any material weaknesses or significant deficiencies and address manners in
8.2which to correct any such material weaknesses or deficiencies.
8.3(b) The board, after receiving the completed audit, must:
8.4(1) provide the commissioner the results of the audit;
8.5(2) identify to the commissioner any material weakness or significant deficiency identified
8.6in the audit and address in writing to the commissioner how the board intends to correct
8.7any such material weakness or significant deficiency in compliance with subdivision 5; and
8.8(3) make public the results of the audit, to the extent the audit contains government data
8.9that is public, including any material weakness or significant deficiency and how the board
8.10intends to correct the material weakness or significant deficiency, by posting the audit results
8.11on the Minnesota Comprehensive Health Association Web site and making the audit results
8.12otherwise available.
8.13    Subd. 5. Actions on audit findings. (a) If an audit results in a finding of material
8.14weakness or significant deficiency with respect to compliance by the association with any
8.15requirement under sections 62E.21 to 62E.25, the board must:
8.16(1) provide a written corrective action plan to the commissioner for approval within 60
8.17days of the completed audit;
8.18(2) implement the corrective action plan; and
8.19(3) provide the commissioner with written documentation of the corrective actions taken.
8.20(b) By December 1 of each year, the board must submit a report to the standing
8.21committees of the legislature having jurisdiction over health and human services and
8.22insurance regarding any finding of material weakness or significant deficiency found in an
8.23audit.

8.24    Sec. 6. [62E.25] ACCOUNTS.
8.25    Subdivision 1. Premium security plan account. The premium security plan account is
8.26created in the special revenue fund of the state treasury. Funds in the account are appropriated
8.27annually to the commissioner of commerce for grants to the Minnesota Comprehensive
8.28Health Association for the operational and administrative costs and reinsurance payments
8.29relating to the start-up and operation of the Minnesota premium security plan.
8.30Notwithstanding section 11A.20, all investment income and all investment losses attributable
8.31to the investment of the premium security plan account shall be credited to the premium
8.32security plan account.
9.1    Subd. 2. Deposits. Except as provided in subdivision 3, funds received by the
9.2commissioner of commerce or other state agency pursuant to the state innovation waiver
9.3request in article 1, section 8, shall be deposited in the premium security plan account in
9.4subdivision 1.
9.5    Subd. 3. Basic health plan trust account. Funds received by the commissioner of
9.6commerce or other state agency pursuant to the state innovation waiver request in article 1,
9.7section 8, that are attributable to the basic health program shall be deposited in the basic
9.8health plan trust account in the federal fund.

9.9    Sec. 7. Laws 2013, chapter 9, section 15, is amended to read:
9.10    Sec. 15. MINNESOTA COMPREHENSIVE HEALTH ASSOCIATION
9.11TERMINATION.
9.12(a) The commissioner of commerce, in consultation with the board of directors of the
9.13Minnesota Comprehensive Health Association, has the authority to develop and implement
9.14the phase-out and eventual appropriate termination of coverage provided by the Minnesota
9.15Comprehensive Health Association under Minnesota Statutes, chapter 62E. The phase-out
9.16of coverage shall begin no sooner than January 1, 2014, or upon the effective date of the
9.17operation of the Minnesota Insurance Marketplace and the ability to purchase qualified
9.18health plans through the Minnesota Insurance Marketplace, whichever is later, and shall,
9.19to the extent practicable, ensure the least amount of disruption to the enrollees' health care
9.20coverage. The member assessments established under Minnesota Statutes, section 62E.11,
9.21shall take into consideration any phase-out of coverage implemented under this section.
9.22(b) Nothing in paragraph (a) applies to the Minnesota premium security plan, as defined
9.23in Minnesota Statutes, section 62E.21, subdivision 12.

9.24    Sec. 8. STATE INNOVATION WAIVER.
9.25    Subdivision 1. Submission of waiver application. The commissioner of commerce
9.26shall apply to the secretary of health and human services under United States Code, title
9.2742, section 18052, for a state innovation waiver to implement the Minnesota premium
9.28security plan for benefit years beginning January 1, 2018, and future years, to maximize
9.29federal funding. The waiver application must clearly state that operation of the Minnesota
9.30premium security plan is contingent on approval of the waiver request.
10.1    Subd. 2. Consultation. In developing the waiver application, the commissioner shall
10.2consult with the commissioner of human services, the commissioner of health, and the
10.3MNsure board.
10.4    Subd. 3. Application timelines; notification. The commissioner shall submit the waiver
10.5application to the secretary of health and human services on or before June 15, 2017. The
10.6commissioner shall make a draft application available for public review and comment by
10.7May 15, 2017. The commissioner shall notify the chairs and ranking minority members of
10.8the legislative committees with jurisdiction over health and human services and insurance,
10.9and the board of directors of the Minnesota Comprehensive Health Association of any
10.10federal actions regarding the waiver request.

10.11    Sec. 9. COSTS RELATED TO IMPLEMENTATION OF THIS ACT.
10.12A state agency that incurs administrative costs to implement any provision of this act
10.13and does not receive an appropriation for administrative costs of this act must implement
10.14the act within the limits of existing appropriations.

10.15    Sec. 10. PREMIUM SECURITY PLAN CONTINGENT ON FEDERAL WAIVER.
10.16If the state innovation waiver request in article 1, section 8, is not approved, the Minnesota
10.17Comprehensive Health Association and its board of directors shall not administer the
10.18Minnesota premium security plan and provide reinsurance payments to eligible health
10.19carriers.

10.20    Sec. 11. PAYMENT PARAMETERS FOR 2018.
10.21(a) Notwithstanding Minnesota Statutes, section 62E.23, and subject to paragraph (b),
10.22the Minnesota premium security plan payment parameters for benefit year 2018 are:
10.23(1) an attachment point of $50,000;
10.24(2) a coinsurance rate of 80 percent; and
10.25(3) a reinsurance cap of $250,000.
10.26(b) The board of directors of the Minnesota Comprehensive Health Association may
10.27alter the payment parameters to the extent necessary to secure federal approval of the state
10.28innovation waiver request in article 1, section 8.

11.1    Sec. 12. DEPOSIT OF FUNDS.
11.2(a) Within ten days of the effective date of this section, the Minnesota Comprehensive
11.3Health Association, as defined in Minnesota Statutes, section 62E.02, subdivision 14, shall
11.4deposit all money, including monetary reserves, the association holds into the premium
11.5security plan account in Minnesota Statutes, section 62E.25, subdivision 1.
11.6(b) Notwithstanding paragraph (a), the Minnesota Comprehensive Health Association
11.7may retain funds necessary to fulfill medical needs and contractual obligations in place for
11.8former Minnesota Comprehensive Health Association enrollees until December 31, 2018.

11.9    Sec. 13. DISPOSITION AND SETTLEMENTS.
11.10Notwithstanding Minnesota Statutes, section 62E.09, and any other law to the contrary,
11.11the board of directors of the Minnesota Comprehensive Health Association, as defined in
11.12Minnesota Statutes, section 62E.02, subdivision 14, shall have authority:
11.13(1) over the disposition and settlement of all funds held by the association, including
11.14prior assessments, to the extent funds have not been transferred pursuant to article 1, section
11.1512; and
11.16(2) to settle and make determinations regarding litigation pending on the effective date
11.17of this act, including litigation that impacts funds held by the association.

11.18    Sec. 14. LEGISLATIVE WORKING GROUP.
11.19A legislative working group is established consisting of the chairs and ranking minority
11.20members of the senate committees with jurisdiction over commerce, health and human
11.21services finance and policy, and human services reform finance and policy and the chairs
11.22and ranking minority members of the house of representatives committees with jurisdiction
11.23over commerce and regulatory reform, health and human services finance, and health and
11.24human services reform. The purpose of the working group is to advise the board of the
11.25Minnesota Comprehensive Health Association on the adoption of payment parameters and
11.26other elements of a reinsurance plan for benefit year 2019. The commissioner of commerce
11.27must provide technical assistance for the working group, and must review and monitor the
11.28following to serve as a resource for the working group:
11.29(1) the effectiveness of reinsurance models adopted in Alaska and other states in
11.30stabilizing premiums in the individual market and the related costs thereof;
11.31(2) the effect of federal health reform legislation on the Minnesota premium security
11.32plan, including but not limited to funding for the plan; and
12.1(3) the status of the health care access fund, and issues relating to its potential continued
12.2use as a source of funding for the Minnesota premium security plan.

12.3    Sec. 15. MINNESOTA PREMIUM SECURITY PLAN FUNDING.
12.4(a) The Minnesota Comprehensive Health Association shall fund the operational and
12.5administrative costs and reinsurance payments of the Minnesota security plan and association
12.6using the following amounts deposited in the premium security plan account in Minnesota
12.7Statutes, section 62E.25, subdivision 1, in the following order:
12.8(1) any federal funding available;
12.9(2) funds deposited under article 1, sections 12 and 13;
12.10(3) any state funds from the health care access fund; and
12.11(4) any state funds from the general fund.
12.12(b) The association shall transfer from the premium security plan account any general
12.13fund amount not used for the Minnesota premium security plan by June 30, 2021, to the
12.14commissioner of commerce. Any amount transferred to the commissioner of commerce
12.15shall be deposited in the general fund.
12.16(c) The association shall transfer from the premium security plan account any health
12.17care access fund amount not used for the Minnesota premium security plan by June 30,
12.182021, to the commissioner of commerce. Any amount transferred to the commissioner of
12.19commerce shall be deposited in the health care access fund in Minnesota Statutes, section
12.2016A.724.
12.21(d) The Minnesota Comprehensive Health Association may not spend more than
12.22$271,000,000 for benefit year 2018 and not more than $271,000,000 for benefit year 2019
12.23for the operational and administrative costs of, and reinsurance payments under, the
12.24Minnesota premium security plan.

12.25    Sec. 16. TRANSFERS.
12.26(a) The commissioner of management and budget shall transfer $200,000,000 in fiscal
12.27year 2018 and $200,000,000 in fiscal year 2019 from the health care access fund to the
12.28premium security plan account in Minnesota Statutes, section 62E.25, subdivision 1. This
12.29is a onetime transfer.
13.1(b) The commissioner of management and budget shall transfer $71,000,000 in fiscal
13.2year 2018 and $71,000,000 in fiscal year 2019 from the general fund to the premium security
13.3plan account in Minnesota Statutes, section 62E.25, subdivision 1. This is a onetime transfer.
13.4EFFECTIVE DATE.This section is effective upon federal approval of the state
13.5innovation request in article 1, section 8. The commissioner of commerce shall inform the
13.6revisor of statutes when federal approval is obtained.

13.7    Sec. 17. TRANSFER; 2018.
13.8The commissioner of management and budget shall transfer $750,000 in fiscal year 2018
13.9from the health care access fund to the premium security plan account in Minnesota Statutes,
13.10section 62E.25, subdivision 1. This is a onetime transfer.

13.11    Sec. 18. APPROPRIATION.
13.12$155,000 in fiscal year 2018 is appropriated from the general fund to the commissioner
13.13of commerce to prepare and submit the state innovation waiver in article 1, section 8.

13.14    Sec. 19. EFFECTIVE DATE.
13.15Sections 1 to 15, 17, and 18 are effective the day following final enactment.

13.16ARTICLE 2
13.17HEALTH POLICY

13.18    Section 1. Minnesota Statutes 2016, section 62K.10, is amended by adding a subdivision
13.19to read:
13.20    Subd. 1a. Health care provider system access. For those counties in which a health
13.21carrier actively markets an individual health plan, the health carrier must offer, in those
13.22same counties, at least one individual health plan with a provider network that includes
13.23in-network access to more than a single health care provider system. This subdivision is
13.24applicable only for the year in which the health carrier actively markets an individual health
13.25plan.
13.26EFFECTIVE DATE.This section is effective January 1, 2018, and applies to individual
13.27health plans offered, issued, or renewed on or after that date.

13.28    Sec. 2. Laws 2017, chapter 2, article 1, section 1, subdivision 3, is amended to read:
13.29    Subd. 3. Eligible individual. "Eligible individual" means a Minnesota resident who:
14.1(1) is not receiving a an advance premium tax credit under Code of Federal Regulations,
14.2title 26, section 1.36B-2, as of the date in a month in which their coverage is effectuated
14.3effective;
14.4(2) is not enrolled in public program coverage under Minnesota Statutes, section
14.5256B.055 , or 256L.04; and
14.6(3) purchased an individual health plan from a health carrier in the individual market.
14.7EFFECTIVE DATE.This section is effective retroactively from January 27, 2017.

14.8    Sec. 3. Laws 2017, chapter 2, article 1, section 2, subdivision 4, is amended to read:
14.9    Subd. 4. Data practices. (a) The definitions in Minnesota Statutes, section 13.02, apply
14.10to this subdivision.
14.11(b) Government data on an enrollee or health carrier under this section are private data
14.12on individuals or nonpublic data, except that the total reimbursement requested by a health
14.13carrier and the total state payment to the health carrier are public data.
14.14(c) Notwithstanding Minnesota Statutes, section 138.17, not public government data on
14.15an enrollee or health carrier under this section must be destroyed by June 30, 2018, or upon
14.16completion by the legislative auditor of the audits required by section 3, whichever is later.
14.17This paragraph does not apply to data maintained by the legislative auditor.
14.18EFFECTIVE DATE.This section is effective retroactively from January 27, 2017.

14.19    Sec. 4. Laws 2017, chapter 2, article 1, section 2, is amended by adding a subdivision to
14.20read:
14.21    Subd. 5. Data sharing. (a) Notwithstanding any law to the contrary, government entities
14.22are permitted to share or disseminate data as follows:
14.23(1) the commissioner of human services and the board of directors of MNsure must
14.24share data on public program enrollment under Minnesota Statutes, sections 256B.055 and
14.25256L.04, as well as data on an enrollee's receipt of a premium tax credit under Code of
14.26Federal Regulations, title 26, section 1.36B-2, with the commissioner of management and
14.27budget; and
14.28(2) the commissioner of management and budget must disseminate data on an enrollee's
14.29public program coverage enrollment under Minnesota Statutes, sections 256B.055 and
14.30256L.04, to health carriers to the extent the commissioner determines is necessary for
15.1determining the enrollee's eligibility for the premium subsidy program authorized by this
15.2act.
15.3(b) Data shared under this subdivision may be collected, stored, or used only for the
15.4purposes of administration of the premium subsidy program authorized by this act and may
15.5not be further shared or disseminated except as otherwise provided by law.
15.6(c) By June 30, 2018, a health carrier must destroy any data it received pursuant to this
15.7subdivision.
15.8EFFECTIVE DATE.This section is effective retroactively from January 27, 2017.

15.9    Sec. 5. Laws 2017, chapter 2, article 1, section 3, is amended to read:
15.10    Sec. 3. AUDITS.
15.11(a) The legislative auditor shall conduct audits of the health carriers' supporting data, as
15.12prescribed by the commissioner, to determine whether payments align with criteria
15.13established in sections 1 and 2. The commissioner of human services shall provide data as
15.14necessary to the legislative auditor to complete the audit. The commissioner shall withhold
15.15or charge back payments to the health carriers to the extent they do not align with the criteria
15.16established in sections 1 and 2, as determined by the audit.
15.17(b) The legislative auditor shall audit the extent to which health carriers provided premium
15.18subsidies to persons meeting the residency and other eligibility requirements specified in
15.19section 1, subdivision 3. The legislative auditor shall report to the commissioner the amount
15.20of premium subsidies provided by each health carrier to persons not eligible for a premium
15.21subsidy. The commissioner, in consultation with the commissioners of commerce and health
15.22human services, shall develop and implement a process to recover from health carriers the
15.23amount of premium subsidies received for enrollees determined to be ineligible for premium
15.24subsidies by the legislative auditor. The legislative auditor, when conducting the required
15.25audit, and the commissioner, when determining the amount of premium subsidy to be
15.26recovered, may take into account the extent to which a health carrier makes use of the
15.27Minnesota eligibility system, as defined in Minnesota Statutes, section 62V.055, subdivision
15.281
.
15.29EFFECTIVE DATE.This section is effective retroactively from January 27, 2017.

15.30    Sec. 6. Laws 2017, chapter 2, article 2, section 13, the effective date, is amended to read:
15.31EFFECTIVE DATE.This section is effective 90 days following final enactment January
15.321, 2018, and applies to provider services provided on or after that date.
16.1EFFECTIVE DATE.This section is effective retroactively from January 27, 2017."
16.2Delete the title and insert:
16.3"A bill for an act
16.4relating to insurance; health; creating the Minnesota premium security plan;
16.5providing funding; establishing a legislative working group; regulating health care
16.6provider system access; modifying premium subsidy program provisions;
16.7appropriating money;amending Minnesota Statutes 2016, sections 62E.10,
16.8subdivision 2; 62K.10, by adding a subdivision; Laws 2013, chapter 9, section 15;
16.9Laws 2017, chapter 2, article 1, sections 1, subdivision 3; 2, subdivision 4, by
16.10adding a subdivision; 3; article 2, section 13; proposing coding for new law in
16.11Minnesota Statutes, chapter 62E."
17.1
We request the adoption of this report and repassage of the bill.
17.2
House Conferees:
17.3
.....
.....
17.4
Greg Davids
Joe Hoppe
17.5
.....
.....
17.6
Matt Dean
Joe Schomacker
17.7
.....
17.8
Laurie Halverson
17.9
Senate Conferees:
17.10
.....
.....
17.11
Gary H. Dahms
Michelle R. Benson
17.12
.....
.....
17.13
Mary Kiffmeyer
Jim Abeler
17.14
.....
17.15
Tony Lourey