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Minnesota Legislature

Office of the Revisor of Statutes

HF 5

as introduced - 88th Legislature (2013 - 2014) Posted on 01/10/2013 11:57am

KEY: stricken = removed, old language.
underscored = added, new language.
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A bill for an act
relating to commerce; establishing the Minnesota Insurance Marketplace;
prescribing its powers and duties; providing for legislative appointments;
appropriating money; amending Minnesota Statutes 2012, section 13.7191, by
adding a subdivision; proposing coding for new law as Minnesota Statutes,
chapter 62V.

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

Section 1.

Minnesota Statutes 2012, section 13.7191, is amended by adding a
subdivision to read:


new text begin Subd. 14a. new text end

new text begin Minnesota Insurance Marketplace. new text end

new text begin Classification and sharing of data
of the Minnesota Insurance Marketplace is governed by section 62V.06.
new text end

Sec. 2.

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. 3.

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 carrier. new text end

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

new text begin Subd. 5. 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. 6. new text end

new text begin Insurance producer. new text end

new text begin "Insurance producer" has the meaning defined
in section 60K.31.
new text end

new text begin Subd. 7. new text end

new text begin Minnesota Insurance Marketplace. new text end

new text begin "Minnesota Insurance Marketplace"
means the Minnesota Insurance Marketplace created as a state health benefit exchange
as described in section 1311 of the federal Patient Protection and Affordable Care Act
(Public Law 111-148), and further defined through amendments to the act and regulations
issued under the act.
new text end

new text begin Subd. 8. new text end

new text begin Navigator. new text end

new text begin "Navigator" has the meaning described in section 1311(i) of
the federal Patient Protection and Affordable Care Act (Public Law 111-148), and further
defined through amendments to the act and regulations issued under the act.
new text end

new text begin Subd. 9. new text end

new text begin Public health care program. new text end

new text begin "Public health care program" means any
public health care program administered by the commissioner of human services whereby
eligibility for the program is determined according to a modified adjusted gross income
standard.
new text end

new text begin Subd. 10. 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. 4.

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), to:
new text end

new text begin (1) promote innovation, competition, quality, value, market participation,
affordability, meaningful choices, health improvement, care management, and portability
of health benefit plans;
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 through the Minnesota
Insurance Marketplace and for employees and employers purchasing in the small group
market through the Minnesota Insurance Marketplace;
new text end

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

new text begin (4) facilitate the integration and transition of individuals between public health care
programs and health benefit plans in the individual market.
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 Minnesota Insurance Marketplace is
subject to review by the legislative auditor under section 3.971.
new text end

new text begin (b) Board members of the Minnesota Insurance Marketplace are subject to section
10A.07 and the personnel of the Minnesota Insurance Marketplace are subject to section
10A.071.
new text end

new text begin (c) 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 personnel 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 (d) The Minnesota Insurance Marketplace and provisions specified under this
chapter are exempt from:
new text end

new text begin (1) chapter 14, including section 14.386;
new text end

new text begin (2) chapters 16B and 16C, with the exception of 16C.16. However, the Minnesota
Insurance Marketplace, in consultation with the commissioner of administration, shall
implement policies and procedures to establish an open and competitive procurement
process for the Minnesota Insurance Marketplace that, to the extent practicable, conforms
to the principles and procedures contained in chapters 16B and 16C. In addition, the
Minnesota Insurance Marketplace may enter into an agreement with the commissioner
of administration for other services; and
new text end

new text begin (3) chapter 16E, however, the Minnesota Insurance Marketplace shall establish
and maintain an agreement with the chief information officer of the Office of Enterprise
Technology for information technology services, applications, and infrastructure that
ensures seamless coordination of eligibility determination and enrollment with public
health care programs. The Minnesota Insurance Marketplace may enter into an agreement
with the chief information officer of the Office of Enterprise Technology for other
information technology services.
new text end

Sec. 5.

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 Minnesota Insurance Marketplace is governed by a
board of directors with seven members.
new text end

new text begin Subd. 2. new text end

new text begin Appointment. new text end

new text begin (a) Board membership of the Minnesota Insurance
Marketplace consists of the following:
new text end

new text begin (1) three members, with one member representing the interests of individual
consumers eligible for individual market coverage, one member representing individual
consumers eligible for public health care program coverage, and one member representing
small employers. Members are appointed to serve a three-year term following the initial
staggered-term lot determination. Each of the following shall appoint one member:
new text end

new text begin (i) majority leader of the senate;
new text end

new text begin (ii) speaker of the house; and
new text end

new text begin (iii) the governor;
new text end

new text begin (2) three members who have demonstrated expertise, leadership, and innovation
in the following areas: health benefits administration; health care finance; health plan
purchasing; health care delivery systems; public health; health disparities; or health policy
issues related to the small group and individual markets, public health care programs, and
the uninsured. Members are appointed to serve a three-year term following the initial
staggered term lot determination. Each of the following shall appoint one member:
new text end

new text begin (i) majority leader of the senate;
new text end

new text begin (ii) speaker of the house; and
new text end

new text begin (iii) the governor; and
new text end

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

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

new text begin (c) Initial appointments shall be made within 30 days of enactment.
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 for the commissioner or the commissioner's designee, who shall serve
until replaced by the governor.
new text end

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

new text begin (c) The appointed members under subdivision 2, paragraph (a), clauses (1) and (2),
shall have an initial term of two, three, or four years, determined by lot by the secretary of
state. For purposes of appointing the members under subdivision 2, paragraph (a), clause
(1), the secretary of state shall determine by lot which member shall be appointed by
which appointing entity.
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) and (2), shall not be employed by, be a member of the board of directors of, or
otherwise be a representative of a health carrier, health care provider, navigator, insurance
producer, or other entity in the business of selling items or services of significant value to
or through the Minnesota Insurance Marketplace.
new text end

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

new text begin Subd. 5. new text end

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

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

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

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

new text begin Subd. 6. new text end

new text begin Chair. new text end

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

new text begin Subd. 7. new text end

new text begin Officers. new text end

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

new text begin Subd. 8. 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.
new text end

new text begin Subd. 9. new text end

new text begin Removal. new text end

new text begin A board member may be removed by the board only for cause,
following notice, hearing, and a two-thirds vote of the board. A conflict of interest as
defined in subdivision 4 shall be cause for removal from the board.
new text end

new text begin Subd. 10. new text end

new text begin Meetings. new text end

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

new text begin Subd. 11. new text end

new text begin Quorum. new text end

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

new text begin Subd. 12. new text end

new text begin Compensation. new text end

new text begin Board members may be compensated according to
section 15.0575.
new text end

new text begin Subd. 13. new text end

new text begin Advisory committees. new text end

new text begin (a) The board may establish, as necessary,
advisory committees to gather information related to the operation of the Minnesota
Insurance Marketplace.
new text end

new text begin (b) Section 15.0597 shall not apply to any advisory committee established by the
board.
new text end

Sec. 6.

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

new text begin Subdivision 1. new text end

new text begin General. new text end

new text begin (a) The board shall operate the Minnesota Insurance
Marketplace according to this chapter and applicable state and federal law.
new text end

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

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

new text begin (2) establish the budget of the Minnesota Insurance Marketplace;
new text end

new text begin (3) seek and accept money, grants, loans, donations, materials, services, or
advertising revenue from government agencies, philanthropic organizations, and public
and private sources to fund the operation of the Minnesota Insurance Marketplace;
new text end

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

new text begin (5) enter into information-sharing agreements with federal and state agencies and
other entities, provided the agreements include adequate protections with respect to
the confidentiality and integrity of the information to be shared, and comply with all
applicable state and federal laws, regulations, and rules; and
new text end

new text begin (6) take any other actions reasonably required to implement and administer its
responsibilities.
new text end

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

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

new text begin Subd. 2. new text end

new text begin Operations funding. new text end

new text begin (a) Beginning January 1, 2015, the board may
retain or collect up to 3.5 percent of premiums for individual market and small group
market health benefit plans sold through the Minnesota Insurance Marketplace to fund
the operations of the Minnesota Insurance Marketplace.
new text end

new text begin (b) Prior to January 1, 2015, the Minnesota Insurance Marketplace shall retain or
collect 3.5 percent of total premiums for individual market and small group market health
benefit plans sold through the Minnesota Insurance Marketplace to fund the operations
of the Minnesota Insurance Marketplace.
new text end

new text begin Subd. 3. new text end

new text begin Compensation; insurance producers. new text end

new text begin (a) The board may establish
requirements and compensation structure for insurance producers assisting individuals and
small employers with coverage through the Minnesota Insurance Marketplace.
new text end

new text begin (b) Within 30 days of enactment, the commissioner of management and budget shall
establish requirements and compensation for insurance producers assisting individuals
and small employers with coverage through the Minnesota Insurance Marketplace. The
requirements and compensation structure established under this paragraph shall remain in
effect until the implementation of the requirements and compensation structure established
under paragraph (a).
new text end

new text begin (c) Beginning January 1, 2015, the board may collect a percentage of premiums
for individual market and small group market health benefit plans sold through the
Minnesota Insurance Marketplace to fund the compensation of insurance producers
assisting individuals and small employers with coverage through the Minnesota Insurance
Marketplace. The percentage collected shall not exceed the percentage of premium paid to
insurance producers in the fully insured individual and small group markets in Minnesota
for the most recent available year as identified in the I-SITE maintained by the National
Association of Insurance Commissioners (NAIC).
new text end

new text begin (d) Prior to January 1, 2015, the Minnesota Insurance Marketplace shall collect a
percentage of premiums for individual market and small group market health benefit plans
sold through the Minnesota Insurance Marketplace to fund the compensation of insurance
producers assisting individuals and small employers with coverage through the Minnesota
Insurance Marketplace. The percentage collected shall equal the percentage of premium
paid to insurance producers in the fully insured individual and small group markets in
Minnesota for 2012 as identified in the I-SITE maintained by the NAIC.
new text end

new text begin Subd. 4. new text end

new text begin Navigator; in-person assisters; call center. new text end

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

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

new text begin (1) the navigator program shall be fulfilled through section 256.962;
new text end

new text begin (2) entities eligible to be navigators, including insurance producers, Indian tribes and
organizations, and counties may serve as in-person assisters;
new text end

new text begin (3) the commissioner of management and budget shall establish requirements
and compensation for the in-person assister program within 30 days of enactment.
Compensation for in-person assisters must take into account any other compensation
received by the in-person assister for conducting the same or similar services; and
new text end

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

new text begin (c) The commissioner of management and budget shall establish a toll-free number
for the Minnesota Insurance Marketplace and may hire and contract for additional
resources as deemed necessary.
new text end

new text begin Subd. 5. new text end

new text begin Health carrier requirements; participation. new text end

new text begin (a) Beginning January 1,
2015, the board shall have the power to establish certification requirements for health
carriers and health benefit plans offered through the Minnesota Insurance Marketplace
unless by June 1, 2013, the legislature enacts regulatory requirements that:
new text end

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

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

new text begin (3) satisfy federal certification requirements for the Minnesota Insurance
Marketplace.
new text end

new text begin (b) The board has the power to select health carriers and health benefit plans for
participation in the Minnesota Insurance Marketplace from the health carriers and health
benefit plans that have met certification requirements. Selection must be determined in the
interests of the individual consumers and employers and within federal requirements.
new text end

new text begin (c) For health benefit plans offered through the Minnesota Insurance Marketplace
beginning January 1, 2015, health carriers must use the most current addendum for Indian
health care providers approved by Centers for Medicare and Medicaid Services and the
tribes as part of their contracts with Indian health care providers.
new text end

new text begin Subd. 6. new text end

new text begin Appeals. new text end

new text begin (a) The board may conduct hearings, appoint hearing officers,
and recommend final orders related to appeals of any Minnesota Insurance Marketplace
determinations, except for those determinations identified in paragraph (d).
new text end

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

new text begin (c) For proceedings under this subdivision, the Minnesota Insurance Marketplace may
be represented by an attorney who is an employee of the Minnesota Insurance Marketplace.
new text end

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

new text begin Subd. 7. new text end

new text begin Agreements; consultation. new text end

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

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

new text begin (2) establish and maintain an agreement with the commissioner of human services
for cost allocation and services regarding eligibility determinations and enrollment for
public health care programs. The board may establish and maintain an agreement with the
commissioner of human services for other services; and
new text end

new text begin (3) establish and maintain an agreement with the commissioners of commerce
and health for services regarding enforcement of Minnesota Insurance Marketplace
certification requirements for health benefit plans offered through the Minnesota Insurance
Marketplace. The board may establish and maintain agreements with the commissioners
of commerce and health for other services.
new text end

new text begin (b) The board shall consult with the commissioners of commerce and health
regarding the operations of the Minnesota Insurance Marketplace.
new text end

new text begin (c) The board shall consult with Indian tribes and organizations regarding the
operation of the Minnesota Insurance Marketplace.
new text end

new text begin (d) The board shall establish advisory committees to provide the health care industry,
consumers, and other stakeholders with the opportunity to share their perspectives
regarding the operations of the Minnesota Insurance Marketplace.
new text end

Sec. 7.

new text begin [62V.06] DATA.
new text end

new text begin (a) The definitions in section 13.02 apply to this section.
new text end

new text begin (b) Government data of the Minnesota Insurance Marketplace on individuals,
employees of employers, and employers using the Minnesota Insurance Marketplace are
private data on individuals or nonpublic data. The Minnesota Insurance Marketplace may
share not public data with state and federal agencies and other entities if the exchange
of the data is reasonably necessary to carry out the functions of the Minnesota Insurance
Marketplace. State agencies shall share not public data with the Minnesota Insurance
Marketplace if the exchange of the data is reasonably necessary to carry out the functions
of the Minnesota Insurance Marketplace. Notwithstanding the provisions governing
summary data in sections 13.02, subdivision 19, and 13.05, subdivision 7, the Minnesota
Insurance Marketplace may derive summary data from nonpublic data under this section.
new text end

Sec. 8.

new text begin [62V.07] FUNDS.
new text end

new text begin All funds received by the Minnesota Insurance Marketplace must be deposited in a
dedicated fund which may earn interest and are appropriated to the Minnesota Insurance
Marketplace for the purpose for which the funds were received. Funds do not cancel
and are available until expended.
new text end

Sec. 9.

new text begin [62V.08] REPORT.
new text end

new text begin The Minnesota Insurance Marketplace shall submit a report to the legislature by
January 15, 2015, and each January 15 thereafter, on: (1) the performance of Minnesota
Insurance Marketplace operations; (2) meeting the Minnesota Insurance Marketplace
responsibilities; and (3) an accounting of the Minnesota Insurance Marketplace budget
activities.
new text end

Sec. 10.

new text begin [62V.09] EXPIRATION AND SUNSET EXCLUSION.
new text end

new text begin Notwithstanding Minnesota Statutes, section 15.059, the Minnesota Insurance
Marketplace Act shall not expire. The board is not subject to review or sunsetting under
Minnesota Statutes, chapter 3D.
new text end

Sec. 11. new text beginTRANSITION OF AUTHORITY.
new text end

new text begin (a) Upon the effective date of this act, the commissioner of management and budget
shall exercise all authorities and responsibilities under Minnesota Statutes, sections
62V.03 and 62V.05 until the board has satisfied the requirements of Minnesota Statutes,
section 62V.05, subdivision 1, paragraph (d).
new text end

new text begin (b) Upon the establishment of bylaws, policies, and procedures governing the
operations of the Minnesota Insurance Marketplace by the board as required under
Minnesota Statutes, section 62V.05, subdivision 1, paragraph (d), all personnel, assets,
contracts, obligations, and funds managed by the commissioner of management and
budget for the design and development of the Minnesota Insurance Marketplace shall be
transferred to the board. Existing personnel managed by the commissioner of management
and budget for the design and development of the Minnesota Insurance Marketplace shall
staff the board upon enactment.
new text end

Sec. 12. new text beginMINNESOTA COMPREHENSIVE HEALTH INSURANCE
TERMINATION.
new text end

new text begin The commissioner of commerce, in consultation with the board of directors of the
Minnesota Comprehensive Health Insurance Association, has the authority to develop and
implement the phase out and eventual termination of coverage provided by the Minnesota
Comprehensive Health Insurance Association under Minnesota Statutes, chapter 62E. The
phase out of coverage shall begin no sooner than January 1, 2014.
new text end

Sec. 13. new text beginEFFECTIVE DATE.
new text end

new text begin Sections 1 to 12 are effective the day following final enactment. Any actions taken
by any state agencies in furtherance of the design, development, and implementation of the
Minnesota Insurance Marketplace prior to the effective date shall be considered actions
taken by the Minnesota Insurance Marketplace and shall be governed by the provisions of
this chapter and state law. Health benefit plan coverage through the Minnesota Insurance
Marketplace is effective January 1, 2014.
new text end