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SF 139

3rd Engrossment - 89th Legislature (2015 - 2016) Posted on 08/13/2015 02:33pm

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Current Version - 3rd Engrossment

A bill for an act
relating to health; eliminating the MNsure Board; designating MNsure as a
state agency; regulating MNsure operations; changing rulemaking provisions;
amending Minnesota Statutes 2014, sections 15.01; 15A.0815, subdivision 2;
62A.02, subdivision 2; 62V.02, subdivisions 2, 11; 62V.03; 62V.04; 62V.05;
62V.06; 62V.07; 62V.08; 62V.09; 256.962, subdivision 5; repealing Minnesota
Statutes 2014, section 62V.11.

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

Section 1.

Minnesota Statutes 2014, section 15.01, is amended to read:


15.01 DEPARTMENTS OF THE STATE.

The following agencies are designated as the departments of the state government:
the Department of Administration; the Department of Agriculture; the Department of
Commerce; the Department of Corrections; the Department of Education; the Department
of Employment and Economic Development; the Department of Health; the Department
of Human Rights; the Department of Labor and Industry; the Department of Management
and Budget; the Department of Military Affairs; the Department of Natural Resources;
the Department of Public Safety; the Department of Human Services; the Department of
Revenue; the Department of Transportation; the Department of Veterans Affairs; the
Department of MNsure;
and their successor departments.

Sec. 2.

Minnesota Statutes 2014, section 15A.0815, subdivision 2, is amended to read:


Subd. 2.

Group I salary limits.

The salary for a position listed in this subdivision
shall not exceed 133 percent of the salary of the governor. This limit must be adjusted
annually on January 1. The new limit must equal the limit for the prior year increased
by the percentage increase, if any, in the Consumer Price Index for all urban consumers
from October of the second prior year to October of the immediately prior year. The
commissioner of management and budget must publish the limit on the department's Web
site. This subdivision applies to the following positions:

Commissioner of administration;

Commissioner of agriculture;

Commissioner of education;

Commissioner of commerce;

Commissioner of corrections;

Commissioner of health;

Commissioner, Minnesota Office of Higher Education;

Commissioner, Housing Finance Agency;

Commissioner of human rights;

Commissioner of human services;

Commissioner of labor and industry;

Commissioner of management and budget;

Commissioner of MNsure;

Commissioner of natural resources;

Commissioner, Pollution Control Agency;

Executive director, Public Employees Retirement Association;

Commissioner of public safety;

Commissioner of revenue;

Executive director, State Retirement System;

Executive director, Teachers Retirement Association;

Commissioner of employment and economic development;

Commissioner of transportation; and

Commissioner of veterans affairs.

Sec. 3.

Minnesota Statutes 2014, section 62A.02, subdivision 2, is amended to read:


Subd. 2.

Approval.

(a) The health plan form shall not be issued, nor shall any
application, rider, endorsement, or rate be used in connection with it, until the expiration
of 60 days after it has been filed unless the commissioner approves it before that time.

(b) Notwithstanding paragraph (a), a rate filed with respect to a policy of accident and
sickness insurance as defined in section 62A.01 by an insurer licensed under chapter 60A,
may be used on or after the date of filing with the commissioner. Rates that are not approved
or disapproved within the 60-day time period are deemed approved. This paragraph does
not apply to Medicare-related coverage as defined in section 62A.3099, subdivision 17.

(c) For coverage to begin on or after January 1, 2016, and each January 1 thereafter,
health plans in the individual and small group markets that are not grandfathered plans to
be offered outside MNsure and qualified health plans to be offered inside MNsure must
receive rate approval from the commissioner no later than 30 days prior to the beginning
of the annual open enrollment period for MNsure. Premium rates for all carriers in the
applicable market for the next calendar year must be made available to the public by the
commissioner only after all rates for the applicable market are final and approved. Final
and approved rates must be publicly released at a uniform time for all individual and small
group health plans that are not grandfathered plans to be offered outside MNsure and
qualified health plans to be offered inside MNsure, and no later than 30 days prior to the
beginning of the annual open enrollment period for MNsure.

Sec. 4.

Minnesota Statutes 2014, section 62V.02, subdivision 2, is amended to read:


Subd. 2.

Board Commissioner.

"Board" "Commissioner" means the Board of
Directors
commissioner of MNsure specified in section 62V.04.

Sec. 5.

Minnesota Statutes 2014, section 62V.02, subdivision 11, is amended to read:


Subd. 11.

Qualified health plan.

"Qualified health plan" means a health plan that
meets the definition in section 1301(a) of the Affordable Care Act, Public Law 111-148,
and has been certified by the board commissioner in accordance with section 62V.05,
subdivision 5
, to be offered through MNsure.

Sec. 6.

Minnesota Statutes 2014, section 62V.03, is amended to read:


62V.03 MNSURE; ESTABLISHMENT.

Subdivision 1.

Creation.

MNsure is created as a board under section 15.012,
paragraph (a),
department of the state government under section 15.01 to:

(1) promote informed consumer choice, innovation, competition, quality, value,
market participation, affordability, suitable and meaningful choices, health improvement,
care management, reduction of health disparities, and portability of health plans;

(2) facilitate and simplify the comparison, choice, enrollment, and purchase of
health plans for individuals purchasing in the individual market through MNsure and for
employees and employers purchasing in the small group market through MNsure;

(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;

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

(5) establish and modify as necessary a name and brand for MNsure based on market
studies that show maximum effectiveness in attracting the uninsured and motivating
them to take action.

Subd. 2.

Application of other law.

(a) MNsure must be reviewed is subject to
audit
by the legislative auditor under section 3.971. The legislative auditor shall audit
the books, accounts, and affairs of MNsure once each year or less frequently as the
legislative auditor's funds and personnel permit. Upon the audit of the financial accounts
and affairs of MNsure, MNsure is liable to the state for the total cost and expenses of the
audit, including the salaries paid to the examiners while actually engaged in making the
examination. The legislative auditor may bill MNsure either monthly or at the completion
of the audit. All collections received for the audits must be deposited in the general fund
and are appropriated to the legislative auditor. 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 MNsure. 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.

(b) Board members of MNsure are subject to sections 10A.07 and 10A.09. Board
members and the personnel of MNsure 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, 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;

(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

(3) meetings, or portions of meetings, regarding not public data described in section
62V.06, subdivision 3, 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.

(d) (b) MNsure and provisions specified under this chapter are exempt from:

(1) chapter 14, including section 14.386 , except as specified in section 62V.05 ; and

(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, MNsure the
commissioner
, in consultation with the commissioner of administration, shall implement
policies and procedures to establish an open and competitive procurement process
for MNsure that, to the extent practicable, conforms to the principles and procedures
contained in chapters 16B and 16C. In addition, MNsure the commissioner may enter into
an agreement with the commissioner of administration for other services.

(e) The board and (c) The Web site are is exempt from chapter 60K. Any employee
of MNsure who sells, solicits, or negotiates insurance to individuals or small employers
must be licensed as an insurance producer under chapter 60K.

(f) (d) Section 3.3005 applies to any federal funds received by MNsure.

(g) MNsure is exempt from the following sections in chapter 16E: 16E.01,
subdivision 3
, paragraph (b); 16E.03, subdivisions 3 and 4; 16E.04, subdivision 1,
subdivision 2, paragraph (c), and subdivision 3, paragraph (b); 16E.0465; 16E.055;
16E.145; 16E.15; 16E.16; 16E.17; 16E.18; and 16E.22.

(h) A MNsure decision that requires a vote of the board, other than a decision that
applies only to hiring of employees or other internal management of MNsure, is an
"administrative action" under section 10A.01, subdivision 2.

Subd. 3.

Continued operation of a private marketplace.

(a) Nothing in this
chapter shall be construed to prohibit: (1) a health carrier from offering outside of MNsure
a health 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 plan
offered outside of MNsure.

(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 MNsure.
Nothing in this chapter shall be construed to compel an individual to enroll in a qualified
health plan or to participate in MNsure.

(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.

Sec. 7.

Minnesota Statutes 2014, section 62V.04, is amended to read:


62V.04 GOVERNANCE.

Subdivision 1.

Board.

MNsure is governed by a board of directors with seven
members.

Subd. 2.

Appointment.

(a) Board membership of MNsure consists of the following:

(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 public health
care program coverage, and one member representing small employers. Members are
appointed to serve four-year terms following the initial staggered-term lot determination;

(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, 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 terms following the initial staggered-term lot
determination; and

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

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

(c) The governor shall make appointments to the board that are consistent with
federal law and regulations regarding its composition and structure. All board members
appointed by the governor must be legal residents of Minnesota.

(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.

(e) Initial appointments shall be made by April 30, 2013.

(f) One of the six members appointed under paragraph (a), clause (1) or (2), must
have experience in representing the needs of vulnerable populations and persons with
disabilities.

(g) Membership on the board must include representation from outside the
seven-county metropolitan area, as defined in section 473.121, subdivision 2.

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.

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, 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 MNsure. For purposes of this
paragraph, "health care provider or entity" does not include an academic institution.

(b) Board members must recuse themselves from discussion of and voting on an
official matter if the board member 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 board member's decisions in matters related to MNsure
or the conduct of activities under this chapter.

(c) No board member shall have a spouse who is an executive of a health carrier.

(d) No member of the board may currently serve as a lobbyist, as defined under
section 10A.01, subdivision 21.

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, 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.

Subd. 9.

Removal.

(a) A board member may be removed by the appointing
authority and a majority vote of the board following notice and hearing before the board.
For purposes of this subdivision, the appointing authority or a designee of the appointing
authority shall be a voting member of the board for purposes of constituting a quorum.

(b) 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.

(a) The board members shall be paid a salary not to
exceed the salary limits established under section 15A.0815, subdivision 4. The salary for
board members shall be set in accordance with this subdivision and section 15A.0815,
subdivision 5. This paragraph expires December 31, 2015.

(b) Beginning January 1, 2016, the board members may be compensated in
accordance with section 15.0575.

Subd. 13.

Advisory committees.

(a) The board commissioner shall establish and
maintain advisory committees to provide insurance producers, health care providers, the
health care industry, consumers, and other stakeholders with the opportunity to advise
the board commissioner regarding the operation of MNsure as required under section
1311(d)(6) of the Affordable Care Act, Public Law 111-148. The board commissioner
shall regularly consult with the advisory committees, and, at a minimum, convene each
advisory committee at least quarterly
. The advisory committees established under this
paragraph shall not expire.

(b) The board commissioner may establish additional advisory committees, as
necessary, to gather and provide information to the board commissioner in order to
facilitate the operation of MNsure. The advisory committees established under this
paragraph shall not expire, except by action of by the board commissioner.

(c) Section 15.0597 shall not apply to any advisory committee established by the
board commissioner under this subdivision.

(d) The board commissioner may provide compensation and expense reimbursement
under section 15.059, subdivision 3, to members of the advisory committees.

(e) The advisory committees established under this subdivision are subject to the
open meeting law in chapter 13D.

Sec. 8.

Minnesota Statutes 2014, section 62V.05, is amended to read:


62V.05 RESPONSIBILITIES AND POWERS OF MNSURE.

Subdivision 1.

General.

(a) The board commissioner shall operate MNsure
according to this chapter and applicable state and federal law.

(b) The board commissioner 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.
This authority is subject to chapters 43A and 179A. The director and managerial staff of
MNsure 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 MNsure;

(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 MNsure. No health carrier or insurance
producer shall advertise on MNsure;

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

(5) (3) 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

(6) (4) exercise all powers reasonably necessary to implement and administer the
requirements of this chapter and the Affordable Care Act, Public Law 111-148.

(c) The board commissioner 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 MNsure in accordance with this chapter.

Subd. 2.

Operations funding.

(a) Prior to January 1, 2015, MNsure shall retain or
collect up to 1.5 percent of total premiums for individual and small group market health
plans and dental plans sold through MNsure to fund the cash reserves of MNsure, 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.

(b) Beginning January 1, 2015, MNsure shall retain or collect up to 3.5 percent of
total premiums for individual and small group market health plans and dental plans sold
through MNsure to fund the operations of MNsure, 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.

(c) Beginning January 1, 2016, MNsure shall retain or collect up to 3.5 percent of
total premiums for individual and small group market health plans and dental plans sold
through MNsure to fund the operations of MNsure, but the amount collected may never
exceed a dollar amount greater than 100 percent of the funds collected under section
62E.11, subdivision 6, for calendar year 2012.

(d) For fiscal years 2014 and 2015, the commissioner of management and budget is
authorized to provide cash flow assistance of up to $20,000,000 from the special revenue
fund or the statutory general fund under section 16A.671, subdivision 3, paragraph (a),
to MNsure. Any funds provided under this paragraph shall be repaid, with interest, by
June 30, 2015.

(e) Funding for the operations of MNsure shall cover any compensation provided to
navigators participating in the navigator program.

Subd. 3.

Insurance producers.

(a) By April 30, 2013, The board commissioner, in
consultation with the commissioner of commerce, shall establish certification requirements
that must be met by insurance producers in order to assist individuals and small employers
with purchasing coverage through MNsure. Prior to January 1, 2015, the board may
amend the requirements, only if necessary, due to a change in federal rules.

(b) Certification requirements shall not exceed the requirements established
under Code of Federal Regulations, title 45, part 155.220. Certification shall include
training on health plans available through MNsure, available tax credits and cost-sharing
arrangements, compliance with privacy and security standards, eligibility verification
processes, online enrollment tools, and basic information on available public health care
programs. Training required for certification under this subdivision shall qualify for
continuing education requirements for insurance producers required under chapter 60K,
and must comply with course approval requirements under chapter 45.

(c) Producer compensation shall be established by health carriers that provide health
plans through MNsure. The structure of compensation to insurance producers must be
similar for health plans sold through MNsure and outside MNsure.

(d) Any insurance producer compensation structure established by a health carrier
for the small group market must include compensation for defined contribution plans that
involve multiple health carriers. The compensation offered must be commensurate with
other small group market defined health plans.

(e) Any insurance producer assisting an individual or small employer with purchasing
coverage through MNsure 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:

(1) the health carriers and qualified health plans offered through MNsure that the
producer is authorized to sell, and that the producer may not be authorized to sell all the
qualified health plans offered through MNsure;

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

(3) that information on all qualified health plans offered through MNsure is available
through the MNsure Web site.

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 MNsure. 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 acknowledged on the application.

(f) Beginning January 15, 2015, each health carrier that offers or sells qualified
health plans through MNsure shall report in writing to the board commissioner and the
commissioner of commerce the compensation and other incentives it offers or provides
to insurance producers with regard to each type of health plan the health carrier offers
or sells both inside and outside of MNsure. Each health carrier shall submit a report
annually and upon any change to the compensation or other incentives offered or provided
to insurance producers.

(g) Nothing in this chapter shall prohibit an insurance producer from offering
professional advice and recommendations to a small group purchaser based upon
information provided to the producer.

(h) An insurance producer that offers health plans in the small group market shall
notify each small group purchaser of which group health 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. Individuals
who are eligible for cost-effective medical assistance will count toward the 75 percent
participation requirement in section 62L.03, subdivision 3.

(i) Nothing in this subdivision shall be construed to limit the licensure requirements
or regulatory functions of the commissioner of commerce under chapter 60K.

(j) The commissioners of human services and MNsure, upon federal approval, shall
establish an insurance producer incentive program to compensate insurance producers for
providing application enrollment assistance for public health care programs. The program
must include certification training standards for insurance producers seeking compensation
under the incentive program. The standards must meet the training modules specified under
Minnesota Rules, part 7700.0050, subpart 1. The amount of compensation to be paid to an
insurance producer under this program is established in section 256.962, subdivision 5.

Subd. 4.

Navigator; in-person assisters; call center.

(a) The board commissioner
shall establish policies and procedures for the ongoing operation of a navigator program,
in-person assister program, call center, and customer service provisions for MNsure 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 met by section 256.962;

(2) entities eligible to be navigators, including entities defined in Code of Federal
Regulations, title 45, part 155.210 (c)(2), may serve as in-person assisters;

(3) The board commissioner shall establish requirements and compensation for
the navigator program and the in-person assister program by April 30, 2013. Entities
eligible to be navigators, including entities defined in Code of Federal Regulations, title
45, part 155.210 (c)(2), may serve as in-person assisters.
Compensation for navigators
and in-person assisters must take into account any other compensation received by the
navigator or in-person assister for conducting the same or similar services; and.

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

(c) (d) The board commissioner shall establish a toll-free number for MNsure and
may hire and contract for additional resources as deemed necessary.

(d) (e) The navigator program and in-person assister program must meet the
requirements of section 1311(i) of the Affordable Care Act, Public Law 111-148. In
establishing training standards for the navigators and in-person assisters, the board
commissioner
must ensure that all entities and individuals carrying out navigator and
in-person assister 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 offered through MNsure; and privacy
and security standards. For calendar year 2014, the commissioner of human services shall
ensure that the navigator program under section 256.962 provides application assistance
for both qualified health plans offered through MNsure and public health care programs.

(e) (f) The board commissioner must ensure that any information provided by
navigators, in-person assisters, the call center, or other customer assistance portals be
accessible to persons with disabilities and that information provided on public health
care programs include information on other coverage options available to persons with
disabilities.

Subd. 5.

Health carrier and health plan requirements; participation.

(a)
Beginning January 1, 2015, the board may establish certification requirements for health
carriers and health plans to be offered through MNsure that satisfy federal requirements
under section 1311(c)(1) of the Affordable Care Act, Public Law 111-148.

(b) Paragraph (a) does not apply if by June 1, 2013, the legislature enacts regulatory
requirements that:

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

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

(3) satisfy minimum federal certification requirements under section 1311(c)(1) of
the Affordable Care Act, Public Law 111-148.

(c) (a) In accordance with section 1311(e) of the Affordable Care Act, Public Law
111-148, the board commissioner shall establish policies and procedures for certification
and selection of health plans to be offered as qualified health plans through MNsure. The
board commissioner shall certify and select a health plan as a qualified health plan to
be offered through MNsure, if:

(1) the health plan meets the minimum certification requirements established in
paragraph (a) or
the market state regulatory requirements in paragraph (b);

(2) the board commissioner determines that making the health plan available through
MNsure is in the interest of qualified individuals and qualified employers;

(3) the health carrier applying to offer the health plan through MNsure also applies
to offer health plans at each actuarial value level and service area that the health carrier
currently offers in the individual and small group markets; and

(4) the health carrier does not apply to offer health plans in the individual and
small group markets through MNsure under a separate license of a parent organization
or holding company under section 60D.15, that is different from what the health carrier
offers in the individual and small group markets outside MNsure.

(d) (b) In determining the interests of qualified individuals and employers under
paragraph (c) (a), clause (2), the board commissioner may not exclude a health plan for
any reason specified under section 1311(e)(1)(B) of the Affordable Care Act, Public Law
111-148. The board commissioner may consider:

(1) affordability;

(2) quality and value of health plans;

(3) promotion of prevention and wellness;

(4) promotion of initiatives to reduce health disparities;

(5) market stability and adverse selection;

(6) meaningful choices and access;

(7) alignment and coordination with state agency and private sector purchasing
strategies and payment reform efforts; and

(8) other criteria that the board commissioner determines appropriate.

(e) (c) For qualified health plans offered through MNsure on or after January 1, 2015
2017
, the board commissioner shall establish policies and procedures under paragraphs (c)
and (d)
in accordance with this subdivision for selection of health plans to be offered as
qualified health plans through MNsure by February 1 of each year, beginning February 1,
2014 2016. The board commissioner shall consistently and uniformly apply all policies
and procedures and any requirements, standards, or criteria to all health carriers and
health plans. For any policies, procedures, requirements, standards, or criteria that are
defined as rules under section 14.02, subdivision 4, the board commissioner may use
the process described in subdivision 9 8.

(f) For 2014, the board shall not have the power to select health carriers and health
plans for participation in MNsure. The board shall permit all health plans that meet the
certification requirements under section 1311(c)(1) of the Affordable Care Act, Public
Law 111-148, to be offered through MNsure.

(g) (d) Under this subdivision, the board commissioner shall have the power
to verify that health carriers and health plans are properly certified to be eligible for
participation in MNsure.

(h) (e) The board commissioner has the authority to decertify health carriers and
health plans that fail to maintain compliance with section 1311(c)(1) of the Affordable
Care Act, Public Law 111-148.

(i) (f) For qualified health plans offered through MNsure 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. MNsure shall comply with all future changes
in federal law with regard to health coverage for the tribes.

Subd. 6.

Appeals.

(a) The board commissioner may conduct hearings, appoint
hearing officers, and recommend final orders related to appeals of any MNsure
determinations, except for those determinations identified in paragraph (d). An appeal by a
health carrier regarding a specific certification or selection determination made by MNsure
the commissioner
under subdivision 5 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 commissioner 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.

(b) MNsure The commissioner may establish service-level agreements with
other 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 MNsure the commissioner.

(c) For proceedings under this subdivision, MNsure may be represented by an
attorney who is an employee of MNsure.

(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 commissioner shall:

(1) establish and maintain an agreement with the chief information officer of the
Office of MN.IT Services 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 MN.IT Services for other information
technology services, including an agreement that would permit MNsure to administer
eligibility for additional health care and public assistance programs under the authority
of the commissioner of human services;

(2) (1) 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 that use a modified adjusted gross income
standard to determine program eligibility. The board commissioner may establish and
maintain an agreement with the commissioner of human services for other services;

(3) (2) establish and maintain an agreement with the commissioners of commerce
and health for services regarding enforcement of MNsure certification requirements for
health plans and dental plans offered through MNsure. The board commissioner may
establish and maintain agreements with the commissioners of commerce and health for
other services; and

(4) (3) establish interagency agreements to transfer funds to other state agencies for
their costs related to implementing and operating MNsure, excluding medical assistance
allocatable costs.

(b) The commissioner shall consult with the Office of MN.IT Services and the
commissioner of human services on all decisions that relate to information technology
services to permit MNsure the ability to administer eligibility for public health care
programs and ensure coordination and compatibility between public health care programs
and qualified health plans.

(b) (c) The board commissioner shall consult with the commissioners of commerce
and health regarding the operations of MNsure.

(c) (d) The board commissioner shall consult with Indian tribes and organizations
regarding the operation of MNsure.

(d) (e) Beginning March 15, 2014 2016, and each March 15 thereafter, the board
commissioner
shall submit a report to the chairs and ranking minority members of the
committees in the senate and house of representatives with primary jurisdiction over
commerce, health, and human services on all the agreements entered into with the chief
information officer of the Office of MN.IT Services, or the commissioners of human
services, health, or commerce in accordance with this subdivision. The report shall include
the agency in which the agreement is with; the time period of the agreement; the purpose
of the agreement; and a summary of the terms of the agreement. A copy of the agreement
must be submitted to the extent practicable.

Subd. 8.

Rulemaking.

(a) If the board's policies, procedures, or other statements are
rules, as defined in section 14.02, subdivision 4, the requirements in either paragraph (b)
or (c) apply, as applicable.

(b) Effective upon enactment until January 1, 2015:

(1) the board shall publish notice of proposed rules in the State Register after
complying with section 14.07, subdivision 2;

(2) interested parties have 21 days to comment on the proposed rules. The board
must consider comments it receives. After the board has considered all comments and
has complied with section 14.07, subdivision 2, the board shall publish notice of the
final rule in the State Register;

(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

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

(c) Beginning January 1, 2015, The board commissioner may adopt rules to
implement any provisions in this chapter using the expedited rulemaking process in
section 14.389.

(d) The notice of proposed rules required in paragraph (b) must provide information
as to where the public may obtain a copy of the rules. The board shall post the proposed
rules on the MNsure Web site at the same time the notice is published in the State Register.

Subd. 9.

Dental plans.

(a) The provisions of this section that apply to health plans
shall apply to dental plans offered as stand-alone dental plans through MNsure, to the
extent practicable.

(b) A stand-alone dental plan offered through MNsure must meet all certification
requirements under section 1311(c)(1) of the Affordable Care Act, Public Law 111-148,
that are applicable to health plans, except for certification requirements that cannot be met
because the dental plan only covers dental benefits.

Subd. 10.

Limitations; risk-bearing.

(a) The board MNsure shall not bear
insurance risk or and the commissioner shall not enter into any agreement with health care
providers to pay claims.

(b) Nothing in this subdivision shall prevent MNsure from providing insurance
for its employees.

Subd. 11.

Prohibition on other product lines.

(a) MNsure is prohibited, either
directly or through another agency or business partner, from certifying, selecting, or
offering products and policies of coverage other than qualified health plans or dental plans.

(b) This subdivision expires July 1, 2018.

Sec. 9.

Minnesota Statutes 2014, section 62V.06, is amended to read:


62V.06 DATA PRACTICES.

Subdivision 1.

Applicability.

MNsure 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.

Subd. 2.

Definitions.

As used in this section:

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

(2) "participating" means that an individual, employee, or employer is seeking, or
has sought an eligibility determination, enrollment processing, or premium processing
through MNsure.

Subd. 3.

General data classifications.

The following data collected, created, or
maintained by MNsure 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:

(1) data on any individual participating in MNsure;

(2) data on any individuals participating in MNsure as employees of an employer
participating in MNsure; and

(3) data on employers participating in MNsure.

Subd. 4.

Application and certification data.

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

(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

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

(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.

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

Subd. 5.

Data sharing.

(a) MNsure The commissioner may share or disseminate
data classified as private or nonpublic in subdivision 3 as follows:

(1) to the subject of the data, as provided in section 13.04;

(2) according to a court order;

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

(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 MNsure,
provided that MNsure the commissioner must enter into a data-sharing agreement with the
agency prior to sharing data under this clause; and

(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
MNsure, provided that MNsure the commissioner must enter into a contract with the
person or entity, as provided in section 13.05, subdivision 6 or 11, prior to disseminating
data under this clause.

(b) MNsure The commissioner may share or disseminate data classified as private
or nonpublic in subdivision 4 as follows:

(1) to the subject of the data, as provided in section 13.04;

(2) according to a court order;

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

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

(5) with a nongovernmental person or entity, only to the extent necessary to carry
out the functions of MNsure, provided that MNsure the commissioner 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.

(c) Sharing or disseminating data outside of MNsure 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
.

(d) Until July 1, 2014, state agencies must share data classified as private or
nonpublic on individuals, employees, or employers participating in MNsure with MNsure,
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 MNsure
participant. The agency must enter into a data-sharing agreement with MNsure prior
to sharing any data under this paragraph.

Subd. 6.

Notice and disclosures.

(a) In addition to the Tennessen warning required
by section 13.04, subdivision 2, MNsure the commissioner must provide any data subject
asked to supply private data with:

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

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

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

Subd. 7.

Summary data.

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

Subd. 8.

Access to data; audit trail.

(a) Only individuals with explicit authorization
from the board commissioner may enter, update, or access not public data collected,
created, or maintained by MNsure. 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 MNsure, 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.

The board commissioner 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 commissioner, the board commissioner shall forward the
matter to the county attorney for prosecution.

(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 MNsure or the
obligation of the board commissioner and MNsure employees to comply with section
3.978, subdivision 2.

(c) This subdivision does not apply to actions taken by a MNsure participant to enter,
update, or access data held by MNsure, if the participant is the subject of the data that
is entered, updated, or accessed.

Subd. 9.

Sale of data prohibited.

MNsure The commissioner may not sell any
data collected, created, or maintained by MNsure, regardless of its classification, for
commercial or any other purposes.

Subd. 10.

Gun and firearm ownership.

MNsure The commissioner shall not
collect information that indicates whether or not an individual owns a gun or has a firearm
in the individual's home.

Sec. 10.

Minnesota Statutes 2014, section 62V.07, is amended to read:


62V.07 FUNDS.

(a) The MNsure account is created in the state government special revenue fund of the
state treasury. All funds received by MNsure shall be deposited in the account. Funds in the
account are appropriated to MNsure for the operation of MNsure.
Notwithstanding section
11A.20, all investment income and all investment losses attributable to the investment of
the MNsure account not currently needed, shall be credited to the MNsure account.

(b) The budget submitted to the legislature under section 16A.11 must include
budget information for MNsure.

Sec. 11.

Minnesota Statutes 2014, section 62V.08, is amended to read:


62V.08 REPORTS.

(a) MNsure The commissioner shall submit a report to the legislature by January 15,
2015 2016, and each January 15 thereafter, on: (1) the performance of MNsure operations;
(2) meeting MNsure responsibilities; (3) an accounting of MNsure budget activities; (4)
practices and procedures that have been implemented to ensure compliance with data
practices laws, and a description of any violations of data practices laws or procedures;
and (5) the effectiveness of the outreach and implementation activities of MNsure in
reducing the rate of uninsurance.

(b) MNsure The commissioner must publish its administrative and operational costs
on a Web site to educate consumers on those costs. The information published must
include: (1) the amount of premiums and federal premium subsidies collected; (2) the
amount and source of revenue received under section 62V.05, subdivision 1, paragraph
(b), clause (3); (3) the amount and source of any other fees collected for purposes of
supporting operations; and (4) any misuse of funds as identified in accordance with section
3.975. The Web site must be updated at least annually.

Sec. 12.

Minnesota Statutes 2014, section 62V.09, is amended to read:


62V.09 EXPIRATION AND SUNSET EXCLUSION.

Notwithstanding section 15.059, the board and its advisory committees established
by the commissioner under this chapter
shall not expire, except as specified in section
62V.04, subdivision 13. The board and its advisory committees are not subject to review
or sunsetting under chapter 3D.

Sec. 13.

Minnesota Statutes 2014, section 256.962, subdivision 5, is amended to read:


Subd. 5.

Incentive program.

Beginning January 1, 2008, the commissioner shall
establish an incentive program for organizations and licensed insurance producers under
chapter 60K
community assistance partners defined in Minnesota Rules, part 7700.0020,
subpart 7,
that directly identify and assist potential enrollees in filling out and submitting
an application. For each applicant who is successfully enrolled in MinnesotaCare,
or
medical assistance, or general assistance medical care, the commissioner, within
the available appropriation,
shall pay the organization or licensed insurance producer
community assistance partner or insurance producer if the insurance producer has
completed the certification training program administered by the commissioner of MNsure
in accordance with section 62V.05, subdivision 3, paragraph (j),
a $25 $70 application
assistance bonus. The organization or licensed insurance producer may provide an
applicant a gift certificate or other incentive upon enrollment.

Sec. 14. EXPANDED ACCESS TO THE SMALL BUSINESS HEALTH CARE
TAX CREDIT.

(a) The commissioner of commerce, in consultation with the commissioner of
MNsure, shall develop a proposal to allow small employers the ability to receive the small
business health care tax credit when the small employer pays the premiums on behalf of
employees enrolled in either a qualified health plan offered through a small business health
options program (SHOP) marketplace or a small group health plan offered outside of the
small health options program marketplace within MNsure. To be eligible for the tax credit,
the small employer must meet the requirements under the Affordable Care Act, except that
employees may be enrolled in a small group health plan product offered outside of MNsure.

(b) The commissioner of commerce shall seek all federal waivers and approvals
necessary to implement this proposal. The commissioner shall submit a draft proposal
to the legislature at least 30 days before submitting a final proposal to the federal
government, and shall notify the legislature of any federal decision or action received
regarding the proposal and submitted waiver.

EFFECTIVE DATE.

This section is effective the day following final enactment.

Sec. 15. REPEALER.

Minnesota Statutes 2014, section 62V.11, is repealed.

Sec. 16. EFFECTIVE DATE.

Sections 1 to 15 are effective July 1, 2015.

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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