Enrollment Report Process Policy

This policy applies to navigator agencies.

Policy Details

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

1. A navigator agency initiates the process for requesting an enrollment report by submitting a completed and signed Enrollment Report: FY 2025 Enrollment Report Request Form (PDF) to the Assister Resource Center (ARC) by email.
   1. 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.
   2. The completed request should be emailed to the ARC.
2. 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.
   1. 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.
   2. 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.
3. If the request is approved, MNsure will notify the data privacy contact and proceed with processing any available enrollment reports.
4. 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

1. After the navigator per-enrollee payments have been finalized for a reporting period (generally 60 days after the close of the reporting period), MNsure will begin processing requested enrollment reports for the reporting period. Anticipated dates for state fiscal year 2024:
   1. July 2024 available after October 1, 2024
   2. August 2024 available after November 1, 2024
   3. September 2024 available after December 1, 2024
   4. October 2024 available after January 1, 2025
   5. November 2024 available after February 1, 2025
   6. December 2024 available after March 1, 2025
   7. January 2025 available after April 1, 2025
   8. February 2025 available after May 1, 2025
   9. March 2025 available after June 1, 2025
   10. April 2025 available after July 1, 2025
   11. May 2025 available after August 1, 2025
   12. June 2025 available after September 1, 2025
2. The enrollment report will be securely emailed to the agency's designated payment coordinator in AMP. The email will come from navigators@mnsure.org. 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.
3. The navigator agency should submit questions regarding the enrollment report to the ARC by email at navigators@mnsure.org.

Procedures for Reporting Potential Discrepancies

1. 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 request an enrollment report from from MNsure.
   1. MNsure will not review any discrepancies for cases more than one year old.
   2. Organizations must use MNsure's discrepancy request form.
   3. Following the change to monthly reporting periods in January 2023, discrepancies will not be reviewed until five months after the close of the reporting period. For example, discrepancies from the July 2024 reporting period will not be reviewed until after December 31, 2024..
2. The form can be requested from navigators@mnsure.org.
3. The completed form must be sent by secure email to the ARC at navigators@mnsure.org.
4. 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.
5. 1. If eligible for payment, a payment will be issued.
   2. If ineligible for payment, the reason will be included.
   3. 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: Statements for each reporting period 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.