Minnesota Administrative Rules

7700.0020 DEFINITIONS.

Subpart 1.

Scope.

As used in this chapter, the terms defined in this part have the meanings given them.

Subp. 2.

Affordable Care Act.

"Affordable Care Act" means the Patient Protection and Affordable Care Act of 2010, Public Law 111-148, as further defined through amendments to the act and regulations issued under the act.

Subp. 3.

Applicable staff.

"Applicable staff" means any person who has access authorized under this chapter to data stored in the MNsure web tool.

Subp. 4.

Board.

"Board" means the Board of MNsure specified in Minnesota Statutes, section 62V.04.

Subp. 5.

Certified application counselor.

"Certified application counselor, " described in Code of Federal Regulations, title 45, part 155.225, means any entity certified by MNsure to provide consumer assistance services without any compensation from MNsure.

Subp. 6.

Conflict of interest.

"Conflict of interest" means any business, private, or personal interest sufficient to influence or appear to influence the objective execution of an entity's or individual's official or professional responsibilities to the extent necessary to carry out the functions of MNsure.

Subp. 7.

Consumer assistance partner.

"Consumer assistance partner " means entities certified by MNsure to serve as a navigator, in-person assister, or certified application counselor.

Subp. 8.

Cost-sharing reduction.

"Cost-sharing reduction" means reductions in cost sharing for an eligible individual enrolled in a silver level plan through MNsure or for an individual who is an American Indian or Alaska Native enrolled in a QHP through MNsure.

Subp. 9.

Enrollment.

"Enrollment" means enrolling individuals in a QHP or public health care program through MNsure, including properly utilizing the appropriate system tools, resources, and data to perform this function.

Subp. 10.

Individual tax credit.

"Individual tax credit" means premium tax credits specified in section 36B of the Internal Revenue Code, as added by section 1401 of the Affordable Care Act, which are provided on an advance basis to an eligible individual enrolled in a QHP through MNsure according to sections 1402 and 1412 of the Affordable Care Act.

Subp. 11.

In-person assister.

"In-person assister" means any entity certified by MNsure to provide services consistent with the applicable requirements of Code of Federal Regulations, title 45, part 155.205,(c), (d), and (e), and is distinct from a navigator.

Subp. 12.

Insurance producer.

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

Subp. 13.

MNsure.

"MNsure" means the "Minnesota Insurance Marketplace" under Minnesota Statutes, chapter 62V, 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.

Subp. 14.

Navigator.

"Navigator" means any entity certified by MNsure to serve as a navigator and has the meaning described in section 1311(i) of the federal Patient Protection and Affordable Care Act (ACA), Public Law 111-148, and further defined through amendments to the act and regulations issued under the act. For calendar year 2014, the navigator program shall be covered by Minnesota Statutes, section 256.962.

Subp. 15.

Qualified health plan or QHP.

"Qualified health plan" or "QHP" 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 according to Minnesota Statutes, section 62V.05, subdivision 5, to be offered through MNsure.

Statutory Authority:

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

History:

37 SR 1579

Published Electronically:

September 10, 2018