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HF 5

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

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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:


Subd. 14a.

Minnesota Insurance Marketplace.

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

Sec. 2.

[62V.01] TITLE.

This chapter may be cited as the "Minnesota Insurance Marketplace Act."

Sec. 3.

[62V.02] DEFINITIONS.

Subdivision 1.

Scope.

For the purposes of this chapter, the following terms have
the meanings given.

Subd. 2.

Board.

"Board" means the board of directors specified in section 62V.04.

Subd. 3.

Health benefit plan.

"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.

Subd. 4.

Health carrier.

"Health carrier" has the meaning defined in section
62A.011.

Subd. 5.

Individual market.

"Individual market" means the market for health
insurance coverage offered to individuals.

Subd. 6.

Insurance producer.

"Insurance producer" has the meaning defined
in section 60K.31.

Subd. 7.

Minnesota Insurance Marketplace.

"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.

Subd. 8.

Navigator.

"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.

Subd. 9.

Public health care program.

"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.

Subd. 10.

Small group market.

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

Sec. 4.

[62V.03] MINNESOTA INSURANCE MARKETPLACE;
ESTABLISHMENT.

Subdivision 1.

Creation.

The Minnesota Insurance Marketplace is created as a
board under section 15.012, paragraph (a), to:

(1) promote innovation, competition, quality, value, market participation,
affordability, meaningful choices, health improvement, care management, and portability
of health benefit plans;

(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;

(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

(4) facilitate the integration and transition of individuals between public health care
programs and health benefit plans in the individual market.

Subd. 2.

Application of other law.

(a) The Minnesota Insurance Marketplace is
subject to review by the legislative auditor under section 3.971.

(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.

(c) All meetings of the board shall comply with the open meeting law in chapter
13D, except that:

(1) meetings regarding personnel negotiations may be closed at the discretion of
the board;

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

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

(d) The Minnesota Insurance Marketplace and provisions specified under this
chapter are exempt from:

(1) chapter 14, including section 14.386;

(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

(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.

Sec. 5.

[62V.04] GOVERNANCE.

Subdivision 1.

Board.

The Minnesota Insurance Marketplace is governed by a
board of directors with seven members.

Subd. 2.

Appointment.

(a) Board membership of the Minnesota Insurance
Marketplace consists of the following:

(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:

(i) majority leader of the senate;

(ii) speaker of the house; and

(iii) the governor;

(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:

(i) majority leader of the senate;

(ii) speaker of the house; and

(iii) the governor; and

(3) the commissioner of human services or a designee.

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

(c) Initial appointments shall be made within 30 days of enactment.

Subd. 3.

Terms.

(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.

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

(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.

Subd. 4.

Conflicts of interest.

(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.

(b) All board members are subject to section 10A.07.

Subd. 5.

Acting chair; first meeting; supervision.

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

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

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

Subd. 6.

Chair.

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

Subd. 7.

Officers.

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

Subd. 8.

Vacancies.

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.

Subd. 9.

Removal.

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.

Subd. 10.

Meetings.

The board shall meet at least quarterly.

Subd. 11.

Quorum.

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.

Subd. 12.

Compensation.

Board members may be compensated according to
section 15.0575.

Subd. 13.

Advisory committees.

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

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

Sec. 6.

[62V.05] RESPONSIBILITIES AND POWERS OF THE MINNESOTA
INSURANCE MARKETPLACE.

Subdivision 1.

General.

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

(b) The board has the power to:

(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;

(2) establish the budget of the Minnesota Insurance Marketplace;

(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;

(4) contract for the receipt and provision of goods and services;

(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

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

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

(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.

Subd. 2.

Operations funding.

(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.

(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.

Subd. 3.

Compensation; insurance producers.

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

(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).

(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).

(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.

Subd. 4.

Navigator; in-person assisters; call center.

(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.

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

(1) the navigator program shall be fulfilled through section 256.962;

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

(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

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

(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.

Subd. 5.

Health carrier requirements; participation.

(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:

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

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

(3) satisfy federal certification requirements for the Minnesota Insurance
Marketplace.

(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.

(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.

Subd. 6.

Appeals.

(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).

(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.

(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.

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

Subd. 7.

Agreements; consultation.

(a) The board shall:

(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;

(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

(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.

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

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

(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.

Sec. 7.

[62V.06] DATA.

(a) The definitions in section 13.02 apply to this section.

(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.

Sec. 8.

[62V.07] FUNDS.

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.

Sec. 9.

[62V.08] REPORT.

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.

Sec. 10.

[62V.09] EXPIRATION AND SUNSET EXCLUSION.

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.

Sec. 11. TRANSITION OF AUTHORITY.

(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).

(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.

Sec. 12. MINNESOTA COMPREHENSIVE HEALTH INSURANCE
TERMINATION.

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.

Sec. 13. EFFECTIVE DATE.

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.

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700 State Office Building, 100 Rev. Dr. Martin Luther King Jr. Blvd., St. Paul, MN 55155 ♦ Phone: (651) 296-2868 ♦ TTY: 1-800-627-3529 ♦ Fax: (651) 296-0569