HF 5

1st Unofficial Engrossment - 88th Legislature (2013 - 2014) Posted on 03/08/2013 03:39pm

1.1A bill for an act

1.2relating to commerce; establishing the Minnesota Insurance Marketplace;
1.3prescribing its powers and duties; authorizing rulemaking; establishing a
1.4legislative oversight committee; appropriating money;amending Minnesota
1.5Statutes 2012, sections 13.7191, by adding a subdivision; 13D.08, by adding a
1.6subdivision; 16A.725, subdivision 3, by adding a subdivision; proposing coding
1.7for new law as Minnesota Statutes, chapter 62V; repealing Minnesota Statutes
1.82012, section 256.9658, subdivision 1.
1.9BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

1.10    Section 1. Minnesota Statutes 2012, section 13.7191, is amended by adding a
1.11subdivision to read:
1.12    Subd. 14a. Minnesota Insurance Marketplace. Classification and sharing of data
1.13of the Minnesota Insurance Marketplace is governed by section 62V.06.

1.14    Sec. 2. Minnesota Statutes 2012, section 13D.08, is amended by adding a subdivision
1.15to read:
1.16    Subd. 5a. Minnesota Insurance Marketplace. Meetings of the Minnesota
1.17Insurance Marketplace are governed by section 62V.03, subdivision 2.

1.18    Sec. 3. Minnesota Statutes 2012, section 16A.725, is amended by adding a subdivision
1.19to read:
1.20    Subd. 2a. Certified Minnesota Insurance Marketplace operating costs. (a) By
1.21March 1 of each year, beginning March 1, 2015, the board of directors of the Minnesota
1.22Insurance Marketplace shall certify to the commissioner of management and budget the
1.23estimated costs necessary to fund the operations of the Minnesota Insurance Marketplace,
1.24under chapter 62V for the next fiscal year.
2.1    (b) By June 1, 2013, the board of directors of the Minnesota Insurance Marketplace
2.2shall certify to the commissioner of management and budget the estimated costs necessary
2.3to fund the operations of the Minnesota Insurance Marketplace under chapter 62V for the
2.4next biennium that are not covered by federal funds.

2.5    Sec. 4. Minnesota Statutes 2012, section 16A.725, subdivision 3, is amended to read:
2.6    Subd. 3. Fund reimbursements. (a) Each fiscal year, beginning fiscal year 2016,
2.7the commissioner of management and budget shall first transfer from the health impact
2.8fund to the Minnesota Insurance Marketplace account in the special revenue fund, the
2.9amount of certified expenditures under subdivision 2a, paragraph (a), or the balance of the
2.10fund, whichever is less.
2.11    (b) For the 2014-2015 biennium, the commissioner of management and budget shall
2.12first transfer from the health impact fund to the Minnesota Insurance Marketplace account
2.13in the special revenue fund, the amount of certified expenditures under subdivision 2a,
2.14paragraph (b), or the balance of the fund, whichever is less. These funds may be used in
2.15either year of the biennium.
2.16Each fiscal year, (c) If any balance remains in the health impact fund after the
2.17transfer in paragraph (a) or (b), the commissioner of management and budget shall first
2.18 transfer from the health impact fund to the general fund an amount sufficient to offset the
2.19general fund cost of the certified expenditures under subdivision 2 or the balance of the
2.20fund, whichever is less.
2.21(b) (d) If any balance remains in the health impact fund after the transfer transfers in
2.22paragraph paragraphs (a) to (c), the commissioner of management and budget shall transfer
2.23to the health care access fund the amount sufficient to offset the health care access fund cost
2.24of the certified expenditures in subdivision 2, or the balance of the fund, whichever is less.

2.25    Sec. 5. [62V.01] TITLE.
2.26This chapter may be cited as the "Minnesota Insurance Marketplace Act."

2.27    Sec. 6. [62V.02] DEFINITIONS.
2.28    Subdivision 1. Scope. For the purposes of this chapter, the following terms have
2.29the meanings given.
2.30    Subd. 2. Board. "Board" means the Board of Directors of the Minnesota Insurance
2.31Marketplace specified in section 62V.04.
2.32    Subd. 3. Dental plan. "Dental plan" has the meaning defined in section 62Q.76,
2.33subdivision 3.
3.1    Subd. 4. Health plan. "Health plan" means a policy, contract, certificate, or
3.2agreement defined in section 62A.011, subdivision 3.
3.3    Subd. 5. Health carrier. "Health carrier" has the meaning defined in section
3.462A.011.
3.5    Subd. 6. Individual market. "Individual market" means the market for health
3.6insurance coverage offered to individuals.
3.7    Subd. 7. Insurance producer. "Insurance producer" has the meaning defined
3.8in section 60K.31.
3.9    Subd. 8. Minnesota Insurance Marketplace. "Minnesota Insurance Marketplace"
3.10means the Minnesota Insurance Marketplace created as a state health benefit exchange
3.11as described in section 1311 of the federal Patient Protection and Affordable Care Act
3.12(Public Law 111-148), and further defined through amendments to the act and regulations
3.13issued under the act.
3.14    Subd. 9. Navigator. "Navigator" has the meaning described in section 1311(i) of
3.15the federal Patient Protection and Affordable Care Act (Public Law 111-148), and further
3.16defined through amendments to the act and regulations issued under the act.
3.17    Subd. 10. Public health care program. "Public health care program" means any
3.18public health care program administered by the commissioner of human services.
3.19    Subd. 11. Qualified health plan. "Qualified health plan" means a health plan that
3.20meets the definition in section 1301(a) of the Affordable Care Act (Public Law 111-148),
3.21and has been certified by the board in accordance with section 62V.05, subdivision 5, to
3.22be offered through the Minnesota Insurance Marketplace.
3.23    Subd. 12. Small group market. "Small group market" means the market for health
3.24insurance coverage offered to small employers as defined in section 62L.02, subdivision 26.

3.25    Sec. 7. [62V.03] MINNESOTA INSURANCE MARKETPLACE;
3.26ESTABLISHMENT.
3.27    Subdivision 1. Creation. The Minnesota Insurance Marketplace is created as a
3.28board under section 15.012, paragraph (a), to:
3.29(1) promote innovation, competition, quality, value, market participation,
3.30affordability, meaningful choices, health improvement, care management, reduction of
3.31health disparities, and portability of health plans;
3.32(2) facilitate and simplify the comparison, choice, enrollment, and purchase of
3.33health plans for individuals purchasing in the individual market through the Minnesota
3.34Insurance Marketplace and for employees and employers purchasing in the small group
3.35market through the Minnesota Insurance Marketplace;
4.1(3) assist small employers with access to small business health insurance tax credits
4.2and to assist individuals with access to public health care programs, premium assistance
4.3tax credits and cost-sharing reductions, and certificates of exemption from individual
4.4responsibility requirements; and
4.5(4) facilitate the integration and transition of individuals between public health care
4.6programs and health plans in the individual market.
4.7    Subd. 2. Application of other law. (a) The Minnesota Insurance Marketplace is
4.8subject to review by the legislative auditor under section 3.971. Upon the audit of the
4.9financial accounts and affairs of the Minnesota Insurance Marketplace, the Minnesota
4.10Insurance Marketplace is liable to the state for the total cost and expenses of the audit,
4.11including the salaries paid to the examiners while actually engaged in making the
4.12examination. The legislative auditor may bill the Minnesota Insurance Marketplace either
4.13monthly or at the completion of the audit. All collections received for the audits must be
4.14deposited in the general fund and are appropriated to the legislative auditor.
4.15(b) Board members of the Minnesota Insurance Marketplace are subject to sections
4.1610A.07 and 10A.09. Board members and the personnel of the Minnesota Insurance
4.17Marketplace are subject to section 10A.071.
4.18(c) All meetings of the board shall comply with the open meeting law in chapter
4.1913D, except that:
4.20(1) meetings regarding personnel negotiations may be closed at the discretion of
4.21the board;
4.22(2) meetings regarding contract negotiations may be closed at the discretion of
4.23the board; and
4.24(3) meetings or portions of meetings where not public data, as defined in section
4.2513.02, subdivision 8a, or trade secret information, as defined in section 13.37, subdivision
4.261, are discussed must be closed to the public.
4.27    (d) The Minnesota Insurance Marketplace and provisions specified under this chapter
4.28are exempt from chapter 14, including section 14.386, except as specified in section 62V.05.
4.29(e) The board and the Web site are exempt from chapter 60K.
4.30(f) Section 3.3005 applies to any federal funds received by the Minnesota Insurance
4.31Marketplace.
4.32(g) The Minnesota Insurance Marketplace is exempt from the following sections in
4.33chapter 16E: 16E.01, subdivision 3, paragraph (b); 16E.03, subdivisions 3 and 4; 16E.04,
4.34subdivision 1, subdivision 2, paragraph (e), and subdivision 3, paragraph (b); 16E.0465;
4.3516E.055; 16E.145; 16E.15; 16E.16; 16E.17; 16E.18; and 16E.22.
5.1(h) A Minnesota Insurance Marketplace decision that requires a vote of the board,
5.2other than a decision that applies only to hiring of employees or other internal management
5.3of the Minnesota Insurance Marketplace, is an "administrative action" under section
5.410A.01, subdivision 2.
5.5(i) All Minnesota state legislators must purchase their health coverage through the
5.6Minnesota Insurance Marketplace.

5.7    Sec. 8. [62V.04] GOVERNANCE.
5.8    Subdivision 1. Board. The Minnesota Insurance Marketplace is governed by a
5.9board of directors with seven members.
5.10    Subd. 2. Appointment. (a) Board membership of the Minnesota Insurance
5.11Marketplace consists of the following:
5.12(1) three members appointed by the governor and confirmed by the senate, with
5.13one member representing the interests of individual consumers eligible for individual
5.14market coverage, one member representing individual consumers eligible for public health
5.15care program coverage, and one member representing small employers. Members are
5.16appointed to serve a four-year term following the initial staggered-term lot determination;
5.17(2) three members appointed by the governor and confirmed by the senate, who
5.18have demonstrated expertise, leadership, and innovation in the following areas: one
5.19member representing the areas of health administration, health care finance, health plan
5.20purchasing, and health care delivery systems; one member representing the areas of
5.21public health, health disparities, public health care programs, and the uninsured; and
5.22one member representing health policy issues related to the small group and individual
5.23markets. Members are appointed to serve a four-year term following the initial staggered
5.24term lot determination; and
5.25(3) the commissioner of human services or a designee.
5.26(b) The governor shall make appointments to the board that are consistent with
5.27federal law and regulations regarding its composition and structure. All board members
5.28appointed by the governor must be legal residents of Minnesota.
5.29(c) Section 15.0597 shall apply to all appointments, except for the commissioner
5.30and initial appointments.
5.31(d) Initial appointments shall be made within 30 days of enactment.
5.32    Subd. 3. Terms. (a) Board members may serve no more than two consecutive
5.33terms, except for the commissioner or the commissioner's designee, who shall serve
5.34until replaced by the governor.
5.35(b) A board member may resign at any time by giving written notice to the board.
6.1(c) The appointed members under subdivision 2, paragraph (a), clauses (1) and (2),
6.2shall have an initial term of two, three, or four years, determined by lot by the secretary of
6.3state.
6.4    Subd. 4. Conflicts of interest. (a) Within one year prior to or at any time during
6.5their appointed term, board members appointed under subdivision 2, paragraph (a),
6.6clauses (1) and (2), shall not be employed by, be a member of the board of directors of, or
6.7otherwise be a representative of a health carrier, health care provider, navigator, insurance
6.8producer, or other entity in the business of selling items or services of significant value to
6.9or through the Minnesota Insurance Marketplace.
6.10(b) No board member shall have a close family member who is an executive of a
6.11health carrier. For purposes of this paragraph, a close family member includes a spouse,
6.12parent, sibling, or child.
6.13    Subd. 5. Acting chair; first meeting; supervision. (a) The governor shall designate
6.14as acting chair one of the appointees described in subdivision 2.
6.15(b) The board shall hold its first meeting within 60 days of enactment.
6.16(c) The board shall elect a chair to replace the acting chair at the first meeting.
6.17    Subd. 6. Chair. The board shall have a chair, elected by a majority of members.
6.18The chair shall serve for one year.
6.19    Subd. 7. Officers. The members of the board shall elect officers by a majority of
6.20members. The officers shall serve for one year.
6.21    Subd. 8. Vacancies. If a vacancy occurs on the board, the governor shall appoint a
6.22new member within 90 days to serve the remainder of the unexpired term.
6.23    Subd. 9. Removal. A board member may be removed by the board only for cause,
6.24following notice, hearing, and a two-thirds vote of the board. A conflict of interest as
6.25defined in subdivision 4 shall be cause for removal from the board.
6.26    Subd. 10. Meetings. The board shall meet at least quarterly.
6.27    Subd. 11. Quorum. A majority of the members of the board constitutes a quorum,
6.28and the affirmative vote of a majority of members of the board is necessary and sufficient
6.29for action taken by the board.
6.30    Subd. 12. Compensation. (a) The board members shall be paid a salary not to
6.31exceed the salary limits established under section 15A.0815, subdivision 4. The salary for
6.32board members shall be set in accordance with this subdivision and section 15A.0815,
6.33subdivision 5. This paragraph expires December 31, 2015.
6.34(b) Beginning January 1, 2016, the board members may be compensated in
6.35accordance with section 15.0575.
7.1    Subd. 13. Advisory committees. (a) The board shall establish and maintain
7.2advisory committees to provide insurance producers, health care providers, the health
7.3care industry, consumers, and other stakeholders with the opportunity to share their
7.4perspectives regarding the operation of the Minnesota Insurance Marketplace as required
7.5under section 1311(d)(6) of the Affordable Care Act (Public Law 111-148). The board
7.6shall regularly consult with the advisory committees. The advisory committees established
7.7under this paragraph shall not expire.
7.8    (b) The board may establish additional advisory committees, as necessary, to gather
7.9and provide information to the board in order to facilitate the operation of the Minnesota
7.10Insurance Marketplace. The advisory committees established under this paragraph shall
7.11not expire, except by action of the board.
7.12    (c) Section 15.0597 shall not apply to any advisory committee established by the
7.13board under this subdivision.

7.14    Sec. 9. [62V.05] RESPONSIBILITIES AND POWERS OF THE MINNESOTA
7.15INSURANCE MARKETPLACE.
7.16    Subdivision 1. General. (a) The board shall operate the Minnesota Insurance
7.17Marketplace according to this chapter and applicable state and federal law.
7.18(b) The board has the power to:
7.19(1) employ personnel and delegate administrative, operational, and other
7.20responsibilities to the director and other personnel as deemed appropriate by the board.
7.21The director and managerial staff of the Minnesota Insurance Marketplace shall serve in
7.22the unclassified service and shall be governed by a compensation plan prepared by the
7.23board, submitted to the commissioner of management and budget for review and comment
7.24within 14 days of its receipt, and approved by the Legislative Coordinating Commission
7.25and the legislature under section 3.855, subdivision 3, except that section 15A.0815,
7.26subdivision 5, paragraph (e), shall not apply;
7.27(2) establish the budget of the Minnesota Insurance Marketplace;
7.28(3) seek and accept money, grants, loans, donations, materials, services, or
7.29advertising revenue from government agencies, philanthropic organizations, and public
7.30and private sources to fund the operation of the Minnesota Insurance Marketplace;
7.31(4) contract for the receipt and provision of goods and services;
7.32(5) enter into information-sharing agreements with federal and state agencies and
7.33other entities as authorized under section 62V.06; and
7.34(6) take any other actions reasonably required to implement and administer its
7.35responsibilities.
8.1(c) Within 180 days of enactment, the board shall establish bylaws, policies,
8.2and procedures governing the operations of the Minnesota Insurance Marketplace in
8.3accordance with this chapter.
8.4    Subd. 2. Operations funding. Funding for the operations of the Minnesota
8.5Insurance Marketplace shall cover any compensation provided to navigators participating
8.6in the navigator program. The Minnesota Insurance Marketplace shall post on its Web site
8.7the annual estimated costs necessary to fund the operations of the Minnesota Insurance
8.8Marketplace as certified to the commissioner of management and budget under section
8.916A.725, subdivision 2a.
8.10    Subd. 3. Insurance producers. (a) Within 30 days of enactment, the commissioner
8.11of management and budget, in consultation with the commissioner of commerce, shall
8.12establish certification requirements that must be met by insurance producers in order to
8.13assist individuals and small employers with purchasing coverage through the Minnesota
8.14Insurance Marketplace. The requirements established under this paragraph shall remain
8.15in effect until the implementation of the requirements established under paragraph (b)
8.16or January 1, 2015, whichever is later. Prior to January 1, 2015, the commissioner of
8.17management and budget may amend the requirements, if necessary, due to a change in
8.18federal rules.
8.19    (b) The board, in consultation with the commissioner of commerce, may establish
8.20certification requirements for insurance producers assisting individuals and small
8.21employers with purchasing coverage through the Minnesota Insurance Marketplace.
8.22Certification shall be issued by the Minnesota Insurance Marketplace.
8.23    (c) Certification requirements shall not exceed the requirements established under
8.24Code of Federal Regulations, title 45, part 155.220. Certification shall include training on
8.25health plans available through the Minnesota Insurance Marketplace, available tax credits
8.26and cost-sharing arrangements, compliance with privacy and security standards, eligibility
8.27verification processes, online enrollment tools, and basic information on available public
8.28health care programs. Training required for certification under this subdivision shall
8.29qualify for continuing education requirements for insurance producers required under
8.30chapter 60K, and must comply with course approval requirements under chapter 45.
8.31    (d) Any compensation, including, but not limited to, commissions, service fees,
8.32and brokerage fees paid to an insurance producer for selling, soliciting, or negotiating
8.33coverage offered through the Minnesota Insurance Marketplace shall be paid by the
8.34health carrier and must be the same for health plans offered or sold inside the Minnesota
8.35Insurance Marketplace as for health plans offered or sold outside the Minnesota Insurance
8.36Marketplace. Compensation must be set by the health carrier and not by the board.
9.1    (e) Any insurance producer compensation structure established by a health carrier
9.2for the small group market must include compensation for defined contribution plans that
9.3involve multiple health carriers. The compensation offered must be commensurate with
9.4other small group market defined health plans.
9.5    (f) Any insurance producer assisting an individual or small employer with
9.6purchasing coverage through the Minnesota Insurance Marketplace must disclose, orally
9.7and in writing, to the individual or small employer at the time of the first solicitation with
9.8the prospective purchaser the following:
9.9    (1) the health carriers and qualified health plans offered through the Minnesota
9.10Insurance Marketplace that the producer is authorized to sell, and that the producer may
9.11not be authorized to sell all the qualified health plans offered through the Minnesota
9.12Insurance Marketplace;
9.13    (2) the producer may be receiving compensation from a health carrier for enrolling
9.14the individual or small employer into a particular health plan; and
9.15    (3) information on all qualified health plans offered through the Minnesota Insurance
9.16Marketplace is available through the Minnesota Insurance Marketplace Web site.
9.17For purposes of this paragraph, "solicitation" means any contact by a producer, or any
9.18person acting on behalf of a producer made for the purpose of selling or attempting to sell
9.19coverage through the Minnesota Insurance Marketplace. If the first solicitation is made by
9.20telephone, the disclosures required under this paragraph need not be made in writing.
9.21    (g) Beginning January 15, 2015, each health carrier that offers or sells qualified
9.22health plans through the Minnesota Insurance Marketplace shall report in writing to the
9.23board and the commissioner of commerce the compensation and other incentives it offers
9.24or provides to insurance producers with regard to each type of health plan the health carrier
9.25offers or sells both inside and outside of the Minnesota Insurance Marketplace. Each
9.26health carrier shall submit a report annually and upon any change to the compensation or
9.27other incentives offered or provided to insurance producers.
9.28    (h) Nothing in this subdivision shall be construed to limit the licensure requirements
9.29or regulatory functions of the commissioner of commerce under chapter 60K.
9.30    Subd. 4. Navigator; in-person assisters; call center. (a) The board shall establish
9.31policies and procedures for the ongoing operation of a navigator program, in-person
9.32assister program, call center, and customer service provisions for the Minnesota Insurance
9.33Marketplace to be implemented beginning January 1, 2015.
9.34(b) Until the implementation of the policies and procedures described in paragraph
9.35(a), the following shall be in effect:
9.36(1) the navigator program shall be met by section 256.962;
10.1(2) entities eligible to be navigators may serve as in-person assisters;
10.2(3) the commissioner of management and budget shall establish requirements and
10.3compensation for the navigator program and the in-person assister program within 30 days
10.4of enactment. Compensation for navigators and in-person assisters must take into account
10.5any other compensation received by the navigator or in-person assister for conducting
10.6the same or similar services; and
10.7(4) call center operations shall utilize existing state resources and personnel,
10.8including referrals to counties for medical assistance.
10.9(c) The commissioner of management and budget shall establish a toll-free number
10.10for the Minnesota Insurance Marketplace and may hire and contract for additional
10.11resources as deemed necessary.
10.12    (d) The navigator program and in-person assister program must meet the
10.13requirements of section 1311(i) of the Affordable Care Act (Public Law 111-148). In
10.14establishing training standards for the navigators and in-person assisters, the board must
10.15ensure that all entities and individuals carrying out navigator and in-person assister
10.16functions have training in the needs of underserved and vulnerable populations; eligibility
10.17and enrollment rules and procedures; the range of available public health care programs
10.18and qualified health plan options offered through the Minnesota Insurance Marketplace;
10.19and privacy and security standards. For calendar year 2014, the commissioner of
10.20human services shall ensure that the navigator program under section 256.962 provides
10.21application assistance for both qualified health plans offered through the Minnesota
10.22Insurance Marketplace and public health care programs.
10.23(e) The board must ensure that any information provided by navigators, in-person
10.24assisters, the call center, or other customer assistance portals be accessible to persons
10.25with disabilities and that information provided on public health care programs include
10.26information on other coverage options available to persons with disabilities.
10.27    Subd. 5. Health carrier and health plan requirements; participation. (a)
10.28Beginning January 1, 2015, the board may establish minimum certification requirements
10.29for health carriers and health plans to be offered through the Minnesota Insurance
10.30Marketplace that satisfy the federal requirements under section 1311(c)(1) of the
10.31Affordable Care Act (Public Law 111-148).
10.32    (b) Paragraph (a) does not apply if by June 1, 2013, the legislature enacts regulatory
10.33requirements that:
10.34    (1) apply uniformly to all health carriers and health plans in the individual market;
10.35    (2) apply uniformly to all health carriers and health plans in the small group market;
10.36and
11.1    (3) satisfy minimum federal certification requirements under section 1311(c)(1) of
11.2the Affordable Care Act (Public Law 111-148).
11.3    (c) In accordance with section 1311(e) of the Affordable Care Act (Public Law
11.4111-148), the board shall establish certification procedures for selection of qualified health
11.5plans to be offered through the Minnesota Insurance Marketplace. The board shall certify
11.6a health plan as a qualified health plan, if:
11.7    (1) the health plan meets the minimum certification requirements established in
11.8paragraph (a) or the market regulatory requirements described in paragraph (b); and
11.9    (2) the board determines that making the health plan available through the Minnesota
11.10Insurance Marketplace is in the interests of qualified individuals and qualified employers
11.11using the Minnesota Insurance Marketplace.
11.12    (d) In determining the interests of qualified individuals and employers under
11.13paragraph (c), clause (2), the board may consider affordability; quality and value of the
11.14health plans; promotion of initiatives to reduce health disparities; market stability; and
11.15meaningful choice and access. The board may not exclude a health plan for any reason
11.16specified under section 1311(e)(1)(B) of the Affordable Care Act (Public Law 111-148).
11.17    (e) For qualified health plans offered through the Minnesota Insurance Marketplace,
11.18effective January 1, 2014, the board shall determine whether a health plan satisfies
11.19paragraph (c), clause (2), by considering a combination of the following criteria:
11.20    (1) reasonableness of expected costs supporting the health plan's premiums and
11.21cost-sharing structure;
11.22    (2) quality and sufficiency of the health plan's provider networks;
11.23    (3) quality improvement activities;
11.24    (4) quality initiatives related to cultural and linguistic competency;
11.25    (5) promotion of initiatives for improving health, disease prevention, and wellness;
11.26and
11.27    (6) providing a manageable number of choices to consumers that present clear
11.28product differentiation.
11.29    (f) For qualified health plans offered through the Minnesota Insurance Marketplace,
11.30on or after January 1, 2015, the board shall establish the criteria for satisfying paragraph
11.31(c), clause (2), by February 1 of each year, beginning February 1, 2014. The criteria
11.32must include the measures to be used by the board to determine whether the criteria have
11.33been met. The board may use the rulemaking process described in subdivision 9 for
11.34selection criteria.
11.35    (g) For qualified health plans offered through the Minnesota Insurance Marketplace
11.36beginning January 1, 2015, health carriers must use the most current addendum for Indian
12.1health care providers approved by Centers for Medicare and Medicaid Services and the
12.2tribes as part of their contracts with Indian health care providers.
12.3    Subd. 6. Appeals process; eligibility determinations. (a) The board shall
12.4establish a process for appeal of individual or employer eligibility determinations or
12.5redeterminations of the Minnesota Insurance Marketplace. The process must provide for a
12.6reasonable opportunity to be heard and timely resolution of the appeal, consistent with the
12.7requirements of federal law and regulations. The process must be substantially similar
12.8to the hearing process under section 256.045 and include judicial review in the manner
12.9specified under section 256.045, subdivisions 7 to 9.
12.10(b) The Minnesota Insurance Marketplace may establish service-level agreements
12.11with state agencies to conduct hearings for appeals. Notwithstanding section 471.59,
12.12subdivision 1, a state agency is authorized to enter into service-level agreements for this
12.13purpose with the Minnesota Insurance Marketplace.
12.14(c) For proceedings under this subdivision and subdivision 7, the Minnesota
12.15Insurance Marketplace may be represented by an attorney who is an employee of the
12.16Minnesota Insurance Marketplace.
12.17(d) This subdivision does not apply to appeals of determinations where a state
12.18agency hearing is available under section 256.045.
12.19    Subd. 7. Contested case proceeding; health carrier determinations. A health
12.20carrier that is aggrieved by a decision of the board regarding its compliance with
12.21certification requirements or participation in the Minnesota Insurance Marketplace under
12.22subdivision 5 is entitled to a contested case proceeding under chapter 14. The report or
12.23order of the administrative law judge constitutes the final decision in the case, subject to
12.24judicial review under sections 14.63 to 14.69.
12.25    Subd. 8. Agreements; consultation. (a) The board shall:
12.26(1) establish and maintain an agreement with the chief information officer of
12.27the Office of Enterprise Technology for information technology services that ensures
12.28coordination with public health care programs. The board may establish and maintain
12.29agreements with the chief information officer of the Office of Enterprise Technology for
12.30other information technology services, including an agreement that would permit the
12.31Minnesota Insurance Marketplace to administer eligibility for additional health care and
12.32public assistance programs under the authority of the commissioner of human services;
12.33(2) establish and maintain an agreement with the commissioner of human services
12.34for cost allocation and services regarding eligibility determinations and enrollment for
12.35public health care programs that use a modified adjusted gross income standard to
13.1determine program eligibility. The board may establish and maintain an agreement with
13.2the commissioner of human services for other services; and
13.3(3) establish and maintain an agreement with the commissioners of commerce
13.4and health for services regarding enforcement of Minnesota Insurance Marketplace
13.5certification requirements for health plans and dental plans offered through the Minnesota
13.6Insurance Marketplace. The board may establish and maintain agreements with the
13.7commissioners of commerce and health for other services.
13.8(b) The board shall consult with the commissioners of commerce and health
13.9regarding the operations of the Minnesota Insurance Marketplace.
13.10(c) The board shall consult with Indian tribes and organizations regarding the
13.11operation of the Minnesota Insurance Marketplace.
13.12(d) Beginning March 15, 2014, and each March 15 thereafter, the board shall submit
13.13a report to the chairs and ranking minority members of the committees in the senate and
13.14house of representatives with primary jurisdiction over commerce, health, and human
13.15services on all the agreements entered into with the chief information officer of the Office
13.16of Enterprise Technology, or the commissioners of human services, health, or commerce
13.17in accordance with this subdivision. The report shall include the agency in which the
13.18agreement is with; the time period of the agreement; the purpose of the agreement; and
13.19a summary of the terms of the agreement. A copy of the agreement must be submitted
13.20to the extent practicable.
13.21    Subd. 9. Rulemaking in the first year. (a) Effective upon enactment until January
13.221, 2014, the Minnesota Insurance Marketplace may adopt rules to implement any
13.23provisions of this chapter following the process in this subdivision.
13.24(b) Before publication of the final rule in the State Register, the agency must submit
13.25the rule to an administrative law judge in the Office of Administrative Hearings. The
13.26administrative law judge shall within ten days approve or disapprove the rule as to its
13.27legality and its form, to the extent the form relates to legality.
13.28(c) The Minnesota Insurance Marketplace shall publish proposed rules in the State
13.29Register.
13.30(d) Interested parties have 21 days after publication to comment on the proposed
13.31rules. After the Minnesota Insurance Marketplace has considered all comments, the
13.32Minnesota Insurance Marketplace shall publish notice in the State Register that the rules
13.33have been adopted and the rules shall take effect on publication.
13.34(e) If the adopted rules are the same as the proposed rules, the notice shall state that
13.35the rules have been adopted as proposed and shall cite the prior publication. If the adopted
13.36rules differ from the proposed rules, the portions of the adopted rules that differ from the
14.1proposed rules shall be included in the notice of adoption, together with a citation to the
14.2prior State Register that contained the notice of the proposed rules.
14.3(f) The Minnesota Insurance Marketplace shall seek comments from the Department
14.4of Administration, Information Policy Analysis Division, before adopting any final rules
14.5involving the sharing, use, or disclosure of not public data.
14.6(g) By January 15, 2014, the board shall submit a report to the chairs and ranking
14.7minority members of the committees in the senate and the house of representatives
14.8with primary jurisdiction over commerce and health, that lists and describes all rules
14.9promulgated under this subdivision.
14.10    (h) If the rulemaking process described in this subdivision is not used, the board
14.11must comply with the standard rulemaking process in chapter 14.
14.12    Subd. 10. Rulemaking after the first year. Beginning January 1, 2014, the
14.13board may adopt rules to implement any provisions in this chapter using the expedited
14.14rulemaking process in section 14.389. If the expedited rulemaking process is not used, the
14.15board must comply with the standard rulemaking process in chapter 14.
14.16    Subd. 11. Dental plans. (a) The provisions of this section that apply to health plans
14.17shall apply to dental plans offered as stand-alone dental plans through the Minnesota
14.18Insurance Marketplace, to the extent practicable.
14.19    (b) A stand-alone dental plan offered through the Minnesota Insurance Marketplace
14.20must meet all certification requirements under section 1311(c)(1) of the Affordable Care
14.21Act (Public Law 111-148) that are applicable to health plans, except for certification
14.22requirements that cannot be met because the dental plan only covers dental benefits.
14.23    Subd. 12. Limitations; risk-bearing. (a) The board shall not bear insurance risk or
14.24enter into any agreement with health care providers to pay claims.
14.25(b) Nothing in this subdivision shall prevent the Minnesota Insurance Marketplace
14.26from providing insurance for its employees.

14.27    Sec. 10. [62V.06] DATA.
14.28(a) The definitions in section 13.02 apply to this section.
14.29(b) Government data of the Minnesota Insurance Marketplace on individuals,
14.30employees of employers, and employers using the Minnesota Insurance Marketplace are
14.31private data on individuals or nonpublic data. The Minnesota Insurance Marketplace
14.32may share not public data with state and federal agencies and other entities if the board
14.33determines that the exchange of the data is necessary to carry out the functions of the
14.34Minnesota Insurance Marketplace. State agencies shall share not public data with the
14.35Minnesota Insurance Marketplace if the board determines that the exchange of the
15.1data is reasonably necessary to carry out the functions of the Minnesota Insurance
15.2Marketplace. Data-sharing agreements must include adequate protections with respect to
15.3the confidentiality and integrity of the data to be shared and comply with applicable law.
15.4Notwithstanding the provisions governing summary data in sections 13.02, subdivision
15.519, and 13.05, subdivision 7, the Minnesota Insurance Marketplace may derive summary
15.6data from nonpublic data under this section. No personal medical data can be shared
15.7under this section.
15.8(c) If a conflict exists between federal data practices law and the law of this state,
15.9Minnesota law controls to the extent it is more protective of the rights and privacy of
15.10data subjects.
15.11(d) The Minnesota Insurance Marketplace shall prepare a list of persons with
15.12whom it has entered into data-sharing agreements under this section and a description
15.13of all databases in which data that are private or nonpublic may be maintained. A
15.14printable version of the list and descriptions must be available on the Minnesota Insurance
15.15Marketplace Web site.
15.16(e) If the board determines that an individual has willfully collected, altered,
15.17accessed, acquired, received, maintained, shared, or disseminated data in violation of this
15.18section or chapter 13, the board shall immediately and permanently revoke the authority
15.19of the individual to have access to data that are not public data. If the board determines
15.20that the individual willfully accessed or acquired data without explicit authorization from
15.21the board, the board shall forward the matter to the appropriate prosecutorial authority.

15.22    Sec. 11. [62V.07] FUNDS.
15.23    The Minnesota Insurance Marketplace account is created in the special revenue fund
15.24of the state treasury. All funds received by the Minnesota Insurance Marketplace shall
15.25be deposited in the account. Funds in the account are appropriated to the Minnesota
15.26Insurance Marketplace for the operation of the Minnesota Insurance Marketplace.

15.27    Sec. 12. [62V.08] REPORT.
15.28The Minnesota Insurance Marketplace shall submit a report to the legislature by
15.29January 15, 2015, and each January 15 thereafter, on: (1) the performance of Minnesota
15.30Insurance Marketplace operations; (2) meeting the Minnesota Insurance Marketplace
15.31responsibilities; (3) an accounting of the Minnesota Insurance Marketplace budget
15.32activities; and (4) practices and procedures that have been implemented to ensure
15.33compliance with data practices laws; the security of private and nonpublic data and the
15.34prevention of unauthorized acquisition of or access to the data; changes in data practices
16.1or classifications required by federal law; and a description of any violations of data
16.2practices laws or procedures.

16.3    Sec. 13. [62V.09] EXPIRATION AND SUNSET EXCLUSION.
16.4Notwithstanding section 15.059, the board and its advisory committees shall not
16.5expire, except as specified in section 62V.04, subdivision 13. The board and its advisory
16.6committees are not subject to review or sunsetting under chapter 3D.

16.7    Sec. 14. [62V.10] LEGISLATIVE OVERSIGHT COMMITTEE.
16.8    Subdivision 1. Legislative oversight. (a) The Legislative Oversight Committee is
16.9established to provide oversight to the implementation of this chapter and the operation
16.10of the Minnesota Insurance Marketplace.
16.11(b) The committee shall review the operations of the Minnesota Insurance
16.12Marketplace at least annually and shall recommend necessary changes in policy,
16.13implementation, and statutes to the board and to the legislature.
16.14(c) The Minnesota Insurance Marketplace shall present to the committee the annual
16.15report required in section 62V.08, as well as the reports on rules required in section
16.1662V.05, subdivision 9, the appeals process under section 62V.05, subdivision 6, and the
16.17actions taken regarding the treatment of multiemployer plans.
16.18    Subd. 2. Membership; meetings; compensation. (a) The Legislative Oversight
16.19Committee shall consist of five members of the senate, three members appointed by
16.20the majority leader of the senate, and two members appointed by the minority leader of
16.21the senate; and five members of the house of representatives, three members appointed
16.22by the speaker of the house, and two members appointed by the minority leader of the
16.23house of representatives.
16.24(b) Appointed legislative members serve at the pleasure of the appointing authority
16.25and shall continue to serve until their successors are appointed.
16.26(c) The first meeting of the committee shall be convened by the chair of the
16.27Legislative Coordinating Commission. Members shall elect a chair at the first meeting.
16.28The chair must convene at least one meeting annually, and may convene other meetings as
16.29deemed necessary.
16.30(d) The members shall serve without compensation.
16.31    Subd. 3. Review of costs. The board shall submit for review the estimated costs
16.32necessary to fund the operations of the Minnesota Insurance Marketplace as certified under
16.33section 16A.725, subdivision 2a, to the committee at the same time as the certification is
16.34provided to the commissioner of management and budget.

17.1    Sec. 15. TRANSITION OF AUTHORITY.
17.2(a) Upon the effective date of this act, the commissioner of management and budget
17.3shall exercise all authorities and responsibilities under Minnesota Statutes, sections 62V.03
17.4and 62V.05 until the board has satisfied the requirements of Minnesota Statutes, section
17.562V.05, subdivision 1, paragraph (c). In exercising these authorities and responsibilities of
17.6the board, the commissioner of management and budget shall be subject to or exempted
17.7from the same statutory provisions as the board, as identified in Minnesota Statutes,
17.8section 62V.03, subdivision 2.
17.9(b) Upon the establishment of bylaws, policies, and procedures governing the
17.10operations of the Minnesota Insurance Marketplace by the board as required under
17.11Minnesota Statutes, section 62V.05, subdivision 1, paragraph (c), all personnel, assets,
17.12contracts, obligations, and funds managed by the commissioner of management and
17.13budget for the design and development of the Minnesota Insurance Marketplace shall be
17.14transferred to the board. Existing personnel managed by the commissioner of management
17.15and budget for the design and development of the Minnesota Insurance Marketplace shall
17.16staff the board upon enactment.

17.17    Sec. 16. MINNESOTA COMPREHENSIVE HEALTH ASSOCIATION
17.18TERMINATION.
17.19The commissioner of commerce, in consultation with the board of directors of
17.20the Minnesota Comprehensive Health Association, has the authority to develop and
17.21implement the phase-out and eventual termination of coverage provided by the Minnesota
17.22Comprehensive Health Association under Minnesota Statutes, chapter 62E. The phase-out
17.23of coverage shall begin no sooner than January 1, 2014, or upon the effective date of the
17.24operation of the Minnesota Insurance Marketplace and the ability to purchase qualified
17.25health plans through the Minnesota Insurance Marketplace, whichever is later, and shall,
17.26to the extent practicable, ensure the least amount of disruption to the enrollees' health care
17.27coverage. The member assessments established under Minnesota Statutes, section 62E.11,
17.28shall take into consideration any phase-out of coverage implemented under this section.

17.29    Sec. 17. REPORT ON APPEALS PROCESS.
17.30By February 1, 2014, and February 1, 2015, the board of directors of the Minnesota
17.31Insurance Marketplace shall submit a report to the chairs and ranking minority members
17.32of the committees in the senate and house of representatives with primary jurisdiction over
17.33commerce, health, and civil law on the appeals process for eligibility determinations
17.34established under Minnesota Statutes, section 62V.05, subdivision 6.

18.1    Sec. 18. CONTINGENT TREATMENT OF MULTIEMPLOYER PLANS.
18.2    On or after the date that final federal regulations are adopted regarding the treatment
18.3of multiemployer plans, the Minnesota Insurance Marketplace shall take such actions as
18.4are necessary, in consultation with the commissioner of commerce and in accordance with
18.5final federal regulations, to: (1) ensure that all multiemployer plans are notified of the
18.6final federal rules; (2) conform all policies and procedures of the Minnesota Insurance
18.7Marketplace with applicable federal rules related to multiemployer plans; and (3) permit
18.8multiemployer plans to be integrated in the Minnesota Insurance Marketplace to the
18.9maximum extent permitted by federal rules. The Minnesota Insurance Marketplace shall
18.10submit written notification to the legislature regarding its compliance with this section.

18.11    Sec. 19. REPEALER.
18.12Minnesota Statutes 2012, section 256.9658, subdivision 1, is repealed.

18.13    Sec. 20. EFFECTIVE DATE.
18.14Sections 1 to 18 are effective the day following final enactment. Any actions taken
18.15by any state agencies in furtherance of the design, development, and implementation
18.16of the Minnesota Insurance Marketplace prior to the effective date shall be considered
18.17actions taken by the Minnesota Insurance Marketplace and shall be governed by the
18.18provisions of this chapter and state law. Health plan and dental plan coverage through the
18.19Minnesota Insurance Marketplace is effective January 1, 2014.