2nd Engrossment - 82nd Legislature (2001 - 2002) Posted on 12/15/2009 12:00am
Engrossments | ||
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Introduction | Posted on 03/01/2001 | |
1st Engrossment | Posted on 04/04/2001 | |
2nd Engrossment | Posted on 05/09/2001 |
1.1 A bill for an act 1.2 relating to insurance; regulating insurers, agents, 1.3 coverages and benefits, costs, claims, investments, 1.4 and notifications and disclosures; prescribing powers 1.5 and duties of the commissioner; eliminating the 1.6 regulation of nonprofit legal services plans; amending 1.7 Minnesota Statutes 2000, sections 60A.06, subdivision 1.8 3; 60A.08, subdivision 13; 60A.11, subdivision 10; 1.9 60A.129, subdivision 2; 60A.14, subdivision 1; 60A.16, 1.10 subdivision 1; 60A.23, subdivision 8; 61A.072, by 1.11 adding a subdivision; 62A.17, subdivision 1; 62A.20, 1.12 subdivision 1; 62A.21, subdivision 2a; 62A.302; 1.13 62A.31, subdivisions 1a, 1i, 3; 62A.65, subdivision 8; 1.14 62E.04, subdivision 4; 62E.06, subdivision 1; 62E.13, 1.15 subdivision 3; 62L.05, subdivisions 1, 2; 62M.03, 1.16 subdivision 2; 62M.05, subdivision 5; 62Q.01, 1.17 subdivision 6; 62Q.73, subdivision 3; 65A.29, 1.18 subdivision 7; 65B.04, subdivision 3; 65B.06, 1.19 subdivisions 1, 4; 65B.16; 65B.19, subdivision 2; 1.20 67A.20, by adding a subdivision; 79A.02, subdivision 1.21 1; 79A.03, subdivision 7; 471.617, subdivision 1; 1.22 proposing coding for new law in Minnesota Statutes, 1.23 chapters 62A; 62L; repealing Minnesota Statutes 2000, 1.24 sections 13.7191, subdivision 11; 60A.111; 62G.01; 1.25 62G.02; 62G.03; 62G.04; 62G.05; 62G.06; 62G.07; 1.26 62G.08; 62G.09; 62G.10; 62G.11; 62G.12; 62G.13; 1.27 62G.14; 62G.15; 62G.16; 62G.17; 62G.18; 62G.19; 1.28 62G.20; 62G.21; 62G.22; 62G.23; 62G.24; 62G.25. 1.29 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 1.30 Section 1. Minnesota Statutes 2000, section 60A.06, 1.31 subdivision 3, is amended to read: 1.32 Subd. 3. [LIMITATION ON COMBINATION POLICIES.] (a) Unless 1.33 specifically authorized by subdivision 1, clause (4), it is 1.34 unlawful to combine in one policy coverage permitted by 1.35 subdivision 1, clauses (4) and (5)(a). This subdivision does 1.36 not prohibit the simultaneous sale of these products, but the 1.37 sale must involve two separate and distinct policies. 2.1 (b) This subdivision does not apply to group policies. 2.2 (c) This subdivision does not apply to policies permitted 2.3 by subdivision 1, clause (4), that contain benefits providing 2.4 acceleration of life, endowment, or annuity benefits in advance 2.5 of the time they would otherwise be payable, or to long-term 2.6 care policies as defined in section 62A.46, subdivision 2, or 2.7 chapter 62S. 2.8 [EFFECTIVE DATE.] This section is effective the day 2.9 following final enactment. 2.10 Sec. 2. Minnesota Statutes 2000, section 60A.08, 2.11 subdivision 13, is amended to read: 2.12 Subd. 13. [REDUCTION OF LIMITS BY COSTS OF DEFENSE 2.13 PROHIBITED.] (a) No insurer shall issue or renew a policy of 2.14 liability insurance in this state that reduces the limits of 2.15 liability stated in the policy by the costs of legal defense. 2.16 (b) This subdivision does not apply to: 2.17 (1) professional liability insurance with annual aggregate 2.18 limits of liabilitygreater thanof at least $100,000, including 2.19 directors' and officers' and errors and omissions liability 2.20 insurance; 2.21 (2) environmental impairment liability insurance; 2.22 (3) insurance policies issued to large commercial risks; or 2.23 (4) coverages that the commissioner determines to be 2.24 appropriate which will be published in the manner prescribed for 2.25 surplus lines insurance in section 60A.201, subdivision 4. 2.26 (c) For purposes of this subdivision, "large commercial 2.27 risks" means an insured whose gross annual revenues in the 2.28 fiscal year preceding issuance of the policy were at least 2.29 $10,000,000. 2.30 [EFFECTIVE DATE.] This section is effective the day 2.31 following final enactment. 2.32 Sec. 3. Minnesota Statutes 2000, section 60A.11, 2.33 subdivision 10, is amended to read: 2.34 Subd. 10. [DEFINITIONS.] The following terms have the 2.35 meaning assigned in this subdivision for purposes of this 2.36 sectionand section 60A.111: 3.1 (a) "Adequate evidence" means a written confirmation, 3.2 advice, or other verification issued by a depository, issuer, or 3.3 custodian bank which shows that the investment is held for the 3.4 company; 3.5 (b) "Adequate security" means a letter of credit qualifying 3.6 under subdivision 11, paragraph (f), cash, or the pledge of an 3.7 investment authorized by any subdivision of this section; 3.8 (c) "Admitted assets," for purposes of computing percentage 3.9 limitations on particular types of investments, means the assets 3.10 as shown by the company's annual statement, required by section 3.11 60A.13, as of the December 31 immediately preceding the date the 3.12 company acquires the investment; 3.13 (d) "Clearing corporation" means The Depository Trust 3.14 Company or any other clearing agency registered with the 3.15 securities and exchange commission pursuant to the Securities 3.16 Exchange Act of 1934, section 17A, Euro-clear Clearance System 3.17 Limited and CEDEL S.A., and, with the approval of the 3.18 commissioner, any other clearing corporation as defined in 3.19 section 336.8-102; 3.20 (e) "Control" has the meaning assigned to that term in, and 3.21 must be determined in accordance with, section 60D.15, 3.22 subdivision 4; 3.23 (f) "Custodian bank" means a bank or trust company or a 3.24 branch of a bank or trust company that is acting as custodian 3.25 and is supervised and examined by state or federal authority 3.26 having supervision over the bank or trust company or with 3.27 respect to a company's foreign investments only by the 3.28 regulatory authority having supervision over banks or trust 3.29 companies in the jurisdiction in which the bank, trust company, 3.30 or branch is located, and any banking institutions qualifying as 3.31 an "Eligible Foreign Custodian" under the Code of Federal 3.32 Regulations, section 270.17f-5, adopted under section 17(f) of 3.33 the Investment Company Act of 1940, and specifically including 3.34 Euro-clear Clearance System Limited and CEDEL S.A., acting as 3.35 custodians; 3.36 (g) "Evergreen clause" means a provision that automatically 4.1 renews a letter of credit for a time certain if the issuer of 4.2 the letter of credit fails to affirmatively signify its 4.3 intention to nonrenew upon expiration; 4.4 (h) "Government obligations" means direct obligations for 4.5 the payment of money, or obligations for the payment of money to 4.6 the extent guaranteed as to the payment of principal and 4.7 interest by any governmental issuer where the obligations are 4.8 payable from ad valorem taxes or guaranteed by the full faith, 4.9 credit, and taxing power of the issuer and are not secured 4.10 solely by special assessments for local improvements; 4.11 (i) "Noninvestment grade obligations" means obligations 4.12 which, at the time of acquisition, were rated below Baa/BBB or 4.13 the equivalent by a securities rating agency or which, at the 4.14 time of acquisition, were not in one of the two highest 4.15 categories established by the securities valuation office of the 4.16 National Association of Insurance Commissioners; 4.17 (j) "Issuer" means the corporation, business trust, 4.18 governmental unit, partnership, association, individual, or 4.19 other entity which issues or on behalf of which is issued any 4.20 form of obligation; 4.21 (k) "Licensed real estate appraiser" means a person who 4.22 develops and communicates real estate appraisals and who holds a 4.23 current, valid license under chapter 82B or a substantially 4.24 similar licensing requirement in another jurisdiction; 4.25 (l) "Member bank" means a national bank, state bank or 4.26 trust company which is a member of the Federal Reserve System; 4.27 (m) "National securities exchange" means an exchange 4.28 registered under section 6 of the Securities Exchange Act of 4.29 1934 or an exchange regulated under the laws of the Dominion of 4.30 Canada; 4.31 (n) "NASDAQ" means the reporting system for securities 4.32 meeting the definition of National Market System security as 4.33 provided under Part I to Schedule D of the National Association 4.34 of Securities Dealers Incorporated bylaws; 4.35 (o) "Obligations" include bonds, notes, debentures, 4.36 transportation equipment certificates, repurchase agreements, 5.1 bank certificates of deposit, time deposits, bankers' 5.2 acceptances, and other obligations for the payment of money not 5.3 in default as to payments of principal and interest on the date 5.4 of investment, whether constituting general obligations of the 5.5 issuer or payable only out of certain revenues or certain funds 5.6 pledged or otherwise dedicated for payment. Leases are 5.7 considered obligations if the lease is assigned for the benefit 5.8 of the company and is nonterminable by the lessee or lessees 5.9 thereunder upon foreclosure of any lien upon the leased 5.10 property, and rental payments are sufficient to amortize the 5.11 investment over the primary lease term; 5.12 (p) "Qualified assets" means the sum of (1) all investments 5.13 qualified in accordance with this section other than investments 5.14 in affiliates and subsidiaries, (2) investments in obligations 5.15 of affiliates as defined in section 60D.15, subdivision 2, 5.16 secured by real or personal property sufficient to qualify the 5.17 investment under subdivision 19 or 23, (3) qualified investments 5.18 in subsidiaries, as defined in section 60D.15, subdivision 9, on 5.19 a consolidated basis with the insurance company without 5.20 allowance for goodwill or other intangible value, and (4) cash 5.21 on hand and on deposit, agent's balances or uncollected premiums 5.22 not due more than 90 days, assets held pursuant to section 5.23 60A.12, subdivision 2, investment income due and accrued, funds 5.24 due or on deposit or recoverable on loss payments under 5.25 contracts of reinsurance entered into pursuant to section 5.26 60A.09, premium bills and notes receivable, federal income taxes 5.27 recoverable, and equities and deposits in pools and 5.28 associations; 5.29 (q) "Qualified net earnings" means that the net earnings of 5.30 the issuer after elimination of extraordinary nonrecurring items 5.31 of income and expense and before income taxes and fixed charges 5.32 over the five immediately preceding completed fiscal years, or 5.33 its period of existence if less than five years, has averaged 5.34 not less than 1-1/4 times its average annual fixed charges 5.35 applicable to the period; 5.36 (r) "Required liabilities" means the sum of (1) total 6.1 liabilities as required to be reported in the company's most 6.2 recent annual report to the commissioner of commerce of this 6.3 state, (2) for companies operating under the stock plan, the 6.4 minimum paid-up capital and surplus required to be maintained 6.5 pursuant to section 60A.07, subdivision 5a, (3) for companies 6.6 operating under the mutual or reciprocal plan, the minimum 6.7 amount of surplus required to be maintained pursuant to section 6.8 60A.07, subdivision 5b, and (4) the amount, if any, by which the 6.9 company's loss and loss adjustment expense reserves exceed 350 6.10 percent of its surplus as it pertains to policyholders as of the 6.11 same date. The commissioner may waive the requirement in clause 6.12 (4) unless the company's written premiums exceed 300 percent of 6.13 its surplus as it pertains to policyholders as of the same 6.14 date. In addition to the required amounts pursuant to clauses 6.15 (1) to (4), the commissioner may require that the amount of any 6.16 apparent reserve deficiency that may be revealed by one to five 6.17 year loss and loss adjustment expense development analysis for 6.18 the five years reported in the company's most recent annual 6.19 statement to the commissioner be added to required liabilities; 6.20 (s) "Revenue obligations" means obligations for the payment 6.21 of money by a governmental issuer where the obligations are 6.22 payable from revenues, earnings, or special assessments on 6.23 properties benefited by local improvements of the issuer which 6.24 are specifically pledged therefor; 6.25 (t) "Security" has the meaning given in section 5 of the 6.26 Security Act of 1933 and specifically includes, but is not 6.27 limited to, stocks, stock equivalents, warrants, rights, 6.28 options, obligations, American Depository Receipts (ADR's), 6.29 repurchase agreements, and reverse repurchase agreements; and 6.30 (u) "Unrestricted surplus" means the amount by which 6.31 qualified assets exceed 110 percent of required liabilities. 6.32 [EFFECTIVE DATE.] This section is effective the day 6.33 following final enactment. 6.34 Sec. 4. Minnesota Statutes 2000, section 60A.129, 6.35 subdivision 2, is amended to read: 6.36 Subd. 2. [LOSS RESERVE CERTIFICATION.] (a) Each domestic 7.1 company engaged in providing the types of coverage described in 7.2 section 60A.06, subdivision 1, clause (1), (2), (3), (5)(b), 7.3 (6), (8), (9), (10), (11), (12), (13), or (14), must have its 7.4 loss reserves certified by a qualified actuary. The company 7.5 must file the certification with the commissioner within 30 days 7.6 of completion of the certification, but not later than June 1. 7.7 The actuary providing the certificationmust notmay be an 7.8 employee of the company but the commissioner may still require 7.9 an independent actuarial certification as described in 7.10 subdivision 1. This subdivision does not apply to township 7.11 mutual companies, or to other domestic insurers having less than 7.12 $1,000,000 of premiums written in any year and fewer than 1,000 7.13 policyholders. The commissioner may allow an exception to the 7.14 stand alone certification where it can be demonstrated that a 7.15 company in a group has a pooling or 100 percent reinsurance 7.16 agreement used in a group which substantially affects the 7.17 solvency and integrity of the reserves of the company, or where 7.18 it is only the parent company of a group which is licensed to do 7.19 business in Minnesota. If these circumstances exist, the 7.20 company may file a written request with the commissioner for an 7.21 exception. Companies writing reinsurance alone are not exempt 7.22 from this requirement. The certification must contain the 7.23 following statement: "The loss reserves and loss expense7.24reserves have been examined and found to be calculated in7.25accordance with generally accepted actuarial principles and7.26practicesIn my opinion, the reserves described in this 7.27 certification are consistent with reserves computed in 7.28 accordance with standards and principles established by the 7.29 Actuarial Standards Board and are fairly stated." 7.30 (b) Each foreign company engaged in providing the types of 7.31 coverage described in section 60A.06, subdivision 1, clause (1), 7.32 (2), (3), (5)(b), (6), (8), (9), (10), (11), (12), (13), or 7.33 (14), required by this section to file an annual audited 7.34 financial report, whose total net earned premium for Schedule P, 7.35 Part 1A to Part 1H plus Part 1R, (Schedule P, Part 1A to Part 1H 7.36 plus Part 1R, Column 4, current year premiums earned, from the 8.1 company's most currently filed annual statement) is equal to 8.2 one-third or more of the company's total net earned premium 8.3 (Underwriting and Investment Exhibit, Part 2, Column 4, total 8.4 line, of the annual statement) must have a reserve certification 8.5 by a qualified actuary at least every three years. In the year 8.6 that the certification is due, the company must file the 8.7 certification with the commissioner within 30 days of completion 8.8 of the certification, but not later than June 1. The actuary 8.9 providing the certification must not be an employee of the 8.10 company. Companies writing reinsurance alone are not exempt 8.11 from this requirement. The certification must contain the 8.12 following statement: "The loss reserves and loss expense 8.13 reserves have been examined and found to be calculated in 8.14 accordance with generally accepted actuarial principles and 8.15 practices and are fairly stated." 8.16 (c) Each company providing life and/or health insurance 8.17 coverages described in section 60A.06, subdivision 1, clause (4) 8.18 or (5)(a), required by this section to file an audited annual 8.19 financial report, whose premiums and annuity considerations (net 8.20 of reinsurance) from accident and health equal one-third or more 8.21 of the company's total premiums and annuity considerations (net 8.22 of reinsurance), as reported in the summary of operations, must 8.23 have its aggregate reserve for accident and health policies and 8.24 liability for policy and contract claims for accident and health 8.25 certified by a qualified actuary at least once every three 8.26 years. The actuary providing the certification must not be an 8.27 employee of the company. Companies writing reinsurance alone 8.28 are not exempt from this requirement. The certification must 8.29 contain the following statement: "The policy and contract 8.30 claims reserves for accident and health have been examined and 8.31 found to be calculated in accordance with generally accepted 8.32 actuarial principles and practices and are fairly stated." 8.33 [EFFECTIVE DATE.] This section is effective the day 8.34 following final enactment. 8.35 Sec. 5. Minnesota Statutes 2000, section 60A.14, 8.36 subdivision 1, is amended to read: 9.1 Subdivision 1. [FEES OTHER THAN EXAMINATION FEES.] In 9.2 addition to the fees and charges provided for examinations, the 9.3 following fees must be paid to the commissioner for deposit in 9.4 the general fund: 9.5 (a) by township mutual fire insurance companies: 9.6 (1) for filing certificate of incorporation $25 and 9.7 amendments thereto, $10; 9.8 (2) for filing annual statements, $15; 9.9 (3) for each annual certificate of authority, $15; 9.10 (4) for filing bylaws $25 and amendments thereto, $10. 9.11 (b) by other domestic and foreign companies including 9.12 fraternals and reciprocal exchanges: 9.13 (1) for filing certified copy of certificate of articles of 9.14 incorporation, $100; 9.15 (2) for filing annual statement, $225; 9.16 (3) for filing certified copy of amendment to certificate 9.17 or articles of incorporation, $100; 9.18 (4) for filing bylaws, $75 or amendments thereto, $75; 9.19 (5) for each company's certificate of authority, $575, 9.20 annually. 9.21 (c) the following general fees apply: 9.22 (1) for each certificate, including certified copy of 9.23 certificate of authority, renewal, valuation of life policies, 9.24 corporate condition or qualification, $25; 9.25 (2) for each copy of paper on file in the commissioner's 9.26 office 50 cents per page, and $2.50 for certifying the same; 9.27 (3) for license to procure insurance in unadmitted foreign 9.28 companies, $575; 9.29 (4) for valuing the policies of life insurance companies, 9.30 one cent per $1,000 of insurance so valued, provided that the 9.31 fee shall not exceed $13,000 per year for any company. The 9.32 commissioner may, in lieu of a valuation of the policies of any 9.33 foreign life insurance company admitted, or applying for 9.34 admission, to do business in this state, accept a certificate of 9.35 valuation from the company's own actuary or from the 9.36 commissioner of insurance of the state or territory in which the 10.1 company is domiciled; 10.2 (5) for receiving and filing certificates of policies by 10.3 the company's actuary, or by the commissioner of insurance of 10.4 any other state or territory, $50; 10.5 (6) for each appointment of an agent filed with the 10.6 commissioner, a domestic insurer shall remit $5 and all other 10.7 insurers shall remit $3; 10.8 (7) for filing forms and rates, $75 per filing, to be paid 10.9 on a quarterly basis in response to an invoice. Billing and 10.10 payment may be made electronically; 10.11 (8) for annual renewal of surplus lines insurer license, 10.12 $300. 10.13 The commissioner shall adopt rules to define filings that 10.14 are subject to a fee. 10.15 [EFFECTIVE DATE.] This section is effective July 1, 2001. 10.16 Sec. 6. Minnesota Statutes 2000, section 60A.16, 10.17 subdivision 1, is amended to read: 10.18 Subdivision 1. [SCOPE.] (1) [DOMESTIC INSURANCE 10.19 CORPORATIONS.] Any two or more domestic insurance corporations, 10.20 formed for any of the purposes for which stock, mutual, or stock 10.21 and mutual insurance corporations, or reciprocal or 10.22 interinsurance contract exchanges might be formed under the laws 10.23 of this state, may be 10.24 (a) merged into one of such domestic insurance 10.25 corporations, or 10.26 (b) consolidated into a new insurance corporation to be 10.27 formed under the laws of this state. 10.28 (2) [DOMESTIC AND FOREIGN INSURANCE CORPORATIONS.] Any such 10.29 domestic insurance corporations and any foreign insurance 10.30 corporations formed to carry on any insurance business for the 10.31 conduct of which an insurance corporation might be organized 10.32 under the laws of this state, may be 10.33 (a) merged into one of such domestic insurance 10.34 corporations, or 10.35 (b) merged into one of such foreign insurance corporations, 10.36 or 11.1 (c) consolidated into a new insurance corporation to be 11.2 formed under the laws of this state, or 11.3 (d) consolidated into a new insurance corporation to be 11.4 formed under the laws of the government under which one of such 11.5 foreign insurance corporations was formed, provided that each of 11.6 such foreign insurance corporations is authorized by the laws of 11.7 the government under which it was formed to effect such merger 11.8 or consolidation. 11.9 [EFFECTIVE DATE.] This section is effective the day 11.10 following final enactment. 11.11 Sec. 7. Minnesota Statutes 2000, section 60A.23, 11.12 subdivision 8, is amended to read: 11.13 Subd. 8. [SELF-INSURANCE OR INSURANCE PLAN ADMINISTRATORS 11.14 WHO ARE VENDORS OF RISK MANAGEMENT SERVICES.] (1) [SCOPE.] This 11.15 subdivision applies to any vendor of risk management services 11.16 and to any entity which administers, for compensation, a 11.17 self-insurance or insurance plan. This subdivision does not 11.18 apply (a) to an insurance company authorized to transact 11.19 insurance in this state, as defined by section 60A.06, 11.20 subdivision 1, clauses (4) and (5); (b) to a service plan 11.21 corporation, as defined by section 62C.02, subdivision 6; (c) to 11.22 a health maintenance organization, as defined by section 62D.02, 11.23 subdivision 4; (d) to an employer directly operating a 11.24 self-insurance plan for its employees' benefits; (e) to an 11.25 entity which administers a program of health benefits 11.26 established pursuant to a collective bargaining agreement 11.27 between an employer, or group or association of employers, and a 11.28 union or unions; or (f) to an entity which administers a 11.29 self-insurance or insurance plan if a licensed Minnesota insurer 11.30 is providing insurance to the plan and if the licensed insurer 11.31 has appointed the entity administering the plan as one of its 11.32 licensed agents within this state. 11.33 (2) [DEFINITIONS.] For purposes of this subdivision the 11.34 following terms have the meanings given them. 11.35 (a) "Administering a self-insurance or insurance plan" 11.36 means (i) processing, reviewing or paying claims, (ii) 12.1 establishing or operating funds and accounts, or (iii) otherwise 12.2 providing necessary administrative services in connection with 12.3 the operation of a self-insurance or insurance plan. 12.4 (b) "Employer" means an employer, as defined by section 12.5 62E.02, subdivision 2. 12.6 (c) "Entity" means any association, corporation, 12.7 partnership, sole proprietorship, trust, or other business 12.8 entity engaged in or transacting business in this state. 12.9 (d) "Self-insurance or insurance plan" means a plan 12.10 providing life, medical or hospital care, accident, sickness or 12.11 disability insurance for the benefit of employees or members of 12.12 an association, or a plan providing liability coverage for any 12.13 other risk or hazard, which is or is not directly insured or 12.14 provided by a licensed insurer, service plan corporation, or 12.15 health maintenance organization. 12.16 (e) "Vendor of risk management services" means an entity 12.17 providing for compensation actuarial, financial management, 12.18 accounting, legal or other services for the purpose of designing 12.19 and establishing a self-insurance or insurance plan for an 12.20 employer. 12.21 (3) [LICENSE.] No vendor of risk management services or 12.22 entity administering a self-insurance or insurance plan may 12.23 transact this business in this state unless it is licensed to do 12.24 so by the commissioner. An applicant for a license shall state 12.25 in writing the type of activities it seeks authorization to 12.26 engage in and the type of services it seeks authorization to 12.27 provide. The license may be granted only when the commissioner 12.28 is satisfied that the entity possesses the necessary 12.29 organization, background, expertise, and financial integrity to 12.30 supply the services sought to be offered. The commissioner may 12.31 issue a license subject to restrictions or limitations upon the 12.32 authorization, including the type of services which may be 12.33 supplied or the activities which may be engaged in. The license 12.34 fee is $1,000 for the initial application and $1,000 for each 12.35 two-year renewal. All licenses are for a period of two years. 12.36 (4) [REGULATORY RESTRICTIONS; POWERS OF THE COMMISSIONER.] 13.1 To assure that self-insurance or insurance plans are financially 13.2 solvent, are administered in a fair and equitable fashion, and 13.3 are processing claims and paying benefits in a prompt, fair, and 13.4 honest manner, vendors of risk management services and entities 13.5 administering insurance or self-insurance plans are subject to 13.6 the supervision and examination by the commissioner. Vendors of 13.7 risk management services, entities administering insurance or 13.8 self-insurance plans, and insurance or self-insurance plans 13.9 established or operated by them are subject to the trade 13.10 practice requirements of sections 72A.19 to 72A.30. In lieu of 13.11 an unlimited guarantee from a parent corporation for a vendor of 13.12 risk management services or an entity administering insurance or 13.13 self-insurance plans, the commissioner may accept a surety bond 13.14 in a form satisfactory to the commissioner in an amount equal to 13.15 120 percent of the total amount of claims handled by the 13.16 applicant in the prior year. If at any time the total amount of 13.17 claims handled during a year exceeds the amount upon which the 13.18 bond was calculated, the administrator shall immediately notify 13.19 the commissioner. The commissioner may require that the bond be 13.20 increased accordingly. 13.21 No contract entered into after July 1, 2001, between a 13.22 licensed vendor of risk management services and a group 13.23 authorized to self-insure for workers' compensation liabilities 13.24 under section 79A.03, subdivision 6, may take effect until it 13.25 has been filed with the commissioner, and either (i) the 13.26 commissioner has approved it, or (ii) 60 days have elapsed and 13.27 the commissioner has not disapproved it as misleading or 13.28 violative of public policy. 13.29 (5) [RULEMAKING AUTHORITY.] To carry out the purposes of 13.30 this subdivision, the commissioner may adopt rules pursuant to 13.31 sections 14.001 to 14.69. These rules may: 13.32 (a) establish reporting requirements for administrators of 13.33 insurance or self-insurance plans; 13.34 (b) establish standards and guidelines to assure the 13.35 adequacy of financing, reinsuring, and administration of 13.36 insurance or self-insurance plans; 14.1 (c) establish bonding requirements or other provisions 14.2 assuring the financial integrity of entities administering 14.3 insurance or self-insurance plans; or 14.4 (d) establish other reasonable requirements to further the 14.5 purposes of this subdivision. 14.6 [EFFECTIVE DATE.] This section is effective July 1, 2001. 14.7 Sec. 8. Minnesota Statutes 2000, section 61A.072, is 14.8 amended by adding a subdivision to read: 14.9 Subd. 6. [ACCELERATED BENEFITS.] (a) "Accelerated benefits" 14.10 covered under this section are benefits payable under the life 14.11 insurance contract: 14.12 (1) to a policyholder or certificate holder, during the 14.13 lifetime of the insured, in anticipation of death upon the 14.14 occurrence of a specified life-threatening or catastrophic 14.15 condition as defined by the policy or rider; 14.16 (2) that reduce the death benefit otherwise payable under 14.17 the life insurance contract; and 14.18 (3) that are payable upon the occurrence of a single 14.19 qualifying event that results in the payment of a benefit amount 14.20 fixed at the time of acceleration. 14.21 (b) "Qualifying event" means one or more of the following: 14.22 (1) a medical condition that would result in a drastically 14.23 limited life span as specified in the contract; 14.24 (2) a medical condition that has required or requires 14.25 extraordinary medical intervention, such as, but not limited to, 14.26 major organ transplant or continuous artificial life support 14.27 without which the insured would die; or 14.28 (3) a condition that requires continuous confinement in an 14.29 eligible institution as defined in the contract if the insured 14.30 is expected to remain there for the rest of the insured's life. 14.31 [EFFECTIVE DATE.] This section is effective July 1, 2001. 14.32 Sec. 9. Minnesota Statutes 2000, section 62A.17, 14.33 subdivision 1, is amended to read: 14.34 Subdivision 1. [CONTINUATION OF COVERAGE.] Every group 14.35 insurance policy, group subscriber contract, and health care 14.36 plan included within the provisions of section 62A.16, except 15.1 policies, contracts, or health care plans covering employees of 15.2 an agency of the federal government, shall contain a provision 15.3 which permits every covered employee who is voluntarily or 15.4 involuntarily terminated or laid off from employment, if the 15.5 policy, contract, or health care plan remains in force for 15.6 active employees of the employer, to elect to continue the 15.7 coverage for the employee and dependents. 15.8 An employee shall be considered to be laid off from 15.9 employment if there is a reduction in hours to the point where 15.10 the employee is no longer eligible under the policy, contract, 15.11 or health care plan. Termination shall not include discharge 15.12 for gross misconduct. 15.13 Upon request by the terminated or laid off employee, a 15.14 health carrier must provide the information necessary to enable 15.15 the employee to elect continuation of coverage. 15.16 [EFFECTIVE DATE.] This section is effective the day 15.17 following final enactment. 15.18 Sec. 10. Minnesota Statutes 2000, section 62A.20, 15.19 subdivision 1, is amended to read: 15.20 Subdivision 1. [REQUIREMENT.] Every policy of accident and 15.21 health insurance providing coverage of hospital or medical 15.22 expense on either an expense-incurred basis or other than an 15.23 expense-incurred basis, which in addition to covering the 15.24 insured also provides coverage to the spouse and dependent 15.25 children of the insured shall contain: 15.26 (1) a provision whichpermitsallows the spouse and 15.27 dependent children to elect to continue coverage when the 15.28 insured becomes enrolled for benefits under Title XVIII of the 15.29 Social Security Act (Medicare); and 15.30 (2) a provision whichpermitsallows the dependent children 15.31 to continue coverage when they cease to be dependent children 15.32 under the generally applicable requirement of the plan. 15.33 Upon request by the insured or the insured's spouse or 15.34 dependent child, a health carrier must provide the information 15.35 necessary to enable the spouse or child to elect continuation of 15.36 coverage. 16.1 [EFFECTIVE DATE.] This section is effective the day 16.2 following final enactment. 16.3 Sec. 11. Minnesota Statutes 2000, section 62A.21, 16.4 subdivision 2a, is amended to read: 16.5 Subd. 2a. [CONTINUATION PRIVILEGE.] Every policy described 16.6 in subdivision 1 shall contain a provision which permits 16.7 continuation of coverage under the policy for the insured's 16.8 former spouse and dependent children upon entry of a valid 16.9 decree of dissolution of marriage. The coverage shall be 16.10 continued until the earlier of the following dates: 16.11 (a) the date the insured's former spouse becomes covered 16.12 under any other group health plan; or 16.13 (b) the date coverage would otherwise terminate under the 16.14 policy. 16.15 If the coverage is provided under a group policy, any 16.16 required premium contributions for the coverage shall be paid by 16.17 the insured on a monthly basis to the group policyholder for 16.18 remittance to the insurer. The policy must require the group 16.19 policyholder to, upon request, provide the insured with written 16.20 verification from the insurer of the cost of this coverage 16.21 promptly at the time of eligibility for this coverage and at any 16.22 time during the continuation period. In no event shall the 16.23 amount of premium charged exceed 102 percent of the cost to the 16.24 plan for such period of coverage for other similarly situated 16.25 spouses and dependent children with respect to whom the marital 16.26 relationship has not dissolved, without regard to whether such 16.27 cost is paid by the employer or employee. 16.28 Upon request by the insured's former spouse or dependent 16.29 child, a health carrier must provide the information necessary 16.30 to enable the child or former spouse to elect continuation of 16.31 coverage. 16.32 [EFFECTIVE DATE.] This section is effective the day 16.33 following final enactment. 16.34 Sec. 12. Minnesota Statutes 2000, section 62A.302, is 16.35 amended to read: 16.36 62A.302 [COVERAGE OF DEPENDENTS.] 17.1 Subdivision 1. [SCOPE OF COVERAGE.] This section applies 17.2 toall health plans as defined in section 62A.011: 17.3 (1) a health plan as defined in section 62A.011; 17.4 (2) coverage described in section 62A.011, subdivision 3, 17.5 clauses (4), (6), (7), (8), (9), and (10); and 17.6 (3) a policy, contract, or certificate issued by a 17.7 community-integrated service network licensed under chapter 62N. 17.8 Subd. 2. [REQUIRED COVERAGE.] Every health plan included 17.9 in subdivision 1 that provides dependent coverage must define 17.10 "dependent" no more restrictively than the definition provided 17.11 in section 62L.02. 17.12 Sec. 13. Minnesota Statutes 2000, section 62A.31, 17.13 subdivision 1a, is amended to read: 17.14 Subd. 1a. [MINIMUM COVERAGE.] The policy must provide a 17.15 minimum of the coverage set out in subdivision 2 and for an 17.16 extended basic plan, the additional requirements of section 17.17 62E.07. 17.18 [EFFECTIVE DATE.] This section is effective the day 17.19 following final enactment. 17.20 Sec. 14. Minnesota Statutes 2000, section 62A.31, 17.21 subdivision 1i, is amended to read: 17.22 Subd. 1i. [REPLACEMENT COVERAGE.] If a Medicare supplement 17.23 policy or certificate replaces another Medicare supplement 17.24 policy or certificate, the issuer of the replacing policy or 17.25 certificate shall waive any time periods applicable to 17.26 preexisting conditions, waiting periods, elimination periods, 17.27 and probationary periods in the new Medicare supplement policy 17.28 or certificate for benefits to the extent the time was spent 17.29 under the original policy or certificate. For purposes of this 17.30 subdivision, "Medicare supplement policy or certificate" means 17.31 all coverage described in section 62A.011, subdivision43, 17.32 clause (10). 17.33 [EFFECTIVE DATE.] This section is effective the day 17.34 following final enactment. 17.35 Sec. 15. Minnesota Statutes 2000, section 62A.31, 17.36 subdivision 3, is amended to read: 18.1 Subd. 3. [DEFINITIONS.] (a) The definitions provided in 18.2 this subdivision apply to sections 62A.31 to 62A.44. 18.3 (b) "Accident," "accidental injury," or "accidental means" 18.4 means to employ "result" language and does not include words 18.5 that establish an accidental means test or use words such as 18.6 "external," "violent," "visible wounds," or similar words of 18.7 description or characterization. 18.8 (1) The definition shall not be more restrictive than the 18.9 following: "Injury or injuries for which benefits are provided 18.10 means accidental bodily injury sustained by the insured person 18.11 which is the direct result of an accident, independent of 18.12 disease or bodily infirmity or any other cause, and occurs while 18.13 insurance coverage is in force." 18.14 (2) The definition may provide that injuries shall not 18.15 include injuries for which benefits are provided or available 18.16 under a workers' compensation, employer's liability or similar 18.17 law, or motor vehicle no-fault plan, unless prohibited by law. 18.18 (c) "Applicant" means: 18.19 (1) in the case of an individual Medicare supplement policy 18.20 or certificate, the person who seeks to contract for insurance 18.21 benefits; and 18.22 (2) in the case of a group Medicare supplement policy or 18.23 certificate, the proposed certificate holder. 18.24 (d) "Bankruptcy" means a situation in which a 18.25 Medicare+Choice organization that is not an issuer has filed, or 18.26 has had filed against it, a petition for declaration of 18.27 bankruptcy and has ceased doing business in the state. 18.28 (e) "Benefit period" or "Medicare benefit period" shall not 18.29 be defined more restrictively than as defined in the Medicare 18.30 program. 18.31 (f) "Certificate" means a certificate delivered or issued 18.32 for delivery in this state or offered to a resident of this 18.33 state under a group Medicare supplement policy or certificate. 18.34 (g) "Certificate form" means the form on which the 18.35 certificate is delivered or issued for delivery by the issuer. 18.36 (h) "Convalescent nursing home," "extended care facility," 19.1 or "skilled nursing facility" shall not be defined more 19.2 restrictively than as defined in the Medicare program. 19.3 (i) "Employee welfare benefit plan" means a plan, fund, or 19.4 program of employee benefits as defined in United States Code, 19.5 title 29, section 1002 (Employee Retirement Income Security Act). 19.6 (j) "Health care expenses" means expenses of health 19.7 maintenance organizations associated with the delivery of health 19.8 care services which are analogous to incurred losses of 19.9 insurers. The expenses shall not include: 19.10 (1) home office and overhead costs; 19.11 (2) advertising costs; 19.12 (3) commissions and other acquisition costs; 19.13 (4) taxes; 19.14 (5) capital costs; 19.15 (6) administrative costs; and 19.16 (7) claims processing costs. 19.17 (k) "Hospital" may be defined in relation to its status, 19.18 facilities, and available services or to reflect its 19.19 accreditation by the joint commission on accreditation of 19.20 hospitals, but not more restrictively than as defined in the 19.21 Medicare program. 19.22 (l) "Insolvency" means a situation in which an issuer, 19.23 licensed to transact the business of insurance in this state, 19.24 including the right to transact business as any type of issuer, 19.25 has had a final order of liquidation entered against it with a 19.26 finding of insolvency by a court of competent jurisdiction in 19.27 the issuer's state of domicile. 19.28 (m) "Issuer" includes insurance companies, fraternal 19.29 benefit societies, health service plan corporations, health 19.30 maintenance organizations, and any other entity delivering or 19.31 issuing for delivery Medicare supplement policies or 19.32 certificates in this state or offering these policies or 19.33 certificates to residents of this state. 19.34 (n) "Medicare" shall be defined in the policy and 19.35 certificate. Medicare may be defined as the Health Insurance 19.36 for the Aged Act, title XVIII of the Social Security Amendments 20.1 of 1965, as amended, or title I, part I, of Public Law Number 20.2 89-97, as enacted by the 89th Congress of the United States of 20.3 America and popularly known as the Health Insurance for the Aged 20.4 Act, as amended. 20.5 (o) "Medicare eligible expenses" means health care expenses 20.6 covered by Medicare, to the extent recognized as reasonable and 20.7 medically necessary by Medicare. 20.8 (p) "Medicare+Choice plan" means a plan of coverage for 20.9 health benefits under Medicare part C as defined in section 1859 20.10 of the federal Social Security Act, United States Code, title 20.11 42, section 1395w-28, and includes: 20.12 (1) coordinated care plans which provide health care 20.13 services, including, but not limited to, health maintenance 20.14 organization plans, with or without a point-of-service option, 20.15 plans offered by provider-sponsored organizations, and preferred 20.16 provider organization plans; 20.17 (2) medical savings account plans coupled with a 20.18 contribution into a Medicare+Choice medical savings account; and 20.19 (3) Medicare+Choice private fee-for-service plans. 20.20 (q) "Medicare-related coverage" means a policy, contract, 20.21 or certificate issued as a supplement to Medicare, regulated 20.22 under sections 62A.31 to 62A.44, including Medicare select 20.23 coverage; policies, contracts, or certificates that supplement 20.24 Medicare issued by health maintenance organizations; or 20.25 policies, contracts, or certificates governed by section 1833 20.26 (known as "cost" or "HCPP" contracts) or 1876 (known as "TEFRA" 20.27 or "risk" contracts) of the federal Social Security Act, United 20.28 States Code, title 42, section 1395, et seq., as amended.; or 20.29 section 4001 of the Balanced Budget Act of 1997 (BBA) Public Law 20.30 Number 105-33, sections 1851 to 1859 of the Social Security Act 20.31 establishing part C of the Medicare program, known as the 20.32 "Medicare+Choice program." 20.33 (r) "Medicare supplement policy or certificate" means a 20.34 group or individual policy of accident and sickness insurance or 20.35 a subscriber contract of hospital and medical service 20.36 associations or health maintenance organizations, or those 21.1 policies or certificates covered by section 1833 of the federal 21.2 Social Security Act, United States Code, title 42, section 1395, 21.3 et seq., or an issued policy under a demonstration project 21.4 specified under amendments to the federal Social Security Act, 21.5 which is advertised, marketed, or designed primarily as a 21.6 supplement to reimbursements under Medicare for the hospital, 21.7 medical, or surgical expenses of persons eligible for Medicare. 21.8 (s) "Physician" shall not be defined more restrictively 21.9 than as defined in the Medicare program or section 62A.04, 21.10 subdivision 1, or 62A.15, subdivision 3a. 21.11 (t) "Policy form" means the form on which the policy is 21.12 delivered or issued for delivery by the issuer. 21.13 (u) "Secretary" means the Secretary of the United States 21.14 Department of Health and Human Services. 21.15 (v) "Sickness" shall not be defined more restrictively than 21.16 the following: 21.17 "Sickness means illness or disease of an insured person 21.18 which first manifests itself after the effective date of 21.19 insurance and while the insurance is in force." 21.20 The definition may be further modified to exclude 21.21 sicknesses or diseases for which benefits are provided under a 21.22 workers' compensation, occupational disease, employer's 21.23 liability, or similar law. 21.24 [EFFECTIVE DATE.] This section is effective the day 21.25 following final enactment. 21.26 Sec. 16. [62A.421] [DEMONSTRATION PROJECTS.] 21.27 Subdivision 1. [ESTABLISHMENT.] The commissioner may 21.28 establish demonstration projects to allow an issuer of Medicare 21.29 supplement policies to extend coverage to individuals enrolled 21.30 in part A or part B, or both, of the Medicare program, Title 21.31 XVIII of the Social Security Act, United States Code, title 42, 21.32 section 1395, et seq. For purposes of this section, the 21.33 commissioner may waive compliance with the benefits described in 21.34 sections 62A.315 and 62A.316 and other applicable statutes and 21.35 rules if there is reasonable evidence that the statutes or rules 21.36 prohibit the operation of the demonstration project, but may not 22.1 waive the six-month guaranteed issue provision. The 22.2 commissioner shall provide for public comment before any statute 22.3 or rule is waived. 22.4 Subd. 2. [BENEFITS.] A demonstration project must provide 22.5 health benefits equal to or exceeding the level of benefits 22.6 provided in Title XVIII of the Social Security Act and an 22.7 out-of-hospital prescription drug benefit. The out-of-hospital 22.8 prescription drug benefit may be waived by the commissioner if 22.9 the issuer presents evidence satisfactory to the commissioner 22.10 that the inclusion of the benefit would restrict the operation 22.11 of the demonstration project. 22.12 Subd. 3. [APPLICATION.] An issuer electing to participate 22.13 in a demonstration project shall apply to the commissioner for 22.14 approval on a form developed by the commissioner. The 22.15 application shall include at least the following: 22.16 (1) a statement identifying the population that the project 22.17 is designed to serve; 22.18 (2) a description of the proposed project including a 22.19 statement projecting a schedule of costs and benefits for the 22.20 policyholder; 22.21 (3) reference to the sections of Minnesota Statutes and 22.22 department of commerce rules for which waiver is requested; 22.23 (4) evidence that application of the requirements of 22.24 applicable Minnesota Statutes and department of commerce rules 22.25 would, unless waived, prohibit the operation of the 22.26 demonstration project; 22.27 (5) an estimate of the number of years needed to adequately 22.28 demonstrate the project's effects; and 22.29 (6) other information the commissioner may reasonably 22.30 require. 22.31 Subd. 4. [TIMELINE.] The commissioner shall approve, deny, 22.32 or refer back to the issuer for modification, the application 22.33 for a demonstration project within 60 days of the receipt of a 22.34 complete application. 22.35 Subd. 5. [PERIOD SPECIFIED.] The commissioner may approve 22.36 an application for a demonstration project for a period of six 23.1 years, with an option to renew. 23.2 Subd. 6. [ANNUAL REPORT.] Each issuer for which a 23.3 demonstration project is approved shall annually file a report 23.4 with the commissioner summarizing the project's experience at 23.5 the same time it files its annual report. The report shall be 23.6 on a form developed by the commissioner and shall be separate 23.7 from the annual report. 23.8 Subd. 7. [RESCISSION OF APPROVAL.] The commissioner may 23.9 rescind approval of a demonstration project if the commissioner 23.10 makes any of the findings listed in section 60A.052 or 62D.15, 23.11 subdivision 1, with respect to the project for which it has not 23.12 been granted a specific exemption, or if the commissioner finds 23.13 that the project's operation is contrary to the information 23.14 contained in the approved application. 23.15 [EFFECTIVE DATE.] This section is effective the day 23.16 following final enactment. 23.17 Sec. 17. Minnesota Statutes 2000, section 62A.65, 23.18 subdivision 8, is amended to read: 23.19 Subd. 8. [CESSATION OF INDIVIDUAL BUSINESS.] 23.20 Notwithstanding the provisions of subdivisions 1 to 7, a health 23.21 carrier may elect to cease doing business in the individual 23.22 health plan market in this state if it complies with the 23.23 requirements of this subdivision. For purposes of this section, 23.24 "cease doing business" means to discontinue issuing new 23.25 individual health plans and to refuse to renew all of the health 23.26 carrier's existing individual health plans issued in this state 23.27 whose terms permit refusal to renew under the circumstances 23.28 specified in this subdivision. This subdivision does not permit 23.29 cancellation of an individual health plan, unless the terms of 23.30 the health plan permit cancellation under the circumstances 23.31 specified in this subdivision. A health carrier electing to 23.32 cease doing business in the individual health plan market in 23.33 this state shall notify the commissioner 180 days prior to the 23.34 effective date of the cessation. Within 30 days after the 23.35 termination, the health carrier shall submit to the commissioner 23.36 a complete list of policyholders that have been terminated. The 24.1 cessation of business does not include the failure of a health 24.2 carrier to offer or issue new business in the individual health 24.3 plan market or continue an existing product line in that market, 24.4 provided that a health carrier does not terminate, cancel, or 24.5 fail to renew its current individual health plan business. A 24.6 health carrier electing to cease doing business in the 24.7 individual health plan market shall provide 120 days' written 24.8 notice to each policyholder covered by an individual health plan 24.9 issued by the health carrier. This notice must also inform each 24.10 policyholder of the existence of the Minnesota comprehensive 24.11 health association, the requirements for being accepted, the 24.12 procedures for applying for coverage, and the telephone numbers 24.13 at the department of health and the department of commerce for 24.14 information about private individual or family health coverage. 24.15 A health carrier that ceases to write new business in the 24.16 individual health plan market shall continue to be governed by 24.17 this section with respect to continuing individual health plan 24.18 business conducted by the health carrier. A health carrier that 24.19 ceases to do business in the individual health plan market after 24.20 July 1, 1994, is prohibited from writing new business in the 24.21 individual health plan market in this state for a period of five 24.22 years from the date of notice to the commissioner. This 24.23 subdivision applies to any health maintenance organization that 24.24 ceases to do business in the individual health plan market in 24.25 one service area with respect to that service area only. 24.26 Nothing in this subdivision prohibits an affiliated health 24.27 maintenance organization from continuing to do business in the 24.28 individual health plan market in that same service area. The 24.29 right to refuse to renew an individual health plan under this 24.30 subdivision does not apply to individual health plans issued on 24.31 a guaranteed renewable basis that does not permit refusal to 24.32 renew under the circumstances specified in this subdivision. 24.33 Sec. 18. Minnesota Statutes 2000, section 62E.04, 24.34 subdivision 4, is amended to read: 24.35 Subd. 4. [MAJOR MEDICAL COVERAGE.] Each insurer and 24.36 fraternal shall affirmatively offer coverage of major medical 25.1 expenses to every applicant who applies to the insurer or 25.2 fraternal for a new unqualified policy, which has a lifetime 25.3 benefit limit of less than $1,000,000, at the time of 25.4 application and annually to every holder of such an unqualified 25.5 policy of accident and health insurance renewed by the insurer 25.6 or fraternal. The coverage shall provide that when a covered 25.7 individual incurs out-of-pocket expenses of $5,000 or more 25.8 within a calendar year for services covered in section 62E.06, 25.9 subdivision 1, benefits shall be payable, subject to any 25.10 copayment authorized by the commissioner, up to a maximum 25.11 lifetime limit of$500,000not less than $1,000,000. The offer 25.12 of coverage of major medical expenses may consist of the offer 25.13 of a rider on an existing unqualified policy or a new policy 25.14 which is a qualified plan. 25.15 Sec. 19. Minnesota Statutes 2000, section 62E.06, 25.16 subdivision 1, is amended to read: 25.17 Subdivision 1. [NUMBER THREE PLAN.] A plan of health 25.18 coverage shall be certified as a number three qualified plan if 25.19 it otherwise meets the requirements established by chapters 62A 25.20and, 62C, and 62Q, and the other laws of this state, whether or 25.21 not the policy is issued in Minnesota, and meets or exceeds the 25.22 following minimum standards: 25.23 (a) The minimum benefits for a covered individual shall, 25.24 subject to the other provisions of this subdivision, be equal to 25.25 at least 80 percent of the cost of covered services in excess of 25.26 an annual deductible which does not exceed $150 per person. The 25.27 coverage shall include a limitation of $3,000 per person on 25.28 total annual out-of-pocket expenses for services covered under 25.29 this subdivision. The coverage shall be subject to a maximum 25.30 lifetime benefit of not less than$500,000$1,000,000. 25.31 The $3,000 limitation on total annual out-of-pocket 25.32 expenses and the$500,000$1,000,000 maximum lifetime benefit 25.33 shall not be subject to change or substitution by use of an 25.34 actuarially equivalent benefit. 25.35 (b) Covered expenses shall be the usual and customary 25.36 charges for the following services and articles when prescribed 26.1 by a physician: 26.2 (1) hospital services; 26.3 (2) professional services for the diagnosis or treatment of 26.4 injuries, illnesses, or conditions, other than dental, which are 26.5 rendered by a physician or at the physician's direction; 26.6 (3) drugs requiring a physician's prescription; 26.7 (4) services of a nursing home for not more than 120 days 26.8 in a year if the services would qualify as reimbursable services 26.9 under Medicare; 26.10 (5) services of a home health agency if the services would 26.11 qualify as reimbursable services under Medicare; 26.12 (6) use of radium or other radioactive materials; 26.13 (7) oxygen; 26.14 (8) anesthetics; 26.15 (9) prostheses other than dental but including scalp hair 26.16 prostheses worn for hair loss suffered as a result of alopecia 26.17 areata; 26.18 (10) rental or purchase, as appropriate, of durable medical 26.19 equipment other than eyeglasses and hearing aids; 26.20 (11) diagnostic X-rays and laboratory tests; 26.21 (12) oral surgery for partially or completely unerupted 26.22 impacted teeth, a tooth root without the extraction of the 26.23 entire tooth, or the gums and tissues of the mouth when not 26.24 performed in connection with the extraction or repair of teeth; 26.25 (13) services of a physical therapist; 26.26 (14) transportation provided by licensed ambulance service 26.27 to the nearest facility qualified to treat the condition; or a 26.28 reasonable mileage rate for transportation to a kidney dialysis 26.29 center for treatment; and 26.30 (15) services of an occupational therapist. 26.31 (c) Covered expenses for the services and articles 26.32 specified in this subdivision do not include the following: 26.33 (1) any charge for care for injury or disease either (i) 26.34 arising out of an injury in the course of employment and subject 26.35 to a workers' compensation or similar law, (ii) for which 26.36 benefits are payable without regard to fault under coverage 27.1 statutorily required to be contained in any motor vehicle, or 27.2 other liability insurance policy or equivalent self-insurance, 27.3 or (iii) for which benefits are payable under another policy of 27.4 accident and health insurance, Medicare, or any other 27.5 governmental program except as otherwise provided by section 27.6 62A.04, subdivision 3, clause (4); 27.7 (2) any charge for treatment for cosmetic purposes other 27.8 than for reconstructive surgery when such service is incidental 27.9 to or follows surgery resulting from injury, sickness, or other 27.10 diseases of the involved part or when such service is performed 27.11 on a covered dependent child because of congenital disease or 27.12 anomaly which has resulted in a functional defect as determined 27.13 by the attending physician; 27.14 (3) care which is primarily for custodial or domiciliary 27.15 purposes which would not qualify as eligible services under 27.16 Medicare; 27.17 (4) any charge for confinement in a private room to the 27.18 extent it is in excess of the institution's charge for its most 27.19 common semiprivate room, unless a private room is prescribed as 27.20 medically necessary by a physician, provided, however, that if 27.21 the institution does not have semiprivate rooms, its most common 27.22 semiprivate room charge shall be considered to be 90 percent of 27.23 its lowest private room charge; 27.24 (5) that part of any charge for services or articles 27.25 rendered or prescribed by a physician, dentist, or other health 27.26 care personnel which exceeds the prevailing charge in the 27.27 locality where the service is provided; and 27.28 (6) any charge for services or articles the provision of 27.29 which is not within the scope of authorized practice of the 27.30 institution or individual rendering the services or articles. 27.31 (d) The minimum benefits for a qualified plan shall 27.32 include, in addition to those benefits specified in clauses (a) 27.33 and (e), benefits for well baby care, effective July 1, 1980, 27.34 subject to applicable deductibles, coinsurance provisions, and 27.35 maximum lifetime benefit limitations. 27.36 (e) Effective July 1, 1979, the minimum benefits of a 28.1 qualified plan shall include, in addition to those benefits 28.2 specified in clause (a), a second opinion from a physician on 28.3 all surgical procedures expected to cost a total of $500 or more 28.4 in physician, laboratory, and hospital fees, provided that the 28.5 coverage need not include the repetition of any diagnostic tests. 28.6 (f) Effective August 1, 1985, the minimum benefits of a 28.7 qualified plan must include, in addition to the benefits 28.8 specified in clauses (a), (d), and (e), coverage for special 28.9 dietary treatment for phenylketonuria when recommended by a 28.10 physician. 28.11 (g) Outpatient mental health coverage is subject to section 28.12 62A.152, subdivision 2. 28.13 Sec. 20. Minnesota Statutes 2000, section 62E.13, 28.14 subdivision 3, is amended to read: 28.15 Subd. 3. [DUTIES OF WRITING CARRIER.] The writing carrier 28.16 shall perform all administrative and claims payment functions 28.17 required by this section. The writing carrier shall provide 28.18 these services for a period of three years, unless a request to28.19terminate is approved by the commissioner. The three-year 28.20 contract period may be renewed for a second three-year period 28.21 without a competitive bidding process upon the approval of the 28.22 commissioner of commerce and the consent of the association and 28.23 the writing carrier. The renewal may include amendments agreed 28.24 to by the association and the writing carrier and approved by 28.25 the commissioner. At any time, either the writing carrier or 28.26 the association may submit a request to terminate to the 28.27 commissioner. The commissioner shall approve or deny a request 28.28 to terminate within 90 days of its receipt. A failure to make a 28.29 final decision on a request to terminate within the specified 28.30 period shall be deemed to be an approval. Six months prior to 28.31 the expiration of each three-year period, the association shall 28.32 invite submissions of policy forms from members of the 28.33 association, including the writing carrier. The association 28.34 shall follow the provisions of subdivision 2 in selecting a 28.35 writing carrier for the subsequent three-year period. 28.36 Sec. 21. Minnesota Statutes 2000, section 62L.05, 29.1 subdivision 1, is amended to read: 29.2 Subdivision 1. [TWO SMALL EMPLOYER PLANS.] Each health 29.3 carrier in the small employer market must make available, on a 29.4 guaranteed issue basis, to any small employer that satisfies the 29.5 contribution and participation requirements of section 62L.03, 29.6 subdivision 3, both of the small employer plans described in 29.7 subdivisions 2 and 3. Under subdivisions 2 and 3, coinsurance 29.8 and deductibles do not apply to child health supervision 29.9 services and prenatal services, as defined by section 62A.047. 29.10 The maximum out-of-pocket costs for covered services must be 29.11 $3,000 per individual and $6,000 per family per year. The 29.12 maximum lifetime benefit must be$500,000not less than 29.13 $1,000,000. 29.14 Sec. 22. Minnesota Statutes 2000, section 62L.05, 29.15 subdivision 2, is amended to read: 29.16 Subd. 2. [DEDUCTIBLE-TYPE SMALL EMPLOYER PLAN.] The 29.17 benefits of the deductible-type small employer plan offered by a 29.18 health carrier must be equal to 80 percent of the charges, as 29.19 specified in subdivision 10, for health care services, supplies, 29.20 or other articles covered under the small employer plan, in 29.21 excess of an annual deductible which must be$500$2,250 per 29.22 individual and$1,000$4,500 per family. 29.23 Sec. 23. [62L.24] [SUSPENSION OF REINSURANCE OPERATIONS; 29.24 REACTIVATION.] 29.25 Subdivision 1. [SUSPENSION.] The commissioner may, by 29.26 order, suspend the operation of sections 62L.13 to 62L.22, upon 29.27 receipt of a recommendation for suspension from the association 29.28 board of directors. The order is effective 30 days after 29.29 publication in the State Register. 29.30 Subd. 2. [SUSPENSION OF REINSURANCE OPERATIONS.] Upon the 29.31 issuance of an order issued pursuant to subdivision 1, the 29.32 association shall suspend its operations in an orderly manner 29.33 supervised by the commissioner and shall provide for the proper 29.34 storage of the association's records. Notwithstanding the 29.35 provisions of subdivision 1, the association may continue to 29.36 levy assessments under section 62L.22 for the purpose of 30.1 satisfying the association's presuspension expenses and the 30.2 expenses associated with the association's suspension activities 30.3 pursuant to this subdivision. The assessments must be approved 30.4 by the commissioner. 30.5 Subd. 3. [NO CANCELLATION PERMITTED.] Effective upon the 30.6 effective date of an order issued pursuant to subdivision 1, 30.7 reinsurance must be terminated for any person reinsured by the 30.8 association pursuant to section 62L.18. No health carrier may 30.9 cancel or fail to renew a health benefit plan for any person 30.10 whose reinsurance with the association has been terminated 30.11 subsequently to the issuance of an order pursuant to subdivision 30.12 1 solely because of the termination of reinsurance. 30.13 Subd. 4. [REACTIVATION OF REINSURANCE OPERATIONS.] The 30.14 commissioner may, by order, reactivate the operation of sections 30.15 62L.13 to 62L.22, on a finding that the private market for 30.16 reinsurance of health benefit plans has failed and that 30.17 commercial reinsurance is unavailable to health carriers 30.18 operating in the small employer market in Minnesota. The 30.19 commissioner may not make findings or issue an order pursuant to 30.20 this subdivision until a hearing is held pursuant to chapter 14. 30.21 Subd. 5. [TRANSITION.] After issuance of any order 30.22 pursuant to subdivision 4, the commissioner shall immediately 30.23 appoint an interim board of directors of the association. The 30.24 terms of members of this interim board must be for a period not 30.25 to exceed 18 months. The board shall cause the reinsurance 30.26 operations of the association to be resumed within 180 days of 30.27 an order issued pursuant to subdivision 4. 30.28 Subd. 6. [MODIFICATION OF FIVE-YEAR RULE.] If the 30.29 commissioner issues an order pursuant to subdivision 4, any 30.30 health carrier may elect to participate in the reinsurance 30.31 association, notwithstanding any departicipation by the health 30.32 carrier within the preceding five years that, pursuant to 30.33 section 62L.17, would have otherwise prohibited the health 30.34 carrier's participation. 30.35 [EFFECTIVE DATE.] This section is effective the day 30.36 following final enactment. 31.1 Sec. 24. Minnesota Statutes 2000, section 62M.03, 31.2 subdivision 2, is amended to read: 31.3 Subd. 2. [NONLICENSED UTILIZATION REVIEW ORGANIZATION.] An 31.4 organization that meets the definition of a utilization review 31.5 organization under section 62M.02, subdivision 21, that is not 31.6 licensed in this state that performs utilization review services 31.7 for Minnesota residents must register with the commissioner of 31.8 commerce and must certify compliance with sections 62M.01 to 31.9 62M.16. 31.10 Initial registration must occur no later than January 1, 31.11 1993. The registration is effective for two years and may be 31.12 renewed for another two years by written request. Each 31.13 utilization review organization registered under this chapter 31.14 shall notify the commissioner of commerce within 30 days of any 31.15 change in the name, address, or ownership of the 31.16 organization. The organization shall pay to the commissioner of 31.17 commerce or the commissioner of health a fee of $1,000 for the 31.18 initial registration application and $1,000 for each two-year 31.19 renewal. 31.20 Sec. 25. Minnesota Statutes 2000, section 62M.05, 31.21 subdivision 5, is amended to read: 31.22 Subd. 5. [NOTIFICATION TO CLAIMS ADMINISTRATOR.] If the 31.23 utilization review organization and the claims administrator are 31.24 separate entities, the utilization review organization must 31.25 forward, electronically or in writing, a notification of 31.26 certification or determination not to certify to the appropriate 31.27 claims administrator for the health benefit plan. If it is 31.28 determined by the claims administrator that the certified health 31.29 care service is not covered by the health benefit plan, the 31.30 claims administrator must promptly notify the claimant and 31.31 provider of this information. 31.32 Sec. 26. Minnesota Statutes 2000, section 62Q.01, 31.33 subdivision 6, is amended to read: 31.34 Subd. 6. [MEDICARE-RELATED COVERAGE.] "Medicare-related 31.35 coverage" means a policy, contract, or certificate issued as a 31.36 supplement to Medicare, regulated under sections 62A.31 to 32.1 62A.44, including Medicare select coverage; policies, contracts, 32.2 or certificates that supplement Medicare issued by health 32.3 maintenance organizations; or policies, contracts, or 32.4 certificates governed by section 1833 (known as "cost" or "HCPP" 32.5 contracts) or 1876 (known as "TEFRA" or "risk" contracts) of the 32.6 federal Social Security Act, United States Code, title 42, 32.7 section 1395, et seq., as amended.; or section 4001 of the 32.8 Balanced Budget Act of 1997 (BBA) Public Law Number 105-33, 32.9 sections 1851 to 1859 of the Social Security Act establishing 32.10 part C of the Medicare program, known as the "Medicare+Choice 32.11 program." 32.12 [EFFECTIVE DATE.] This section is effective the day 32.13 following final enactment. 32.14 Sec. 27. Minnesota Statutes 2000, section 62Q.73, 32.15 subdivision 3, is amended to read: 32.16 Subd. 3. [RIGHT TO EXTERNAL REVIEW.] (a) Any enrollee or 32.17 anyone acting on behalf of an enrollee who has received an 32.18 adverse determination may submit a written request for an 32.19 external review of the adverse determination, if applicable 32.20 under section 62Q.68, subdivision 1, or 62M.06, to the 32.21 commissioner of health if the request involves a health plan 32.22 company regulated by that commissioner or to the commissioner of 32.23 commerce if the request involves a health plan company regulated 32.24 by that commissioner. Notification of the enrollee's right to 32.25 external review must accompany the denial issued by the insurer 32.26 on forms acceptable to the appropriate commissioner. The 32.27 written request must be accompanied by a filing fee of $25. The 32.28 fee may be waived by the commissioner of health or commerce in 32.29 cases of financial hardship. 32.30 (b) Nothing in this section requires the commissioner of 32.31 health or commerce to independently investigate an adverse 32.32 determination referred for independent external review. 32.33 (c) If an enrollee requests an external review, the health 32.34 plan company must participate in the external review. The cost 32.35 of the external review in excess of the filing fee described in 32.36 paragraph (a) shall be borne by the health plan company. 33.1 Sec. 28. Minnesota Statutes 2000, section 65A.29, 33.2 subdivision 7, is amended to read: 33.3 Subd. 7. [RENEWAL; NOTICE REQUIREMENT.] No insurer shall 33.4 refuse to renew, or reduce limits of coverage, or eliminate any 33.5 coverage in a homeowner's insurance policy unless it mails or 33.6 delivers to the insured, at the address shown in the policy, at 33.7 least 60 days' advance notice of its intention. The notice must 33.8 contain the specific underwriting or other reason or reasons for 33.9 the indicated action and must state the name of the insurer and 33.10 the date the notice is issued. 33.11 Proof of mailing this notice to the insured at the address 33.12 shown in the policy is sufficient proof that the notice required 33.13 by this section has been given. 33.14 [EFFECTIVE DATE.] This section is effective the day 33.15 following final enactment. 33.16 Sec. 29. Minnesota Statutes 2000, section 65B.04, 33.17 subdivision 3, is amended to read: 33.18 Subd. 3. [AMENDMENTS.] The plan of operation may be 33.19 amended by a majority vote of the governing committee,and the 33.20 approval of the commissionerand ratification by a majority of33.21the members. An order by the commissioner disapproving an 33.22 amendment to the plan of operation must be issued within 30 days 33.23 of receipt by the commissioner of the proposed amendment, 33.24 certified by the governing committee as having been adopted by 33.25 that committee by a majority vote, or the amendment shall be 33.26 deemed approved by the commissioner. An order of disapproval 33.27 may be appealed as provided in chapter 14. 33.28 [EFFECTIVE DATE.] This section is effective the day 33.29 following final enactment. 33.30 Sec. 30. Minnesota Statutes 2000, section 65B.06, 33.31 subdivision 1, is amended to read: 33.32 Subdivision 1. With respect to private passenger, nonfleet 33.33 automobiles, the facility shall provide for the equitable 33.34 distribution of qualified applicants to members in accordance 33.35 with the participation ratio or among these insurance companies 33.36 as selected under the provisions of the plan of operation. 34.1 [EFFECTIVE DATE.] This section is effective the day 34.2 following final enactment. 34.3 Sec. 31. Minnesota Statutes 2000, section 65B.06, 34.4 subdivision 4, is amended to read: 34.5 Subd. 4. Coverage made available under this section shall 34.6 be thestandardautomobile policy and endorsement forms, as 34.7 approved by the commissioner, with such changes, additions and 34.8 amendments as are adopted by the governing committee and 34.9 approved by the commissioner. 34.10 [EFFECTIVE DATE.] This section is effective the day 34.11 following final enactment. 34.12 Sec. 32. Minnesota Statutes 2000, section 65B.16, is 34.13 amended to read: 34.14 65B.16 [STATEMENT OF REASONS FOR CANCELLATION OR 34.15 REDUCTION.] 34.16 No notice of cancellation or reduction in the limits of 34.17 liability of coverage of an automobile insurance policy under 34.18 section 65B.15 shall be effective unless the specific 34.19 underwriting or other reason or reasons for such cancellation or 34.20 reduction in the limits of liability of coverage are stated in 34.21 such notice and the notice is mailed or delivered by the insurer 34.22 so as to provide the named insured with at least 30daysdays' 34.23 notice prior to the effective date of cancellation; provided, 34.24 however, that when nonpayment of premium is the reason for 34.25 cancellation or when the company is exercising its right to 34.26 cancel insurance which has been in effect for less than 60 days 34.27 at least ten days' notice of cancellation, and the reasons for 34.28 the cancellation, shall be given. Information regarding moving 34.29 traffic violations or motor vehicle accidents must be 34.30 specifically requested on the application in order for a company 34.31 to use those incidents to exercise its right to cancel within 34.32 the first 59 days of coverage. When nonpayment of premiums is 34.33 the reason for cancellation, the reason must be given to the 34.34 insured with the notice of cancellation; and if the company is 34.35 exercising its right to cancel within the first 59 days of 34.36 coverage and notice is given with less than ten days remaining 35.1 in the 59-day period, the coverage must be extended, to expire 35.2 ten days after notice was mailed. 35.3 Sec. 33. Minnesota Statutes 2000, section 65B.19, 35.4 subdivision 2, is amended to read: 35.5 Subd. 2. [NOTICE OF RIGHT TO COMPLAIN.] When the insurer 35.6 notifies the policyholder of nonrenewal, cancellation or 35.7 reduction in the limits of liability of coverage under section 35.8 65B.16 or 65B.17, the insurer shall also notify the named 35.9 insured of the right to complain within 30 days of receipt by 35.10 the named insured of notice of nonrenewal, cancellation or 35.11 reduction in the limits of liability to the commissioner of such 35.12 action and of the nature of and possible eligibility for 35.13 insurance through the Minnesota automobile insurance plan. Such 35.14 notice shall be included in the notice of nonrenewal, 35.15 cancellation or reduction in the limits of liability of 35.16 coverage, and shall state that such notice of the insured's 35.17 right of complaint to the commissioner and of the availability 35.18 of insurance through the Minnesota automobile insurance plan is 35.19 given pursuant to sections 65B.14 to 65B.21. The notice must 35.20 state the name of the insurer and the date the notice is issued. 35.21 Sec. 34. Minnesota Statutes 2000, section 67A.20, is 35.22 amended by adding a subdivision to read: 35.23 Subd. 3. [WITH LICENSED INSURERS.] Township mutual fire 35.24 insurance companies may enter into reinsurance agreements with 35.25 any Minnesota licensed insurer authorized to write the same 35.26 lines of business. 35.27 [EFFECTIVE DATE.] This section is effective the day 35.28 following final enactment. 35.29 Sec. 35. Minnesota Statutes 2000, section 79A.02, 35.30 subdivision 1, is amended to read: 35.31 Subdivision 1. [MEMBERSHIP.] For the purposes of assisting 35.32 the commissioner, there is established a workers' compensation 35.33 self-insurers' advisory committee of five members that are 35.34 employers authorized to self-insure in Minnesota. Three of the 35.35 members and three alternates shall be elected by the 35.36 self-insurers' security fund board of trustees and two members 36.1 and two alternates shall be appointed by the 36.2 commissioner. Notwithstanding section 15.059, subdivision 5a, 36.3 the advisory committee does not expire June 30, 2001. 36.4 [EFFECTIVE DATE.] This section is effective the day 36.5 following final enactment. 36.6 Sec. 36. Minnesota Statutes 2000, section 79A.03, 36.7 subdivision 7, is amended to read: 36.8 Subd. 7. [FINANCIAL STANDARDS.] A self-insurer group shall 36.9 have and maintain: 36.10 (a) A combined net worth of all of the members of an amount 36.11 at least equal to the greater of ten times the retention 36.12 selected with the workers' compensation reinsurance association 36.13 or one-third of the current annual modified premium of the 36.14 members. 36.15 (b) Sufficient assets, net worth, and liquidity to promptly 36.16 and completely meet all obligations of its members under chapter 36.17 176 or this chapter. In determining whether a group is in sound 36.18 financial condition, consideration shall be given to the 36.19 combined net worth of the member companies; the consolidated 36.20 long-term and short-term debt to equity ratios of the member 36.21 companies; any excess insurance other than reinsurance with the 36.22 workers' compensation reinsurance association, purchased by the 36.23 group from an insurer licensed in Minnesota or from an 36.24 authorized surplus line carrier; other financial data requested 36.25 by the commissioner or submitted by the group; and the combined 36.26 workers' compensation experience of the group for the last four 36.27 years. 36.28 No authority to self-insure will be granted unless, over 36.29 the term of the policy year, at least 65 percent of total 36.30 revenues from all sources for the year are available for the 36.31 payment of its claim and assessment obligations, and insurance 36.32 premiums for stop loss coverage. For purposes of this 36.33 calculation, claim and assessment obligations include the cost 36.34 of allocated loss expenses as well as special compensation fund 36.35 and self-insurers' security fund assessments, but exclude the 36.36 cost of unallocated loss expenses. 37.1 [EFFECTIVE DATE.] This section is effective July 1, 2001. 37.2 Sec. 37. Minnesota Statutes 2000, section 471.617, 37.3 subdivision 1, is amended to read: 37.4 Subdivision 1. [IF MORE THAN 100 EMPLOYEES; CONDITIONS.] A 37.5 statutory or home rule charter city, county, school district, or 37.6 instrumentality thereof which has more than 100 employees, may 37.7 by ordinance or resolution self-insure for any employee health 37.8 benefits including long-term disability, but not for employee 37.9 life benefits. Any self-insurance plan shall provide all 37.10 benefits which are required by law to be provided by group 37.11 health insurance policies. Self-insurance plansshallmust be 37.12 certified as provided by section 62E.05 and must be filed and 37.13 certified by the department of commerce before they are issued 37.14 or delivered to any person in this state. 37.15 [EFFECTIVE DATE.] This section is effective the day 37.16 following final enactment. 37.17 Sec. 38. [REPEALER.] 37.18 Minnesota Statutes 2000, sections 13.7191, subdivision 11; 37.19 60A.111; 62G.01; 62G.02; 62G.03; 62G.04; 62G.05; 62G.06; 62G.07; 37.20 62G.08; 62G.09; 62G.10; 62G.11; 62G.12; 62G.13; 62G.14; 62G.15; 37.21 62G.16; 62G.17; 62G.18; 62G.19; 62G.20; 62G.21; 62G.22; 62G.23; 37.22 62G.24; and 62G.25, are repealed. 37.23 [EFFECTIVE DATE.] This section is effective the day 37.24 following final enactment.