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Minnesota Legislature

Office of the Revisor of Statutes

HF 5

9th Engrossment - 88th Legislature (2013 - 2014) Posted on 03/21/2013 08:32am

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; prohibiting abortion coverage with certain
exemptions; recognizing the right to a person's physician of choice; establishing
the right not to participate; specifying open meeting requirements and data
practices procedures; 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 MAGI public health care program. new text end

new text begin "MAGI public health care
program" means any exchange enrollment 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 informed consumer choice through innovation, competition, quality,
value, market participation, affordability, suitable and 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 MAGI public health care programs, premium
assistance tax credits and cost-sharing reductions, and certificates of exemption from
individual responsibility requirements;
new text end

new text begin (4) facilitate the integration and transition of individuals between MAGI public
health care programs and health benefit plans in the individual or group market and
develop processes that, to the maximum extent possible, provide for continuous coverage;
new text end

new text begin (5) establish a name for the Web-based exchange based on market studies that show
maximum effectiveness in attracting the uninsured and motivating them to take action; and
new text end

new text begin (6) evaluate the effectiveness of the outreach and implementation activities of the
Minnesota Insurance Marketplace in reducing the rate of uninsurance in Minnesota and
in addressing the above responsibilities.
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
must be reviewed by the legislative auditor under section 3.971. The legislative auditor
shall audit the books, accounts, and affairs of the Minnesota Insurance Marketplace
once each year or less frequently as the legislative auditor's funds and personnel permit.
Pursuant to section 3.97, subdivision 3a, the Legislative Audit Commission is requested
to direct the legislative auditor to report by March 1, 2014, to the legislature on any
duplication of services that occurs within state government as a result of the creation of the
Minnesota Insurance Marketplace. The legislative auditor may make recommendations on
consolidating or eliminating any services deemed duplicative. The board shall reimburse
the legislative auditor for any costs incurred in the creation of this report.
new text end

new text begin (b) Board members of the Minnesota Insurance Marketplace are subject to section
10A.07. Board members 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, or portions of meetings, regarding compensation negotiations with the
director or managerial staff may be closed in the same manner and according to the same
procedures identified in section 13D.03;
new text end

new text begin (2) meetings regarding contract negotiation strategy may be closed in the same
manner and according to the same procedures identified in section 13D.05, subdivision 3,
paragraph (c); and
new text end

new text begin (3) meetings, or portions of meetings, regarding not public data described in section
62V.06, subdivision 2, and regarding trade secret information as defined in section 13.37,
subdivision 1, paragraph (b), are closed to the public, but must otherwise comply with
the procedures identified in chapter 13D.
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 but not sections 14.48 to 14.69; and
new text end

new text begin (2) chapters 16B and 16C, with the exception of sections 16C.08, subdivision
2, paragraph (b), clauses (1) to (8); 16C.086; 16C.09, paragraph (a), clauses (1) and
(3), paragraph (b), and paragraph (c); and section 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.
new text end

new text begin Subd. 3. new text end

new text begin Continued operation of a private marketplace. new text end

new text begin (a) Nothing in this
chapter shall be construed to prohibit: (1) a health carrier from offering outside of
the Minnesota Insurance Marketplace a health benefit plan to a qualified individual
or qualified employer; and (2) a qualified individual from enrolling in, or a qualified
employer from selecting for its employees, a health benefit plan offered outside of the
Minnesota Insurance Marketplace.
new text end

new text begin (b) Nothing in this chapter shall be construed to restrict the choice of a qualified
individual to enroll or not enroll in a qualified health plan or to participate in the Minnesota
Insurance Marketplace. Nothing in this chapter shall be construed to compel an individual
to enroll in a qualified health plan or to participate in the Minnesota Insurance Marketplace.
new text end

new text begin (c) For purposes of this subdivision, "qualified individual" and "qualified employer"
have the meanings given in section 1312 of the Affordable Care Act, Public Law 111-148,
and further defined through amendments to the act and regulations issued under the act.
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 appointed by the governor with the advice and consent of both
the senate and the house of representatives acting separately in accordance with paragraph
(d), with one member representing the interests of individual consumers eligible for
individual market coverage, one member representing individual consumers eligible
for MAGI public health care program coverage, and one member representing small
employers. Members are appointed to serve four-year staggered terms following the
initial staggered-term lot determination;
new text end

new text begin (2) three members appointed by the governor with the advice and consent of both the
senate and the house of representatives acting separately in accordance with paragraph (d)
who have demonstrated expertise, leadership, and innovation in the following areas: one
member representing the areas of health administration, health care finance, health plan
purchasing, and health care delivery systems; one member representing the areas of public
health, health disparities, MAGI public health care programs, and the uninsured; and
one member representing health policy issues related to the small group and individual
markets. Members are appointed to serve four-year staggered terms following the initial
staggered-term lot determination; 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) The governor shall make appointments to the board that are consistent with
federal law and regulations regarding its composition and structure.
new text end

new text begin (d) Upon appointment by the governor, a board member shall exercise duties of
office immediately. If both the house of representatives and the senate vote not to confirm
an appointment, the appointment terminates on the day following the vote not to confirm
in the second body to vote.
new text end

new text begin (e) Initial appointments shall be made by April 30, 2013.
new text end

new text begin (f) One of the members appointed under paragraph (a), clauses (1) and (2), must have
experience in representing the needs of vulnerable populations and persons with disabilities.
new text end

new text begin (g) Membership on the board must include representation from outside the
seven-county metropolitan area, as defined in section 473.121, subdivision 2.
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.
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, institutional health care provider or
other entity providing health care, navigator, insurance producer, or other entity in the
business of selling items or services of significant value to or through the Minnesota
Insurance Marketplace. No member of the board may currently serve as a lobbyist, as
defined under section 10A.01, subdivision 21.
new text end

new text begin (b) Directors must recuse themselves from discussion of and voting on an official
matter if the director has a conflict of interest. A conflict of interest means an association
including a financial or personal association that has the potential to bias or have the
appearance of biasing a director's decisions in matters related to the exchange or the
conduct of activities under this act.
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 that was appointed
by the governor, the governor shall appoint a new member within 90 days, and the
newly appointed member shall be subject to the same confirmation process described in
subdivision 2.
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.
This authority is subject to chapters 43A and 179A. 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. No
revenue raising effort shall advantage any specific health benefit plan, health carrier, or
insurer producer active in the business 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, including the requirements of
section 62V.06; and
new text end

new text begin (6) exercise all powers reasonably necessary to implement and administer the
requirements of this chapter and the Affordable Care Act, Public Law 111-148.
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 (e) If the board's policies, procedures, or other statements are rules, as defined in
section 14.02, subdivision 4, the following requirements apply:
new text end

new text begin (1) the board shall publish proposed rules in the State Register;
new text end

new text begin (2) interested parties have 30 days to comment on the proposed rules. The board
must consider comments it receives. After the board has considered all comments, the
board shall publish the final rule in the State Register;
new text end

new text begin (3) if the adopted rules are the same as the proposed rules, the notice shall state that
the rules have been adopted as proposed and shall cite the prior publication. If the adopted
rules differ from the proposed rules, the portions of the adopted rules that differ from the
proposed rules shall be included in the notice of adoption, together with a citation to the
prior State Register that contained the notice of the proposed rules; and
new text end

new text begin (4) rules published in the State Register before January 1, 2014, take effect upon
publication. Rules published in the State Register on and after January 1, 2014, take
effect 30 days after publication.
new text end

new text begin Subd. 2. new text end

new text begin Operations funding. new text end

new text begin (a) Prior to January 1, 2015, the Minnesota
Insurance Marketplace shall retain or collect up to 3.5 percent of total premiums for
individual market and small group market health benefit plans sold through the Minnesota
Insurance Marketplace to fund cash reserves of the Minnesota Insurance Marketplace, but
the amount collected shall not exceed a dollar amount equal to 25 percent of the funds
collected under section 62E.11, subdivision 6, for calendar year 2012.
new text end

new text begin (b) Beginning January 1, 2015, the Minnesota Insurance Marketplace shall 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 operations of the
Minnesota Insurance Marketplace, but the amount collected shall not exceed a dollar
amount equal to 50 percent of the funds collected under section 62E.11, subdivision 6,
for calendar year 2012.
new text end

new text begin (c) Beginning January 1, 2016, the Minnesota Insurance Marketplace shall 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 operations
of the Minnesota Insurance Marketplace, but the annual growth in the amount collected
or retained shall not exceed the annual rate of inflation after accounting for year-to-year
enrollment changes and may never exceed 100 percent of the funds collected under section
62E.11, subdivision 6, for calendar year 2012.
new text end

new text begin Subd. 3. new text end

new text begin Abortion coverage prohibited. new text end

new text begin (a) No abortion coverage may be provided
by a qualified health benefit plan offered through the Minnesota Insurance Marketplace
created pursuant to the Affordable Care Act, Public Law 111-148.
new text end

new text begin (b) This limitation shall not apply to an abortion:
new text end

new text begin (1) performed to prevent the death of the mother;
new text end

new text begin (2) when the pregnancy is the result of criminal sexual conduct as defined in
section 609.342, subdivision 1, clauses (c), (d), (e), item (i), and (f), and the incident is
reported within 48 hours after the incident occurs to a valid law enforcement agency for
investigation, unless the victim is physically unable to report the criminal sexual conduct,
in which case the report shall be made within 48 hours after the victim becomes physically
able to report the criminal sexual conduct; or
new text end

new text begin (3) when the pregnancy is the result of incest, but only if the incident and relative are
reported to a valid law enforcement agency for investigation prior to the abortion.
new text end

new text begin Subd. 4. new text end

new text begin Insurance producers. new text end

new text begin (a) The board, in consultation with the
commissioner of commerce, shall establish minimum standards for certifying insurance
producers who may sell health benefit plans through the Minnesota Insurance Marketplace.
Producers must complete four hours of training in order to receive certification. The
training must include online enrollment tools, compliance with privacy and security
standards, an assessment of the affordability of various cost-sharing responsibilities, how
to evaluate known health needs for that individual and the likely health needs for the
relevant age group, the eligibility requirements for premium assistance and MAGI public
health care programs, the availability of navigator assistance and enrollment support,
tax provisions that may apply to group health benefit plan purchases, and Minnesota
specific programs and marketplace laws. Certification and training shall be administered
by the commissioner of commerce, and the training required under this section shall
qualify as continuing education required under chapter 60K. In order to remain certified
under this subdivision, insurance producers must comply with all applicable certification
requirements, including the requirements established under paragraphs (d) and (e). A
person shall not sell, solicit, or negotiate insurance for any class or classes of insurance
unless the person is licensed for that line of authority under sections 60K.30 to 60K.56.
new text end

new text begin (b) Producer compensation shall be established by health carriers that provide health
benefit plans through the Minnesota Insurance Marketplace. Compensation to producers
must be equivalent for health benefit plans sold through the marketplace or outside the
marketplace.
new text end

new text begin (c) Each health carrier that offers or sells health benefit plans through the Minnesota
Insurance Marketplace shall report in writing to the marketplace on a quarterly basis the
compensation and other incentives it offers or provides to its insurance producers with
regard to each type of health benefit plan the health carrier offers or sells both inside and
outside the marketplace.
new text end

new text begin (d) Nothing in this act shall prohibit an insurance producer from offering professional
advice and recommendations to a small group purchaser based upon information provided
to the producer.
new text end

new text begin (e) An insurance producer that offers health benefit plans in the individual market
must not sell or renew an individual health benefit plan to a person whose income
indicates the person may be eligible for either premium assistance or a MAGI public
health program, without first informing the person of the person's potential eligibility for
premium assistance or a MAGI public health program and either offering assistance in
determining the person's eligibility, or referring the person for assistance in determining
eligibility. Nothing in this paragraph prohibits an individual from refusing to apply for
any public program or tax credit.
new text end

new text begin (f) An insurance producer that offers health benefit plans in the small group market
shall notify each small group purchaser of which group health benefit plans qualify for
Internal Revenue Service approved section 125 tax benefits. The insurance producer shall
also notify small group purchasers of state law provisions that benefit small group plans
when the employer agrees to pay 50 percent or more of its employees' premium. Persons
who are eligible for cost-effective medical assistance will count toward the 75 percent
participation requirement in section 62L.03, subdivision 3.
new text end

new text begin (g) Any insurance producer assisting an individual or small employer with
purchasing coverage through the Minnesota Insurance Marketplace must disclose, orally
and in writing, to the individual or small employer at the time of the first solicitation with
the prospective purchaser the following:
new text end

new text begin (1) the health carriers and qualified health plans offered through the Minnesota
Insurance Marketplace that the producer is authorized to sell, and that the producer may
not be authorized to sell all the qualified health plans offered through the Minnesota
Insurance Marketplace;
new text end

new text begin (2) the producer may be receiving compensation from a health carrier for enrolling
the individual or small employer into a particular health plan; and
new text end

new text begin (3) information on all qualified health plans offered through the Minnesota Insurance
Marketplace is available through the Minnesota Insurance Marketplace Web site.
new text end

new text begin For purposes of this paragraph, "solicitation" means any contact by a producer, or any
person acting on behalf of a producer made for the purpose of selling or attempting to sell
coverage through the Minnesota Insurance Marketplace. If the first solicitation is made by
telephone, the disclosures required under this paragraph need not be made in writing, but
the fact that disclosure has been made must be memorialized when the policy is delivered.
new text end

new text begin Subd. 5. new text end

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

new text begin (a) The board shall 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. The policies and procedures
must require that a person complete at least eight hours of training specific to helping
people obtain insurance through the exchange before working as an in-person assister or
before working as or on behalf of a navigator directly with people seeking insurance
through the exchange.
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 board shall establish requirements and compensation for the in-person
assister program by April 30, 2013. 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 board 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 (d) In establishing training standards for the navigator program, the board must
ensure that all entities and individuals carrying out navigator functions have training in
the needs of underserved and vulnerable populations; eligibility and enrollment rules
and procedures; the range of available public health care programs and qualified health
plan options available through the Minnesota Insurance Marketplace; and privacy and
security standards. For calendar year 2014, the commissioner of human services shall
ensure that the program under section 256.962 provides application assistance for both
qualified health plans offered through the Minnesota Insurance Marketplace and public
health care programs.
new text end

new text begin (e) Any individual or entity acting as a navigator or in-person assister shall be
personally liable for all damages resulting from the individual's or entity's acts or
omissions in providing assistance to marketplace participants.
new text end

new text begin Subd. 6. 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) For certification requirements established by the board under paragraph (a), the
board shall establish network adequacy requirements that are not inconsistent with the
most popular health benefit plans offered through the Minnesota Insurance Marketplace
under paragraph (c) in 2014 or 2015.
new text end

new text begin (c) No health carrier shall be required to participate in the Minnesota Insurance
Marketplace. Beginning January 1, 2015, for those health carriers that opt to participate in
the Minnesota Insurance Marketplace, the board shall approve two health benefit plans,
of which one must be the most popular health benefit plan that a health carrier offers at
each of the catastrophic, bronze, silver, and gold actuarial value levels for each service
area in which the health carrier offers coverage in the individual and small group markets.
The most popular health benefit plan is determined by the highest enrollment inside and
outside the Minnesota Insurance Marketplace by number of lives at the end of the open
enrollment period in the preceding year, excluding health benefit plans closed to new
enrollment as of the preceding year. In determining the most popular health benefit
plans, health benefit plans offered in the individual market prior to January 1, 2014, are
not included. If a health carrier participating in the Minnesota Insurance Marketplace
offers less than two health benefit plans in an actuarial value level or service area in the
individual or small group market, the health carrier shall offer all health benefit plans it
offers in that actuarial value level or service area in the individual or small group market
in the Minnesota Insurance Marketplace.
new text end

new text begin (d) If a health carrier or parent organization participating in the Minnesota Insurance
Marketplace offers health benefit plans outside the Minnesota Insurance Marketplace in
the individual or small group market, the health carrier must offer health benefit plans
at the silver and gold actuarial levels outside the Minnesota Insurance Marketplace for
each service area in which the health carrier offers coverage in the individual and small
group markets.
new text end

new text begin (e) Beginning January 1, 2015, the board has the power to select health benefit plans
in addition to those specified in paragraph (c) to participate in the Minnesota Insurance
Marketplace. In the selection process, the board shall seek to provide health coverage
choices that offer the optimal combination of choice, value, quality, and service. Selection
of additional health benefit plans must be determined in the best interests of individual
consumers and employers and within federal requirements. The board shall consistently
and uniformly apply requirements, standards, and criteria to all health carriers and health
benefit plans. In determining the best interests, the board shall consider:
new text end

new text begin (1) affordability and value;
new text end

new text begin (2) promotions of high-quality care;
new text end

new text begin (3) promotion of prevention and wellness;
new text end

new text begin (4) ensuring access to care;
new text end

new text begin (5) alignment and coordination with state agency and private sector purchasing
strategies and payment reform efforts; and
new text end

new text begin (6) other criteria that the board determines appropriate.
new text end

new text begin (f) 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 the 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 (g) For 2014, the board shall not have the power to select health carriers and health
benefit plans for participation in the Minnesota Insurance Marketplace. The board shall
have the power to verify that health carriers and health benefit plans were properly
certified under certification guidance in place on January 1, 2013, to be eligible for
participation in the Minnesota Insurance Marketplace. Notwithstanding the foregoing, any
catastrophic health plan, as defined in section 1302(e) of the federal Patient Protection
and Affordable Care Act (Public Law 111-148), shall be eligible for participation in the
Minnesota Insurance Marketplace in 2014.
new text end

new text begin (h) The board has the authority to decertify health carriers and health benefit plans
that fail to maintain compliance with section 1311(c) of the federal Patient Protection and
Affordable Care Act (Public Law 111-148).
new text end

new text begin Subd. 7. 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). An appeal
by a health carrier regarding a specific certification or selection determination made by
the Minnesota Insurance Marketplace under subdivision 6, paragraph (a) or (b), must be
conducted as a contested case proceeding under chapter 14, with the report or order of
the administrative law judge constituting the final decision in the case, subject to judicial
review under sections 14.63 to 14.69. For other appeals, the board shall establish hearing
processes which provide for a reasonable opportunity to be heard and timely resolution of
the appeal and which are consistent with the requirements of federal law and guidance.
An appealing party may be represented by legal counsel at these hearings, but this is
not a requirement.
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. 8. 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 MAGI 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
MAGI public health care programs. The board may establish and maintain an agreement
with the commissioner of human services for other services;
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; and
new text end

new text begin (4) establish interagency agreements to transfer funds to other state agencies for
their costs related to implementing and operating the Minnesota Insurance Marketplace,
excluding medical assistance allocatable costs.
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 an advisory committee consisting of representatives
from the health care industry, consumers, and other stakeholders to provide information
and advise the board on the operations of the Minnesota Insurance Marketplace.
new text end

new text begin Subd. 9. new text end

new text begin Limitations; risk-bearing. new text end

new text begin (a) The board shall not bear insurance risk or
enter into any agreement with health care providers to pay claims.
new text end

new text begin (b) Nothing in this subdivision shall prevent the Minnesota Insurance Marketplace
from providing insurance for its employees.
new text end

Sec. 7.

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

new text begin Subdivision 1. new text end

new text begin Applicability. new text end

new text begin The Minnesota Insurance Marketplace is a state
agency for purposes of the Minnesota Government Data Practices Act and is subject to all
provisions of chapter 13, in addition to the requirements contained in this section.
new text end

new text begin Subd. 2. new text end

new text begin Definitions. new text end

new text begin As used in this section:
new text end

new text begin (1) "individual" means an individual according to section 13.02, subdivision 8, but
does not include a vendor of services; and
new text end

new text begin (2) "participating" means that an individual, employee, or employer is seeking, or
has sought an eligibility determination, enrollment processing, or premium processing
through the Minnesota Insurance Marketplace.
new text end

new text begin Subd. 3. new text end

new text begin General data classifications. new text end

new text begin The following data collected, created, or
maintained by the Minnesota Insurance Marketplace (Marketplace) are classified as
private data on individuals, as defined in section 13.02, subdivision 12, or nonpublic data,
as defined in section 13.02, subdivision 9:
new text end

new text begin (1) data on any individual participating in the Marketplace;
new text end

new text begin (2) data on any individuals participating in the Marketplace as employees of an
employer participating in the Marketplace; and
new text end

new text begin (3) data on employers participating in the Marketplace.
new text end

new text begin Subd. 4. new text end

new text begin Application and certification data. new text end

new text begin (a) Data submitted by an insurance
producer in an application for certification to sell a health benefit plan through the
Marketplace, or submitted by an applicant seeking permission or a commission to act as a
navigator or in-person assister, are classified as follows:
new text end

new text begin (1) at the time the application is submitted, all data contained in the application are
private data, as defined in section 13.02, subdivision 12, or nonpublic data as defined in
section 13.02, subdivision 9, except that the name of the applicant is public; and
new text end

new text begin (2) upon a final determination related to the application for certification by the
Marketplace, all data contained in the application are public, with the exception of trade
secret data as defined in section 13.37.
new text end

new text begin (b) Data created or maintained by a government entity as part of the evaluation of
an application are protected nonpublic data, as defined in section 13.02, subdivision 13,
until a final determination as to certification is made and all rights of appeal have been
exhausted. Upon a final determination and exhaustion of all rights of appeal, these data are
public, with the exception of trade secret data as defined in section 13.37 and data subject
to attorney-client privilege or other protection as provided in section 13.393.
new text end

new text begin (c) If an application is denied, the public data must include the criteria used by the
board to evaluate the application and the specific reasons for the denial, and these data
must be published on the Marketplace Web site.
new text end

new text begin Subd. 5. new text end

new text begin Data sharing. new text end

new text begin (a) The Minnesota Insurance Marketplace may share or
disseminate data classified as private or nonpublic in subdivision 4 as follows:
new text end

new text begin (1) to the subject of the data, as provided in section 13.04;
new text end

new text begin (2) according to a court order;
new text end

new text begin (3) according to a state or federal law specifically authorizing access to the data;
new text end

new text begin (4) with other state or federal agencies, only to the extent necessary to verify the
identity of, determine the eligibility of, process premiums for, process enrollment of, or
investigate fraud related to an individual, employer, or employee participating in the
Marketplace, provided that the Marketplace must enter into a data-sharing agreement with
the agency prior to sharing data under this clause; and
new text end

new text begin (5) with a nongovernmental person or entity, only to the extent necessary to verify
the identity of, determine the eligibility of, process premiums for, process enrollment
of, or investigate fraud related to an individual, employer, or employee participating in
the Marketplace, provided that the Marketplace must enter a contract with the person
or entity, as provided in section 13.05, subdivision 6 or 11, prior to disseminating data
under this clause.
new text end

new text begin (b) The Minnesota Insurance Marketplace may share or disseminate data classified
as private or nonpublic in subdivision 4 as follows:
new text end

new text begin (1) to the subject of the data, as provided in section 13.04;
new text end

new text begin (2) according to a court order;
new text end

new text begin (3) according to a state or federal law specifically authorizing access to the data;
new text end

new text begin (4) with other state or federal agencies, only to the extent necessary to carry out the
functions of the Marketplace, provided that the Marketplace must enter into a data-sharing
agreement with the agency prior to sharing data under this clause; and
new text end

new text begin (5) with a nongovernmental person or entity, only to the extent necessary to carry
out the functions of the Marketplace, provided that the Marketplace must enter a contract
with the person or entity, as provided in section 13.05, subdivision 6 or 11, prior to
disseminating data under this clause.
new text end

new text begin (c) Sharing or disseminating data outside of the exchange in a manner not authorized
by this subdivision is prohibited. The list of authorized dissemination and sharing
contained in this subdivision must be included in the Tennessen warning required by
section 13.04, subdivision 2.
new text end

new text begin (d) Until July 1, 2014, state agencies must share data classified as private or
nonpublic on individuals, employees, or employers participating in the Marketplace with
the Marketplace, only to the extent such data are necessary to verify the identity of,
determine the eligibility of, process premiums for, process enrollment of, or investigate
fraud related to a Marketplace participant. The agency must enter into a data-sharing
agreement with the Marketplace prior to sharing any data under this paragraph.
new text end

new text begin (e) The Minnesota Insurance Marketplace may not share or disseminate outside of
the marketplace data that indicates whether or not an individual or employee participating
in the marketplace has a history of tobacco use or owns a gun or has a firearm in their home.
new text end

new text begin Subd. 6. new text end

new text begin Notice and disclosures. new text end

new text begin (a) In addition to the Tennessen warning required
by section 13.04, subdivision 2, the Marketplace must provide any data subject asked to
supply private data with:
new text end

new text begin (1) a notice of rights related to the handling of genetic information, pursuant to
section 13.386; and
new text end

new text begin (2) a notice of the records retention policy of the Marketplace, detailing the length of
time the Marketplace will retain data on the individual and the manner in which it will
be destroyed upon expiration of that time.
new text end

new text begin (b) All notices required by this subdivision, including the Tennessen warning, must
be provided in an electronic format suitable for downloading or printing.
new text end

new text begin Subd. 7. new text end

new text begin Summary data. new text end

new text begin In addition to creation and disclosure of summary data
derived from private data on individuals, as permitted by section 13.05, subdivision 7,
the Marketplace may create and disclose summary data derived from data classified as
nonpublic under this section.
new text end

new text begin Subd. 8. new text end

new text begin Access to data; audit trail. new text end

new text begin (a) Only individuals with explicit authorization
from the board may enter, update, or access not public data collected, created, or
maintained by the Marketplace. The ability of authorized individuals to enter, update, or
access data must be limited through the use of role-based access that corresponds to
the official duties or training level of the individual, and the statutory authorization that
grants access for that purpose. All queries and responses, and all actions in which data are
entered, updated, accessed, or shared or disseminated outside of the marketplace, must
be recorded in a data audit trail. Data contained in the audit trail are public, to the extent
that the data are not otherwise classified by this section.
new text end

new text begin The board shall immediately and permanently revoke the authorization of any
individual determined to have willfully entered, updated, accessed, shared, or disseminated
data in violation of this section, or any provision of chapter 13. If an individual is
determined to have willfully gained access to data without explicit authorization from the
board, the board shall forward the matter to the county attorney for prosecution.
new text end

new text begin (b) This subdivision shall not limit or affect the authority of the legislative auditor to
access data needed to conduct audits, evaluations, or investigations of the Marketplace
or the obligation of the board and Marketplace employees to comply with section 3.978,
subdivision 2.
new text end

new text begin (c) This subdivision does not apply to actions taken by a Minnesota Insurance
Marketplace participant to enter, update, or access data held by the Minnesota Insurance
Marketplace, if the participant is the subject of the data that is entered, updated, or accessed.
new text end

new text begin Subd. 9. new text end

new text begin Sale of data prohibited. new text end

new text begin The Marketplace may not sell any data collected,
created, or maintained by the Marketplace, regardless of its classification, for commercial
or any other purposes.
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 account in the special revenue fund which may earn interest and are appropriated
to the Minnesota Insurance Marketplace for the purpose for which the funds were received.
new text end

Sec. 9.

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

new text begin (a) 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

new text begin (b) The exchange must publish the administrative and operational costs of the
exchange on a Web site to educate consumers on those costs. The information published
must include the amount of premiums and federal premium subsidies collected by the
exchange; the amount and source of revenue received under section 62V.05, subdivision
1, paragraph (b), clause (3); the amount and source of any other fees collected by the
exchange for purposes of supporting its operations; and any misuse of funds as identified
in accordance with section 3.975. The Web site must be updated at least annually.
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 begin [62V.10] RIGHT NOT TO PARTICIPATE.
new text end

new text begin Nothing in this chapter infringes on the right of a Minnesota citizen not to participate
in the Minnesota Insurance Marketplace.
new text end

Sec. 12.

new text begin [62V.11] RIGHT TO PHYSICIAN OF CHOICE.
new text end

new text begin Nothing in this chapter shall prohibit a person using a federal premium tax credit or
cost-sharing subsidy to purchase a health benefit plan through the Minnesota Insurance
Exchange from receiving care from the physician of their choice.
new text end

Sec. 13. 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. 14. new text beginMINNESOTA COMPREHENSIVE HEALTH ASSOCIATION.
new text end

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

Sec. 15. new text beginEFFECTIVE DATE.
new text end

new text begin Sections 1 to 14 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