1.1                          A bill for an act
  1.2             relating to insurance; requiring disclosure of how 
  1.3             enrollee cost sharing is affected by provider payment 
  1.4             arrangements; proposing coding for new law in 
  1.5             Minnesota Statutes, chapter 62Q. 
  1.6   BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
  1.7      Section 1.  [62Q.49] [ENROLLEE COST SHARING; NEGOTIATED 
  1.8   PROVIDER PAYMENTS.] 
  1.9      Subdivision 1.  [APPLICABILITY.] This section applies to 
  1.10  all health plans, as defined in section 62Q.01, subdivision 3, 
  1.11  that provide coverage for health care to be provided entirely or 
  1.12  partially: 
  1.13     (1) through contracts in which health care providers agree 
  1.14  to accept discounted charges, negotiated charges, or other 
  1.15  limits on health care provider charges; 
  1.16     (2) by employees of, or facilities or entities owned by, 
  1.17  the issuer of the health plan; or 
  1.18     (3) through contracts with health care providers that 
  1.19  provide for payment to the providers on a fully or partially 
  1.20  capitated basis or on any other non-fee-for-service basis. 
  1.21     Subd. 2.  [DISCLOSURE REQUIRED.] (a) All health plans 
  1.22  included in subdivision 1 must clearly specify how the cost of 
  1.23  health care used to calculate any copayments, coinsurance, or 
  1.24  lifetime benefits will be affected by the arrangements described 
  1.25  in subdivision 1. 
  2.1      (b) Any summary or other marketing material used in 
  2.2   connection with marketing of a health plan that is subject to 
  2.3   this section must prominently disclose and clearly explain the 
  2.4   provisions required under paragraph (a), if the summary or other 
  2.5   marketing material refers to copayments, coinsurance, or maximum 
  2.6   lifetime benefits. 
  2.7      (c) A health plan that is subject to paragraph (a) must not 
  2.8   be used in this state if the commissioner of commerce or health, 
  2.9   as appropriate, has determined that it does not comply with this 
  2.10  section. 
  2.11     Sec. 2.  [EFFECTIVE DATE.] 
  2.12     Section 1 is effective January 1, 1997, and applies to 
  2.13  health plans issued or renewed on or after that date.