Minnesota Administrative Rules

7700.0030 ELIGIBILITY REQUIREMENTS; CERTIFIED CONSUMER ASSISTANCE PARTNERS.

Subpart 1.

Federal prohibitions.

A.

Consumer assistance partners must not be health insurance issuers, subsidiaries of a health insurance issuer, stop loss insurance issuers, subsidiaries of a stop loss insurance issuer, or professional associations that include members of or lobby on behalf of the insurance industry according to federal requirements in Code of Federal Regulations, title 45, section 155.210 (d).

B.

Consumer assistance partners must not have a conflict of interest while serving as a consumer assistance partner.

(1)

Consumer assistance partners must not receive any compensation directly or indirectly from any health insurance issuer in connection with the enrollment of any individuals or employees in a qualified health plan or a nonqualified health plan as specified in Code of Federal Regulations, title 45, section 155.210 (d)(4).

(2)

Consumer assistance partners must follow the requirements pursuant to Minnesota's Level One Establishment Notice of Grant Award, Special Terms and Conditions, Attachment B, #19: "In order to provide services that meet the requirements of Code of Federal Regulations, title 45, sections 155.205 (d)-(e), and 155.405, individuals performing in-person assistance functions must operate in a fair and impartial manner and must meet and adhere to appropriate conflict of interest standards which include, but are not limited to the following: Do not receive any direct or indirect compensation from an issuer in connection with enrolling consumers in health plans; and are not subsidiaries of an issuer or associations that include members of, or lobby on behalf of, the insurance industry."

Subp. 2.

Qualifications.

A.

Consumer assistance partners must demonstrate the ability to carry out those responsibilities as defined by the board.

B.

Consumer assistance partners must:

(1)

demonstrate proven connections to the communities MNsure will serve, or demonstrate the ability to form relationships with consumers, including uninsured and underinsured consumers;

(2)

successfully complete MNsure's certification training program; and

(3)

comply with any privacy and security standards applicable to MNsure.

Subp. 3.

Eligible entities.

Consumer assistance partners eligible for certification by MNsure are any of the following entities able to demonstrate to the board that the entity has existing relationships, or could readily establish relationships with consumers in Minnesota, including uninsured, underinsured, and vulnerable populations, likely to be eligible to enroll through MNsure: 501(c)(3) community-based organizations, for-profit businesses, government agencies, and any other entity recognized by the Office of the Secretary of State including, but not limited to:

A.

community and consumer-focused nonprofit groups;

B.

trade, industry, and professional associations;

C.

farming organizations;

D.

religious organizations;

E.

chambers of commerce;

F.

insurance producers, subject to subpart 1;

G.

tribal organizations; and

H.

state or local human services agencies.

MNsure will consider coalitions or collaboratives of entities meeting the requirements of subpart 3.

Statutory Authority:

MS s 62V.05; L 2013 c 9 s 14

History:

37 SR 1579

Published Electronically:

July 11, 2013