Navigator agencies follow this process to receive an enrollment report providing details on the enrollments for which MNsure is paying a per-enrollee payment. The enrollment report enables navigator agencies to identify any discrepancies between their enrollment records and MNsure's per-enrollment payments.
Procedures for Privacy and Security Policies Questionnaire
The request must be completed by the data privacy contact party designated by the navigator agency in their Agency Management Program (AMP) account. If the information privacy and security responsible party has changed, an authorized individual must update the agency’s contact online using AMP.
The completed request should be faxed or emailed to the ARC.
MNsure will evaluate the agency’s compliance with privacy and security requirements by reviewing the agency's current Data Privacy and Security Information Questionnaire in the agency's AMP account.
In order to be approved for an enrollment report, the agency must indicate that the agency has current, written policies and procedures for compliance with privacy and security standards and that electronically stored personally identifiable information (PII) is encrypted and password-protected.
If there are any questions about the agency's data privacy and security practices, MNsure will contact the data privacy contact listed in their Agency Management Program (AMP) account for clarification.
If the request is approved, MNsure will notify the data privacy contact and proceed with processing any available enrollment reports.
If the request is denied, MNsure will notify the data privacy contact. After being notified of a denial, an agency has 30 days to appeal the decision. An agency that is denied may submit a new request in the next fiscal year.
Procedures for Sending Enrollment Reports
After the navigator per-enrollee payments have been finalized for a quarter (generally 60 days after the close of the quarter), MNsure will begin processing requested enrollment reports for the quarter. Anticipated dates for state fiscal year 2019:
3rd Quarter 2020 available after December 1, 2020
4th Quarter 2020 available after March 1, 2021
1st Quarter 2021 available after June 1, 2021
2nd Quarter 2021 available after September 1, 2021
The enrollment report will be securely emailed to the agency's designated payment coordinator in AMP. The email will come from email@example.com. The navigator agency is responsible for notifying MNsure immediately if there is any change to the designated payment coordinator by having an authorized individual update the agency’s contacts online using the AMP.
The navigator agency should submit questions regarding the enrollment report to the ARC by email at firstname.lastname@example.org.
Procedures for Reporting Potential Discrepancies
After a navigator agency has reviewed their enrollment report, they may report any potential discrepancies between MNsure's enrollment records and their own. To report potential discrepancies, the navigator agency must send an Excel file with a list of any cases for which they believe they should receive a payment. The file should include:
Consumer's first and last name (required)
Consumer's date of birth (required)
The date the application was submitted or the enrollment was completed (required)
If known, the consumer's address
If known, the method of application (online vs. paper)
MNsure will process reports of potential discrepancies in the order received as resources are available, but not any earlier than the following:
Discrepancies from 3rd quarter 2020 will not be reviewed until after April 30, 2021.
Discrepancies from 4th quarter 2020 will not be reviewed until after August 30, 2021.
Discrepancies from 1st quarter 2021 will not be reviewed until after November 30, 2021.
Discrepancies from 2nd quarter 2021 will not be reviewed until after January 30, 2022.
MNsure will review all reported potential discrepancies to determine whether the case meets payment requirements (see MNsure's Navigator Payment Policy). Once MNsure has completed reviewing the file, the navigator agency will receive a file from MNsure which indicates whether the case was determined eligible for payment, ineligible for payment, or more information is required.
If eligible for payment, a payment will be issued.
If ineligible for payment, the reason will be included.
If more information is required, MNsure will continue to review the case until a final determination can be made.
Terms and Definitions
Agency Management Program: Agency Management Program (AMP) is the online self-service method for authorized agency contacts to manage their agency’s roster and agency information.
Enrollment report: Quarterly spreadsheet listing individual enrollments by a contracted navigator agency based on MNsure’s accounting of enrollment payments. Data elements of the enrollment report are first name and last name of consumer, first name and last name of the primary applicant, city, date of birth, application received date, Assister ID, agency name, program into which consumer was enrolled.
Per-enrollee payment statements: Quarterly statements sent by MNsure to a navigator agency's payment coordinator that summarize the agency's per-enrollee payments by navigator ID and program determination.
Data Privacy and Security Information: A series of questions about an agency's data and privacy practices completed in AMP as part of the process for contracting with MNsure as a navigator agency.
Data Privacy contact: The individual designated by the navigator agency in their AMP account that is responsible for complying with data privacy and security for the agreement. This role can be updated at any time in AMP.