The newly enacted health insurance exchange law was presented to Governor Dayton yesterday and he is expected to sign it later this week. The new law entitled "The Minnesota Insurance Marketplace Act" is effectively immediately and some of the exchange deadlines are very aggressive. Open enrollment in the exchange will begin as early as October, and in January public subsidies will be available for some exchange enrollees. Prior to the October roll-out, health plans will have to qualified for sale through the exchange, insurance producers will have to take training and be certified to sell exchange products, navigators will be hired, privacy standards will be developed and the exchange web site will be finalized.
The state's health insurance exchange is referred to as the Minnesota Insurance Marketplace. The term exchange had too many negative connotations for many individuals and businesses. This is a temporary name since a consultant has been retained to develop a permanent exchange title. Here are some of the highlights of the new law.
The exchange will be a semi-state agency and be governed by a seven member board appointed by the governor. The board will have considerable power in establishing and operating the exchange. For example, the board will establish certification requirements for insurance producers and policies and procedures for the navigator program. Three members will be representatives of exchange purchasers and three will be representatives with knowledge of health administration, health care finance or health plan purchasing. However under a conflict of interest provision in the new law, members of the board cannot be affiliated or employed by a health care provider, health plan, insurance company or insurance producer for one year prior to their appointment. This could mean either retirees or professors on the insurance side of the board. The final member of the board will be the commissioner of human services.
Qualified Health Plans
Health plans must meet the requirements of the Affordable Care Act and become "qualified" to be sold on the exchange. Health plans have until May 17 to submit their plan designs and rates. This qualification will be done by the Minnesota Department of Commerce.
Which plans could be sold on the exchange was a very controversial issue. Proponents of the ACA wanted the board to have the ability to limit the number of plans sold through the exchange. They fear consumers would be overwrought with plan choices. On the other hand, the industry thought that any health plan that made the effort in time and money to submit a plan and the plan was qualified by the Department of Commerce should be made available on the exchange. The final language was an attempt at compromise. It allows for any qualified plan to be offered on the exchange during 2014, the first year of the exchange. In 2015, the board would have the ability to select exchange plans.
Any licensed insurance agent who wishes to sell products from the insurance exchange will be able to do so once they are certified by the exchange. The exchange board, in consultation with the commissioner of commerce, will be developing certification requirements for exchange producers. This certification will require training relating to cost-sharing arrangements, tax credits, eligibility verification, online enrollment, available health plans and basic information on public programs. Agents will be able to complete this training at any time which will most likely be Internet based. You can expect this training to be available in a couple of months.
Insurance producers placing business through the exchange will be compensated by the insurance carriers. This was a major change from the original proposal which had producers compensated by the exchange itself. Insurers will have to develop a compensation structure for defined contribution plans that involve multiple carriers.
The law requires producers to disclose to potential purchasers the plans the producer is authorized to sell, that the producer may be compensated by the insurance carrier, and information on plans is available on the exchange Web site.
The exchange will provide interim funding for a navigator program as required under the ACA. The board will then establish procedures for the ongoing operation of a navigator program to be implemented beginning Jan. 1, 2015. The exchange will also be authorized to employ in-person assistors, call center and customer service staff to assist with questions and services related to the Web site. They will be spending a good deal of time enrolling the projected 800,000 individuals who will enroll in public programs. Data Practices. Since a good deal of private information including financial data will be collected for eligibility and tax credit purposes, the exchange will need to maintain privacy of purchaser information. All data collected by insurance producers will be classified as private data. Certification training will include data practices and data sharing requirements. Any individual has the right to refuse to participate in the exchange.
The board of the exchange will act as an autonomous state agency and have a good deal of power over the state's health insurance marketplace. In order to assure legislative oversight, the law creates a Legislative Oversight Committee of 10 members, five senators and five representatives. The Oversight Committee will review any proposed exchange rules and monitor its implementation. It will also receive an operating report from the exchange annually.
Minnesota Comprehensive Health Association
The commissioner of commerce, in consultation with the MCHA board of directors, is given the authority to develop a phase-out plan for those currently enrolled in the program. The phase-out must begin January 2014 when qualified plans will become available. The phase-out plan however will ensure the least amount of disruption to the enrollee's current health care coverage. The length of the phase-out is yet to be determined.
Want more information. The MIIAB Annual Convention will feature an overview of the insurance exchange and other federal health care reforms on Thursday, May 9th from 8:30am to 11:30am at the Minneapolis Convention Center.