Current through Register Vol. 49, No. 13, September 23, 2024
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.
