1.1.................... moves to amend H.F. No. 5, the seventh engrossment, as follows:
1.2Page 11, line 10, delete everything after "participation."
1.3Page 11, delete lines 11 to 36 and insert:
1.4"(a) Beginning January 1, 2015, the board shall have the power to establish
1.5certification requirements for health carriers and health benefit plans offered through the
1.6Minnesota Insurance Marketplace unless by June 1, 2013, the legislature enacts regulatory
1.7requirements that:
1.8(1) apply uniformly to all health carriers and health benefit plans in the individual
1.9market;
1.10(2) apply uniformly to all health carriers and health benefit plans in the small
1.11group market; and
1.12(3) satisfy federal certification requirements for the Minnesota Insurance
1.13Marketplace.
1.14(b) For certification requirements established by the board under paragraph (a), the
1.15board shall establish network adequacy requirements that are not inconsistent with the
1.16most popular health benefit plans offered through the Minnesota Insurance Marketplace
1.17under paragraph (c) in 2014 or 2015.
1.18(c) No health carrier shall be required to participate in the Minnesota Insurance
1.19Marketplace. Beginning January 1, 2015, for those health carriers that opt to participate
1.20in the Minnesota Insurance Marketplace, the Board shall approve two health benefit
1.21plans, of which one must be the most popular health benefit plan that a health carrier
1.22offers at each of the catastrophic, bronze, silver, and gold actuarial value levels for each
1.23service area in which the health carrier offers coverage in the individual and small group
1.24markets. The most popular health benefit plan is determined by the highest enrollment
1.25inside and outside the Minnesota Insurance Marketplace by number of lives at the end of
1.26the open enrollment period in the preceding year, excluding health benefit plans closed to
1.27new enrollment as of the preceding year. In determining the most popular health benefit
2.1plans, health benefit plans offered in the individual market prior to January 1, 2014, are
2.2not included. If a health carrier participating in the Minnesota Insurance Marketplace
2.3offers less than two health benefit plans in an actuarial value level or service area in the
2.4individual or small group market, the health carrier shall offer all health benefit plans it
2.5offers in that actuarial value level or service area in the individual or small group market
2.6in the Minnesota Insurance Marketplace.
2.7(d) If a health carrier or parent organization participating in the Minnesota Insurance
2.8Marketplace offers health benefit plans outside the Minnesota Insurance Marketplace in
2.9the individual or small group market, the health carrier must offer health benefit plans
2.10at the silver and gold actuarial levels outside the Minnesota Insurance Marketplace for
2.11each service area in which the health carrier offers coverage in the individual and small
2.12group markets.
2.13(e) Beginning January 1, 2015, the board has the power to select health benefit plans
2.14in addition to those specified in paragraph (c) to participate in the Minnesota Insurance
2.15Marketplace. In the selection process, the board shall seek to provide health coverage
2.16choices that offer the optimal combination of choice, value, quality, and service. Selection
2.17of additional health benefit plans must be determined in the best interests of individual
2.18consumers and employers and within federal requirements. The board shall consistently
2.19and uniformly apply requirements, standards, and criteria to all health carriers and health
2.20benefit plans. In determining the best interests, the board shall consider:
2.21(1) affordability and value;
2.22(2) promotions of high-quality care;
2.23(3) promotion of prevention and wellness;
2.24(4) ensuring access to care;
2.25(5) alignment and coordination with state agency and private sector purchasing
2.26strategies and payment reform efforts; and
2.27(6) other criteria that the board determines appropriate.
2.28(f) For health benefit plans offered through the Minnesota Insurance Marketplace
2.29beginning January 1, 2015, health carriers must use the most current addendum for Indian
2.30health care providers approved by the Centers for Medicare and Medicaid Services and
2.31the tribes as part of their contracts with Indian health care providers.
2.32(g) For 2014, the board shall not have the power to select health carriers and health
2.33benefit plans for participation in the Minnesota Insurance Marketplace. The board shall
2.34have the power to verify that health carriers and health benefit plans were properly
2.35certified under certification guidance in place on January 1, 2013, to be eligible for
2.36participation in the Minnesota Insurance Marketplace. Notwithstanding the foregoing, any
3.1catastrophic health plan, as defined in section 1302(e) of the federal Patient Protection
3.2and Affordable Care Act (Public Law 111-148), shall be eligible for participation in the
3.3Minnesota Insurance Marketplace in 2014.
3.4(h) The board has the authority to decertify health carriers and health benefit plans
3.5that fail to maintain compliance with section 1311(c) of the federal Patient Protection and
3.6Affordable Care Act (Public Law 111-148)."
3.7Page 12, delete lines 1 and 2