1.1                          A bill for an act 
  1.2             relating to human services; creating an 
  1.3             employer-subsidized health coverage program; proposing 
  1.4             coding for new law in Minnesota Statutes, chapter 256. 
  1.5   BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
  1.6      Section 1.  [256.9370] [EMPLOYER-SUBSIDIZED INSURANCE 
  1.7   PROGRAM.] 
  1.8      Subdivision 1.  [ESTABLISHMENT.] (a) Upon federal approval 
  1.9   of all necessary waivers and state plan proposals to obtain 
  1.10  children's health insurance program matching funds under title 
  1.11  XXI of the Social Security Act, the commissioner shall establish 
  1.12  and administer an employer-subsidized insurance program to 
  1.13  subsidize premiums for employer-subsidized health coverage for 
  1.14  eligible families with children. 
  1.15     (b) The program must be administered according to the 
  1.16  federal regulations adopted under the children's health 
  1.17  insurance program under title XXI of the Social Security Act. 
  1.18     (c) The commissioner may contract with a business entity or 
  1.19  other private organization to administer the program. 
  1.20     Subd. 2.  [ELIGIBILITY.] Families with children between the 
  1.21  ages of two to 18 who meet the following criteria are eligible 
  1.22  for the program: 
  1.23     (1) the family's gross income must be greater than 150 
  1.24  percent of the federal poverty guidelines but must not exceed 
  1.25  200 percent of the federal poverty guidelines; 
  2.1      (2) the child must be eligible for the MinnesotaCare 
  2.2   program, except for the barriers to enrollment under section 
  2.3   256L.07, subdivision 2 or 3; 
  2.4      (3) the employer-subsidized health coverage available to 
  2.5   the child must be cost-effective as determined by the 
  2.6   commissioner; and 
  2.7      (4) the child must be uninsured at the time of application. 
  2.8      For the purpose of determining the cost-effectiveness of an 
  2.9   employer-subsidized health plan, the commissioner must determine 
  2.10  that the state cost of paying the premium for the coverage does 
  2.11  not exceed the estimated state cost that would otherwise be 
  2.12  incurred under the medical assistance program. 
  2.13     For the purpose of this section, "employer-subsidized 
  2.14  health coverage" or "employer-subsidized health plan" has the 
  2.15  same meaning provided in section 256L.07, subdivision 2, 
  2.16  paragraph (b). 
  2.17     Subd. 3.  [COVERAGE.] (a) Coverage under this program 
  2.18  includes the health care services covered under the eligible 
  2.19  child's employer-subsidized health plan, plus all health care 
  2.20  services reimbursed under chapter 256B.  
  2.21     (b) To be covered under this program, a health care service 
  2.22  must be provided by a health care provider who is eligible for 
  2.23  reimbursement under the medical assistance program. 
  2.24     Subd. 4.  [REIMBURSEMENT TO THE FAMILY.] The commissioner 
  2.25  shall reimburse an eligible family upon proof of payment of the 
  2.26  employee's share of the employer-subsidized health plan premium 
  2.27  that is attributable to dependent coverage, minus any premium 
  2.28  calculated under subdivision 6.  The commissioner shall not 
  2.29  reimburse the family for any portion of a premium that is 
  2.30  attributable to the employee or other adult family member. 
  2.31     Subd 5.  [REIMBURSEMENT TO THE HEALTH CARE PROVIDER.] (a) 
  2.32  Payment for services provided under the employer-subsidized 
  2.33  health plan shall be reimbursed in accordance with the health 
  2.34  plan. 
  2.35     (b) Payment for services that are not covered under the 
  2.36  employer-subsidized health plan shall be reimbursed at the same 
  3.1   rate and conditions established for fee-for-service under 
  3.2   medical assistance.  
  3.3      (c) The employer-subsidized health plan shall be considered 
  3.4   the primary payer to the extent that the services provided are 
  3.5   covered under the health plan. 
  3.6      Subd. 6.  [PREMIUMS.] Families with children who are 
  3.7   eligible for the program shall pay a premium determined 
  3.8   according to a sliding fee scale established by the 
  3.9   commissioner.  The sliding fee scale must be based on the 
  3.10  family's gross income during the previous four months. 
  3.11     Subd. 7.  [APPLICATION.] Applicants may apply to the 
  3.12  commissioner, to a local county human services agency that 
  3.13  determines eligibility for the MinnesotaCare program, or to the 
  3.14  licensed insurance broker who provides employee benefits to the 
  3.15  applicant's employer.  The licensed insurance broker shall 
  3.16  accept applications and forward them to the commissioner for 
  3.17  processing. 
  3.18     Sec. 2.  [EFFECTIVE DATE.] 
  3.19     Section 1 is effective 90 days after receipt of all 
  3.20  necessary federal approval or January 1, 2001, whichever is 
  3.21  later.