1.1 	A bill for an act
1.2 	relating to health; providing a statewide health insurance program for Minnesota 
1.3 	employees; modifying private sector health coverages; requiring a medical 
1.4 	malpractice insurance report; authorizing service cooperatives to operate health 
1.5 	reinsurance programs; authorizing participation by certain political subdivisions; 
1.6 	appropriating money;amending Minnesota Statutes 2004, sections 43A.317; 
1.7 	62D.095, subdivisions 3, 4, by adding a subdivision; 123A.21, subdivision 7; 
1.8 	471.61, by adding a subdivision; 471.617, subdivision 3, by adding a subdivision; 
1.9 	proposing coding for new law in Minnesota Statutes, chapter 62Q.
1.10 	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

1.11 	ARTICLE 1
1.12 	MINNESOTA EMPLOYEES INSURANCE PROGRAM

1.13 	Section 1. Minnesota Statutes 2004, section 43A.317, is amended to read:
1.14 	43A.317 MINNESOTA EMPLOYEES INSURANCE PROGRAM.
1.15 		Subdivision 1.Intent. The legislature finds that the creation of a statewide program 
1.16 	to provide employers with the advantages of a large pool for insurance purchasing would 
1.17 	advance the welfare of the citizens of the state.
1.18 		Subd. 2.Definitions. (a) Scope. For the purposes of this section, the terms defined 
1.19 	have the meaning given them. 
1.20 	(b)  Commissioner Board."Commissioner" means the commissioner of employee 
1.21 	relations. "Board" means the board of directors created under subdivision 4.
1.22 	(c)  Eligible employee. "Eligible employee" means an employee eligible to 
1.23 	participate in the program under the terms described in subdivision 6. 
1.24 	(d)  Eligible employer. "Eligible employer" means an employer eligible to 
1.25 	participate in the program under the terms described in subdivision 5. 
2.1 	(e)  Eligible individual. "Eligible individual" means a person eligible to participate 
2.2 	in the program under the terms described in subdivision 6. 
2.3 	(f)  Employee. "Employee" means an employee of an eligible employer. "Employee" 
2.4 	includes a sole proprietor, partner of a partnership, member of a limited liability company, 
2.5 	or independent contractor. 
2.6 	(g)  Employer. "Employer" means a private person, firm, corporation, partnership, 
2.7 	limited liability company, association, or other entity actively engaged in business or 
2.8 	public services. "Employer" includes both for-profit and nonprofit entities. 
2.9 	(h)  Program. "Program" means the Minnesota employees insurance program 
2.10 	created by this section. 
2.11 		Subd. 3.Entity status and administration. After consulting with the chairs of the 
2.12 	senate Governmental Operations and Veterans Committee and the house of representatives 
2.13 	Governmental Operations and Veterans Affairs Policy Committee, the commissioner 
2.14 	may determine when the program provided under this section is available. When the 
2.15 	commissioner makes the program available, The board is created and may operate as an 
2.16 	unincorporated association and may incorporate as a Minnesota nonprofit corporation 
2.17 	under chapter 317A. The board shall have all powers available under that chapter, except 
2.18 	to the extent inconsistent with this section.  The commissioner board shall, consistent 
2.19 	with the provisions of this section, administer the program and determine its coverage 
2.20 	options, funding and premium arrangements, contractual arrangements, and all other 
2.21 	matters necessary to administer the program. The commissioner's contracting authority 
2.22 	for the program, including authority for competitive bidding and negotiations, is governed 
2.23 	by section  43A.23.
2.24 		Subd. 4.Advisory committee Board of directors. After the commissioner 
2.25 	consults as required in subdivision 3 and then determines to make the program available,
2.26 	The commissionergovernor shall establish a appoint an initial ten-member advisory 
2.27 	committee board of directors that includes five members who represent eligible employers 
2.28 	andfive, two members who represent eligible individuals. The committee shall advise 
2.29 	the commissioner on issues related to administration of the program. The committee is 
2.30 	governed by sections  15.014 and  15.059, and continues to exist while the program remains 
2.31 	in operation., and three public members, for initial terms of two years for five directors 
2.32 	and three years for the other five directors. Subsequent board members shall be appointed 
2.33 	by the governor to serve staggered three-year terms. The governor may decide when to 
2.34 	activate the board and the program by making the initial appointments.
2.35 		Subd. 5.Employer eligibility. (a) Procedures. All employers are eligible for 
2.36 	coverage through the program subject to the terms of this subdivision. The commissioner
3.1 	board shall establish procedures for an employer to apply for coverage through the 
3.2 	program. 
3.3 	(b)  Term. The initial term of an employer's coverage may must be for up to at least
3.4 	two years from the effective date of the employer's application. After that, coverage 
3.5 	will be automatically renewed for an additional term of two years unless the employer 
3.6 	gives notice of withdrawal from the program according to procedures established by 
3.7 	the commissioner board or the commissioner board gives notice to the employer of the 
3.8 	discontinuance of the program. The commissioner board may establish conditions under 
3.9 	which an employer may withdraw from the program prior to the expiration of a term, 
3.10 	including by reason of an increase in health coverage premiums of 50 percent or more 
3.11 	from one insurance year to the next. An employer that withdraws from the program may 
3.12 	not reapply for coverage for a period of time equal to its initial term of coverage two years. 
3.13 	(c)  Minnesota work force. An employer is not eligible for coverage through the 
3.14 	program if five 50 percent or more of its eligible employees work primarily outside 
3.15 	Minnesota, except that an employer that either does or does not meet that requirement 
3.16 	may apply to the program on behalf of only those employees who work primarily in 
3.17 	Minnesota, and the board may accept or reject the application. 
3.18 	(d)  Employee participation; aggregation of groups. An employer is not eligible 
3.19 	for coverage through the program unless its application includes all eligible employees 
3.20 	who work primarily in Minnesota, except employees who waive coverage as permitted by 
3.21 	subdivision 6. Private entities that are eligible to file a combined tax return for purposes 
3.22 	of state tax laws are considered a single employer, except as otherwise approved by the 
3.23 	commissioner board. 
3.24 	(e)  Private employer. A private employer is not eligible for coverage unless it has 
3.25 	two or more eligible employees who live in the state of Minnesota. If an employer has 
3.26 	only two eligible employees and one is the spouse, child, sibling, parent, or grandparent of 
3.27 	the other, the employer must be a Minnesota domiciled employer and have paid Social 
3.28 	Security or self-employment tax on behalf of both eligible employees. 
3.29 	(f)  Minimum participation. The commissioner must require as a condition of 
3.30 	employer eligibility that at least 75 percent of its eligible employees who have not waived 
3.31 	coverage participate in the program. The participation level of eligible employees must be 
3.32 	determined at the initial offering of coverage and at the renewal date of coverage. For 
3.33 	purposes of this section, waiver of coverage includes only waivers due to coverage under 
3.34 	another group health benefit plan. eligible for waiver under section 62L.03, subdivision 3, 
3.35 	paragraph (a). An employer may not offer any employee health coverage other than that 
3.36 	offered by the board, except with prior approval of the board.
4.1 	(g)  Employer contribution. The commissioner board must require as a condition 
4.2 	of employer eligibility that the employer contribute at least 50 percent toward the cost 
4.3 	of the premium of the employee and may require that the contribution toward the cost 
4.4 	of coverage is structured in a way that promotes price competition among the coverage 
4.5 	options available through the program. 
4.6 	(h)  Enrollment cap. The commissioner board may limit employer enrollment in the 
4.7 	program if necessary to avoid exceeding the program's reserve capacity. 
4.8 		Subd. 6.Individual eligibility. (a) Procedures. The commissioner board shall 
4.9 	establish procedures for eligible employees and other eligible individuals to apply for 
4.10 	coverage through the program. 
4.11 	(b)  Employees. An employer shall determine when it applies to the program the 
4.12 	criteria its employees must meet to be eligible for coverage under its plan. An employer 
4.13 	may subsequently change the criteria annually or at other times with approval of the 
4.14 	commissioner board. The criteria must provide that new employees become eligible for 
4.15 	coverage after a probationary period of at least 30 days, but no more than 90 days. 
4.16 	(c)  Other individuals. An employer may elect to cover under its plan: 
4.17 	(1) the spouse, dependent children, and dependent grandchildren of a covered 
4.18 	employee;
4.19 	(2) a retiree who is eligible to receive a pension or annuity from the employer and a 
4.20 	covered retiree's spouse, dependent children, and dependent grandchildren;
4.21 	(3) the surviving spouse, dependent children, and dependent grandchildren of a 
4.22 	deceased employee or retiree, if the spouse, children, or grandchildren were covered 
4.23 	at the time of the death;
4.24 	(4) a covered employee who becomes disabled, as provided in sections  62A.147
4.25 	and  62A.148; or 
4.26 	(5) any other categories of individuals for whom group coverage is required by 
4.27 	state or federal law.
4.28 	An employer shall determine when it applies to the program the criteria individuals 
4.29 	in these categories must meet to be eligible for coverage. An employer may subsequently 
4.30 	change the criteria annually, or at other times with approval of the commissioner board. 
4.31 	The criteria for dependent children and dependent grandchildren may be no more 
4.32 	inclusive than the criteria under section  43A.18, subdivision 2. This paragraph shall 
4.33 	not be interpreted as relieving the program from compliance with any federal and state 
4.34 	continuation of coverage requirements. 
4.35 	(d)  Waiver and late entrance. An eligible individual may waive coverage at the 
4.36 	time the employer joins the program or when coverage first becomes available. The 
5.1 	commissioner board may establish a preexisting condition exclusion of not more than 18 
5.2 	months for late entrants as defined in section  62L.02, subdivision 19. 
5.3 	(e)  Continuation coverage. The program shall provide all continuation coverage 
5.4 	required by state and federal law. 
5.5 		Subd. 7.Coverage. Coverage is available through the program beginning on 
5.6 	July 1, 1993. Until an arrangement is in place to provide coverage may be provided
5.7 	through a transfer of risk to one or more carriers regulated under chapter 62A, 62C, or 
5.8 	62D, the commissioner shall solicit bids under section  43A.23, from carriers regulated 
5.9 	under chapters 62A, 62C, and 62D, to provide coverage of eligible individuals. The 
5.10 	commissioner shall provide coverage through contracts with carriers, unless the 
5.11 	commissioner receives no reasonable bids from carriers; through a group self-insured 
5.12 	arrangement under chapter 62H; or through a combination of those methods. The board 
5.13 	may, on behalf of the program, participate in an insured or self-insured reinsurance pool. 
5.14 	(a)  Health coverage. Health coverage is available to all employers in the program. 
5.15 	The commissioner board shall attempt to establish health coverage options that have 
5.16 	strong care management features to control costs and promote quality and shall attempt to 
5.17 	make a choice of health coverage options available. Health coverage for a retiree who 
5.18 	is eligible for the federal Medicare program must be administered as though the retiree 
5.19 	is enrolled in Medicare parts A and, B, and D. To the extent feasible as determined by 
5.20 	the commissioner and in the best interests of the program, the commissioner shall model 
5.21 	coverage after the plan established in section  43A.18, subdivision 2. Health coverage 
5.22 	must include at least the benefits required of a carrier regulated under chapter 62A, 62C, 
5.23 	or 62D for comparable coverage. Coverage under this paragraph must not be provided 
5.24 	as part of the health plans available to state employees.
5.25 	(b)  Choice of providers. All benefits provided by the program relating to expenses 
5.26 	incurred for medical treatment or services of a health care provider must also include 
5.27 	treatment and services of any other type of licensed, certified, or registered health care 
5.28 	provider to the extent that the services and treatment are within the scope of the provider's 
5.29 	licensure, certification, or registration.
5.30 	(c) Optional coverages. In addition to offering health coverage, the commissioner
5.31 	board may arrange to offer dental or other health-related coverage through the program. 
5.32 	Employers with health coverage may choose to offer dental or other health-related 
5.33 	coverage according to the terms established by the commissioner board. 
5.34 	(c) (d)Open enrollment. The program must meet all underwriting requirements of 
5.35 	chapter 62L and must provide periodic open enrollments for eligible individuals for those 
5.36 	coverages where a choice exists. 
6.1 	(d) (e)Technical assistance. The commissioner board may arrange for technical 
6.2 	assistance and referrals for eligible employers in areas such as health promotion and 
6.3 	wellness, employee benefits structure, tax planning, and health care analysis services 
6.4 	as described in section  62J.2930. 
6.5 		Subd. 8.Premiums. (a) Payments. Employers enrolled in the program shall pay 
6.6 	premiums according to terms established by the commissioner board. If an employer 
6.7 	fails to make the required payments, the commissioner board may cancel coverage and 
6.8 	pursue other civil remedies. 
6.9 	(b)  Rating method. The commissioner board shall determine the premium rates and 
6.10 	rating method for the program. The rating method for eligible small employers must meet 
6.11 	or exceed the requirements of chapter 62L. The rating methods must recover in premiums 
6.12 	all of the ongoing costs for state administration and for maintenance of a premium stability 
6.13 	and claim fluctuation reserve. On June 30, 1999, after paying all necessary and reasonable 
6.14 	expenses, the commissioner must apply up to $2,075,000 of any remaining balance in 
6.15 	the Minnesota employees' insurance trust fund to repayment of any amounts drawn or 
6.16 	expended for this program from the health care access fund.The board may decide to rate 
6.17 	specific employers separately for premium purposes, if the board determines that doing 
6.18 	so is in the best interests of the program.
6.19 	(c)  Taxes and assessments. To the extent that the program operates as a self-insured 
6.20 	group, the premiums paid to the program are not subject to the taxes imposed by chapter 
6.21 	297I, but the program is subject to a Minnesota Comprehensive Health Association 
6.22 	assessment under section  62E.11. 
6.23 	(d) The board may require that employers entering the program pay a premium of up 
6.24 	to three times the normal monthly premium, as a contribution to reserves. If an employer 
6.25 	leaves the program, the board may refund the excess premium if the program's reserves 
6.26 	would remain adequate in the judgment of the board.
6.27 		Subd. 9.Minnesota employees insurance trust fund. (a) Contents.The Minnesota 
6.28 	employees insurance trust fund in the state treasury consists of deposits received from 
6.29 	eligible employers and individuals, contractual settlements or rebates relating to the 
6.30 	program, investment income or losses, and direct appropriations. 
6.31 	(b)  Appropriation.All money in the fund is appropriated to the commissioner to 
6.32 	pay insurance premiums, approved claims, refunds, administrative costs, and other costs 
6.33 	necessary to administer the program. 
6.34 	(c)Reserves.(a) For any coverages for which the program does not contract to 
6.35 	transfer full financial responsibility, the commissioner board shall establish and maintain 
6.36 	reserves: 
7.1 	(1) for claims in process, incomplete and unreported claims, premiums received but 
7.2 	not yet earned, and all other accrued liabilities; and
7.3 	(2) to ensure premium stability and the timely payment of claims in the event of 
7.4 	adverse claims experience. The reserve for premium stability and claim fluctuations must 
7.5 	be established according to the sound actuarial standards of section  62C.09, subdivision 3, 
7.6 	except that the reserve may exceed the upper limit under this standard until July 1, 1997. 
7.7 	(d)  Investments.The State Board of Investment shall invest the fund's assets 
7.8 	according to section  11A.24. Investment income and losses attributable to the fund must 
7.9 	be credited to the fund. 
7.10 	(b) If the board determines that it needs additional funds for start-up costs, the 
7.11 	board may access additional funds as needed in the form of loans from the health care 
7.12 	access fund, not to exceed a total indebtedness of $1,000,000 at any one time. Such loans 
7.13 	accrue interest at three percent per annum simple interest and must be payable in monthly 
7.14 	installments beginning no later than two years after the board first provides coverage 
7.15 	and must be fully repaid no later than five years after that date. The monthly repayment 
7.16 	installments must be reamortized as needed to reflect repayments and additional loan 
7.17 	amounts accessed, so that monthly installments will be sufficient to repay the existing 
7.18 	balance, including accrued interest, at the end of that five-year period. The board may 
7.19 	make additional repayments of principal and interest at any time. The $1,000,000 amount 
7.20 	is available until the end of that five-year period. Amounts of principal repaid are available 
7.21 	to be accessed for new loans within that period.
7.22 		Subd. 10.Program status. The Minnesota employees insurance program is a 
7.23 	state state-created program to provide the advantages of a large pool to small employers 
7.24 	for purchasing providing health coverage, other coverages, and related services from 
7.25 	insurance companies, health maintenance organizations, and other organizations. The 
7.26 	program is not an insurance company. Coverage under this program shall be considered 
7.27 	a certificate of insurance or similar evidence of coverage and is subject to all applicable 
7.28 	requirements of chapters 60A, 62A, 62C, 62D, 62E, 62H, 62L, and 72A, and is subject to 
7.29 	regulation by the commissioner of commerce to the extent applicable.
7.30 		Subd. 12.Status of agents. Notwithstanding sections  60K.49 and  72A.07, the 
7.31 	program may use, and pay referral fees, commissions, or other compensation to, agents 
7.32 	licensed as insurance producers under chapter 60K or licensed under section  62C.17, 
7.33 	regardless of whether the agents are appointed to represent the particular health carriers or 
7.34 	community integrated service networks that provide the coverage available through the 
7.35 	program. When acting under this subdivision, an agent is not an agent of the health carrier 
7.36 	or community integrated service network, with respect to that transaction. 

8.1 	Sec. 2. APPROPRIATION.
 8.2 	$1,000,000 is appropriated from the health care access fund to the commissioner 
8.3 	of employee relations for the as-needed loans to the Minnesota Employees Insurance 
8.4 	Program, as provided in Minnesota Statutes, section 43A.317, subdivision 9, paragraph (b).

8.5 	ARTICLE 2
8.6 	PRIVATE SECTOR HEALTH COVERAGE PROVISIONS

8.7 	Section 1. Minnesota Statutes 2004, section 62D.095, subdivision 3, is amended to 
8.8 	read:
8.9 		Subd. 3.Deductibles. (a) A health maintenance contract issued by a health 
8.10 	maintenance organization that is assessed less than three percent of the total annual amount 
8.11 	assessed by the Minnesota comprehensive health association may impose deductibles not 
8.12 	to exceed $3,000 $5,000 per person, per year and $6,000 $10,000 per family, per year. For 
8.13 	purposes of the percentage calculation, a health maintenance organization's assessments 
8.14 	include those of its affiliates.
8.15 	(b) All other health maintenance contracts may impose deductibles not to exceed 
8.16 	$2,250 per person, per year and $4,500 per family, per year.

8.17 	Sec. 2. Minnesota Statutes 2004, section 62D.095, subdivision 4, is amended to read:
8.18 		Subd. 4.Annual out-of-pocket maximums. (a) A health maintenance contract 
8.19 	issued by a health maintenance organization that is assessed less than three percent of the 
8.20 	total annual amount assessed by the Minnesota comprehensive health association must 
8.21 	include a limitation not to exceed $4,500 $5,000 per person and $7,500 $10,000 per 
8.22 	family on total annual out-of-pocket enrollee cost-sharing expenses. For purposes of the 
8.23 	percentage calculation, a health maintenance organization's assessments include those 
8.24 	of its affiliates.
8.25 	(b) All other health maintenance contracts must include a limitation not to 
8.26 	exceed $3,000 per person and $6,000 per family on total annual out-of-pocket enrollee 
8.27 	cost-sharing expenses.

8.28 	Sec. 3. Minnesota Statutes 2004, section 62D.095, is amended by adding a subdivision 
8.29 	to read:
8.30 		Subd. 5a. Lifetime maximum benefit. A health maintenance contract issued by 
8.31 	a health maintenance organization may impose a lifetime maximum benefit no less 
8.32 	than $3,000,000. At no time shall a health maintenance organization impose a lifetime 
9.1 	maximum lower than the required lifetime maximum of the comprehensive health 
9.2 	insurance plan under section 62E.12.

9.3 	Sec. 4. [62Q.645] DISTRIBUTION OF INFORMATION; ADMINISTRATIVE 
9.4 	EFFICIENCY AND COVERAGE OPTIONS.
9.5 	(a) The commissioner may use reports submitted by health  plan companies, service 
9.6 	cooperatives, and the public employee  insurance program created in section 43A.316 to 
9.7 	compile  entity specific administrative efficiency report cards; may make  these report 
9.8 	cards available on state agency Web sites,  including minnesotahealthinfo.com; and may 
9.9 	include information  on: 
9.10 	(1) number of covered lives;  
9.11 	(2) covered services;  
9.12 	(3) geographic availability;  
9.13 	(4) whom to contact to obtain current premium rates;  
9.14 	(5) administrative costs, using the definition of  administrative costs developed under 
9.15 	section 62J.38;  
9.16 	(6) Internet links to information on the health plan, if  available; and  
9.17 	(7) any other information about the health plan identified  by the commissioner 
9.18 	as being useful for employers, consumers,  providers, and others in evaluating health 
9.19 	plan options. 
9.20 	(b) This section does not apply to a health plan company  unless its annual Minnesota 
9.21 	premiums exceed $50,000,000 based on the most recent assessment base of the Minnesota 
9.22 	Comprehensive Health Association. For purposes of this  determination, the premiums of a 
9.23 	health plan company include  those of its affiliates. 

9.24 	Sec. 5. [62Q.676] MEDICATION THERAPY MANAGEMENT CARE.
9.25 	(a) A health plan company or pharmacy benefit manager that provides prescription 
9.26 	drug coverage must provide or arrange for medication therapy management services for 
9.27 	enrollees taking four or more prescriptions to treat or prevent two or more chronic medical 
9.28 	conditions. For purposes of this section, "medication therapy management" means the 
9.29 	provision of the following pharmaceutical care services by a licensed pharmacist to 
9.30 	optimize the therapeutic outcomes of the patient's  medications: 
9.31 	(1) performing or obtaining necessary assessments of the patient's health status in 
9.32 	compliance with applicable health data privacy laws;  
9.33 	(2) formulating a medication treatment plan;  
10.1 	(3) monitoring and evaluating the patient's response to therapy, including safety 
10.2 	and effectiveness;  
10.3 	(4) performing a comprehensive medication review to identify, resolve, and prevent 
10.4 	medication related problems, including adverse drug events;  
10.5 	(5) documenting the care delivered and communicating essential information to 
10.6 	the patient's other primary care providers;  
10.7 	(6) providing verbal education and training designed to enhance patient 
10.8 	understanding and appropriate use of the patient's medications;  
10.9 	(7) providing information, support services, and resources designed to enhance 
10.10 	patient adherence with the patient's therapeutic regimens; and  
10.11 	(8) coordinating and integrating medication therapy management services within the 
10.12 	broader health care management services being provided to the patient.  
10.13 	(b) Nothing in this section shall be construed to expand or modify the scope of 
10.14 	practice of the pharmacist as  defined in section 151.01, subdivision 27.  

10.15 	Sec. 6. MEDICAL MALPRACTICE INSURANCE REPORT.
 10.16 	(a) The commissioner of commerce shall provide to the legislature, no later than 
10.17 	June 1 each year, a brief written report on the status of the market for medical malpractice 
10.18 	insurance in Minnesota. The report must summarize, interpret, explain, and analyze 
10.19 	information on that subject available to the commissioner, through annual statements filed 
10.20 	by insurance companies, information obtained under paragraph (c), and other sources. 
10.21 	(b) The annual report must consider, to the extent possible, Minnesota specific data 
10.22 	on market shares; premiums received; amounts paid to settle claims that were not litigated, 
10.23 	claims that were settled after litigation began, and claims that were litigated to court 
10.24 	judgment; amounts spent on processing, investigation, litigation, and otherwise handling 
10.25 	claims; other sales and administrative costs; and the loss ratios of the insurers. 
10.26 	(c) Each insurance company that provides medical malpractice insurance in this state 
10.27 	shall, no later than April 1 each year, file with the commissioner of commerce, on a form 
10.28 	prescribed by the commissioner, the Minnesota specific data referenced in paragraph (b), 
10.29 	other than market share, for the previous calendar year for that insurance company, shown 
10.30 	separately for the categories of coverage provided to hospitals, medical clinics, nursing 
10.31 	homes, physicians who provide emergency medical care, obstetrician gynecologists, and 
10.32 	ambulance services. An insurance company need not comply with this paragraph if its 
10.33 	direct premium written in the state for the previous calendar year is less than $2,000,000.

11.1 	ARTICLE 3
11.2 	SERVICE COOPERATIVES

11.3 	Section 1. Minnesota Statutes 2004, section 123A.21, subdivision 7, is amended to 
11.4 	read:
11.5 		Subd. 7.Educational programs and services. (a) The board of directors of each 
11.6 	SC shall submit annually a plan to the members. The plan shall identify the programs and 
11.7 	services which are suggested for implementation by the SC during the following year and 
11.8 	shall contain components of long-range planning determined by the SC. These programs 
11.9 	and services may include, but are not limited to, the following areas:
11.10 	(1) administrative services;
11.11 	(2) curriculum development;
11.12 	(3) data processing;
11.13 	(4) distance learning and other telecommunication services;
11.14 	(5) evaluation and research;
11.15 	(6) staff development;
11.16 	(7) media and technology centers;
11.17 	(8) publication and dissemination of materials;
11.18 	(9) pupil personnel services;
11.19 	(10) planning;
11.20 	(11) secondary, postsecondary, community, adult, and adult vocational education;
11.21 	(12) teaching and learning services, including services for students with special 
11.22 	talents and special needs;
11.23 	(13) employee personnel services;
11.24 	(14) vocational rehabilitation;
11.25 	(15) health, diagnostic, and child development services and centers;
11.26 	(16) leadership or direction in early childhood and family education;
11.27 	(17) community services;
11.28 	(18) shared time programs;
11.29 	(19) fiscal services and risk management programs, including health reinsurance 
11.30 	programs;
11.31 	(20) technology planning, training, and support services;
11.32 	(21) health and safety services;
11.33 	(22) student academic challenges; and
11.34 	(23) cooperative purchasing services.
12.1 	(b) An SC may contract for goods and services in conjunction with its health 
12.2 	reinsurance programs, including management, actuarial, investment, and legal services 
12.3 	from others within or without this state to ensure the efficient operation of these programs. 
12.4 	It shall rebid its contracts for reinsurance that it purchases at least every two years.
12.5 	(c) A health reinsurance program operated by one or more SCs may:
12.6 	(1) provide reinsurance or stop-loss coverage to nursing homes licensed under 
12.7 	chapter 144A and boarding care homes licensed under sections 144.50 to 144.56 and 
12.8 	certified for participation in the medical assistance program, located in this state; and
12.9 	(2) determine premiums for its reinsurance or stop-loss coverage individually for 
12.10 	specific employers or may determine them on a pooled or other basis established by the SC.
12.11 	(d) A health coverage program provided by one or more SCs:
12.12 	(1) may provide coverage to nursing homes licensed under chapter 144A and 
12.13 	boarding care homes licensed under sections 144.50 to 144.56 and certified for 
12.14 	participation in the medical assistance program, located in this state;
12.15 	(2) must rebid contracts for insurance and third-party administration at least every 
12.16 	four years; and 
12.17 	(3) must comply with section 72A.20, subdivision 26, notwithstanding section 
12.18 	13.203, and must also provide that same information to exclusive representatives of the 
12.19 	employees upon request.

12.20 	Sec. 2. Minnesota Statutes 2004, section 471.61, is amended by adding a subdivision 
12.21 	to read:
12.22 		Subd. 6.Reinsuring health risks.  Any political subdivision, or any two or more 
12.23 	political subdivisions acting jointly, may provide for the reinsuring of risks incurred as a 
12.24 	result of providing the insurance or protection authorized by this section by participating 
12.25 	in a pool operated by a service cooperative or cooperatives pursuant to section 471.617, 
12.26 	subdivision 3a.

12.27 	Sec. 3. Minnesota Statutes 2004, section 471.617, subdivision 3, is amended to read:
12.28 		Subd. 3.Stop-loss coverage. Any self-insurance plan covering fewer than 1,000 
12.29 	employees shall include excess or stop-loss coverage provided by a licensed insurance 
12.30 	company, an insurance company approved pursuant to sections  60A.195 to  60A.209, 
12.31 	or service plan corporation, but excess or stop-loss coverage need not be obtained for 
12.32 	long-term disability. 
12.33 	This excess or stop-loss coverage shall cover all eligible claims incurred during 
12.34 	the term of the policy or contract. In addition to excess or stop-loss coverage, the 
13.1 	self-insurance plan shall provide for reserving of an appropriate amount of funds to cover 
13.2 	the estimated cost of claims incurred, but unpaid, during the term of the policy or contract 
13.3 	which shall be added to the expected claim level. These funds shall be in addition to funds 
13.4 	reserved to cover the claims paid during the term of the policy or contract. The excess or 
13.5 	stop-loss coverage shall be provided at levels in excess of self-insured retention which is 
13.6 	appropriate, taking into account the number of covered persons in the group.
13.7 	Coverage under subdivision 3a qualifies under this subdivision.

13.8 	Sec. 4. Minnesota Statutes 2004, section 471.617, is amended by adding a subdivision 
13.9 	to read:
13.10 		Subd. 3a.Reinsurance pools.  A statutory or home rule charter city, county, school 
13.11 	district, or instrumentality of any of them may provide for the reinsuring of risks incurred 
13.12 	as a result of providing the health benefits authorized by this section through a pool 
13.13 	operated by a service cooperative or service cooperatives established pursuant to section 
13.14 	123A.21.

13.15 	Sec. 5. EFFECTIVE DATE.
 13.16 	Sections 1 to 4 are effective the day following final enactment.