HF 3096

Introduction - 79th Legislature (1995 - 1996)

Posted on 12/15/2009 12:00 a.m.

  1.1                          A bill for an act
  1.2             relating to employee relations; requiring certain 
  1.3             health plans providing health benefits to state 
  1.4             employees to offer a point-of-service product; 
  1.5             proposing coding for new law in Minnesota Statutes, 
  1.6             chapter 43A. 
  1.7   BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
  1.8      Section 1.  [43A.235] [POINT-OF-SERVICE OPTION.] 
  1.9      Subdivision 1.  [DEFINITION.] For purposes of this section, 
  1.10  "point-of-service product" means a health plan under which the 
  1.11  health plan company or entity offering the health plan will 
  1.12  reimburse an appropriately licensed provider for providing 
  1.13  covered, medically necessary services to an enrollee, without 
  1.14  regard to whether the provider belongs to a particular provider 
  1.15  network or particular health care clinic, and without regard to 
  1.16  whether the enrollee was referred to the provider by another 
  1.17  provider.  For purposes of this definition, a health plan 
  1.18  offered by a health plan company is a point-of-service product 
  1.19  only if it includes comprehensive supplemental benefits in 
  1.20  compliance with section 62D.05, subdivision 6, and Minnesota 
  1.21  Rules, part 4685.1955. 
  1.22     Subd. 2.  [REQUIREMENT.] Each health plan company, as 
  1.23  defined in section 62Q.01, under contract with the commissioner 
  1.24  under section 43A.23, and any self-insured health plan 
  1.25  administered by the commissioner under section 43A.23, shall 
  1.26  offer enrollees a point-of-service option if the health plan 
  2.1   company or self-insured health plan is the only entity in a 
  2.2   county providing health care benefits under section 43A.23. 
  2.3      Subd. 3.  [PREMIUMS AND COST-SHARING.] A health plan 
  2.4   company or self-insured health plan offering a point-of-service 
  2.5   option under subdivision 2 may charge enrollees choosing that 
  2.6   option additional premiums and may impose higher cost-sharing 
  2.7   requirements than are applied to enrollees not choosing that 
  2.8   option as long as the additional premiums and higher 
  2.9   cost-sharing are actuarially justified.  Actuarial 
  2.10  determinations shall be made by the commissioner regulating the 
  2.11  health plan company.  The commissioner of commerce shall be 
  2.12  responsible for actuarial determinations for any self-insured 
  2.13  health plan administered by the commissioner of employee 
  2.14  relations under section 43A.23. 
  2.15     Sec. 2.  [EFFECTIVE DATE.] 
  2.16     Section 1 is effective January 1, 1997, and applies to 
  2.17  health care benefits provided under Minnesota Statutes, section 
  2.18  43A.23, on or after that date.