HF 2251

as introduced - 87th Legislature (2011 - 2012) Posted on 03/08/2012 03:14pm

A bill for an act
relating to insurance; shifting regulatory authority over health maintenance
organizations from the commissioner of health to the commissioner of commerce;
amending Minnesota Statutes 2010, sections 62D.02, subdivision 3; 62D.05,
subdivision 6; 62D.12, subdivision 1.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

Section 1.

Minnesota Statutes 2010, section 62D.02, subdivision 3, is amended to read:

Subd. 3.

Commissioner of deleted text begin health deleted text end new text begin commerce new text end or commissioner.

"Commissioner of
deleted text begin health deleted text end new text begin commerce new text end " or "commissioner" means the state commissioner of deleted text begin health deleted text end new text begin commerce new text end
or a designee.

Sec. 2.

Minnesota Statutes 2010, section 62D.05, subdivision 6, is amended to read:

Subd. 6.

Supplemental benefits.

(a) A health maintenance organization may, as
a supplemental benefit, provide coverage to its enrollees for health care services and
supplies received from providers who are not employed by, under contract with, or
otherwise affiliated with the health maintenance organization. Supplemental benefits may
be provided if the following conditions are met:

(1) a health maintenance organization desiring to offer supplemental benefits must at
all times comply with the requirements of sections 62D.041 and 62D.042;

(2) a health maintenance organization offering supplemental benefits must maintain
an additional surplus in the first year supplemental benefits are offered equal to the
lesser of $500,000 or 33 percent of the supplemental benefit expenses. At the end of
the second year supplemental benefits are offered, the health maintenance organization
must maintain an additional surplus equal to the lesser of $1,000,000 or 33 percent of the
supplemental benefit expenses. At the end of the third year benefits are offered and every
year after that, the health maintenance organization must maintain an additional surplus
equal to the greater of $1,000,000 or 33 percent of the supplemental benefit expenses.
When in the judgment of the commissioner the health maintenance organization's surplus
is inadequate, the commissioner may require the health maintenance organization to
maintain additional surplus;

(3) claims relating to supplemental benefits must be processed in accordance with
the requirements of section 72A.201; and

(4) in marketing supplemental benefits, the health maintenance organization shall
fully disclose and describe to enrollees and potential enrollees the nature and extent of the
supplemental coverage, and any claims filing and other administrative responsibilities in
regard to supplemental benefits.

(b) The commissioner may, pursuant to chapter 14, adopt, enforce, and administer
rules relating to this subdivision, including: rules insuring that these benefits are
supplementary and not substitutes for comprehensive health maintenance services by
addressing percentage of out-of-plan coverage; rules relating to the establishment of
necessary financial reserves; rules relating to marketing practices; and other rules necessary
for the effective and efficient administration of this subdivision. deleted text begin The commissioner, in
adopting rules, shall give consideration to existing laws and rules administered and
enforced by the Department of Commerce relating to health insurance plans.
deleted text end

Sec. 3.

Minnesota Statutes 2010, section 62D.12, subdivision 1, is amended to read:

Subdivision 1.

False representations.

No health maintenance organization or
representative thereof may cause or knowingly permit the use of advertising or solicitation
which is untrue or misleading, or any form of evidence of coverage which is deceptive.
Each health maintenance organization shall be subject to sections 72A.17 to 72A.32,
relating to the regulation of trade practices, except deleted text begin (a) deleted text end to the extent that the nature of a
health maintenance organization renders such sections clearly inappropriate deleted text begin and (b) that
enforcement shall be by the commissioner of health and not by the commissioner of
commerce deleted text end . Every health maintenance organization shall be subject to sections 8.31 and
325F.69.

Sec. 4. new text begin REVISOR'S INSTRUCTION.
new text end

new text begin The revisor of statutes shall, in conforming with section 1, change the terms
"commissioner of health" or similar term to "commissioner of commerce" or similar term
and "department of health" or similar term to "department of commerce" or similar term in
each place it occurs in Minnesota Statutes, chapter 62D.
new text end

Sec. 5. new text begin EFFECTIVE DATE.
new text end

new text begin Sections 1 to 4 are effective August 1, 2012.
new text end