April Todd-Malmlov has resigned from her post as executive director of MNsure, Minnesota's state exchange.

Scott Leitz, a state Department of Human Services official, will become the interim executive director while the MNsure board looks for a permanent chief.

Todd-Malmlov could not immediately be reached for comment. .

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MNsure has become the fourth state-based exchange to lose its top executive since the Patient Protection and Affordable Care Act open enrollment period began Oct. 1.

Rocky King, the Cover Oregon executive director, is out on medical leave.

Rebecca Bearce, the executive director of the Maryland Health Benefit Exchange, resigned from her position earlier this month, and Coral Andrews, executive director of the Hawai'i Health Connector, decided against a contract renewal request, after it expired earlier this month.

Todd-Malmlov is the second exchange head to leave amid reports about vacation complaints. 

Bearce resigned after Maryland news media said she'd taken a vacation in the Caribbean without giving the right people advance notice or staying in close enough contact with her office.

In Minnesota, critics complained about Todd-Malmlov taking a two-week vacation in Costa Rica around Thanksgiving, even though she'd received advance board approval and talked to staff daily.

The $150 million exchange reported that Minnesota residents used the MNsure exchange to sign up for coverage for 71,579 people in October and November. About one-fifth of the consumers who've selected plans are on track to have private "qualified health plan" coverage.

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Allison Bell

Allison Bell, a senior reporter at ThinkAdvisor and BenefitsPRO, previously was an associate editor at National Underwriter Life & Health. She has a bachelor's degree in economics from Washington University in St. Louis and a master's degree in journalism from the Medill School of Journalism at Northwestern University. She can be reached through X at @Think_Allison.