1.1A bill for an act1.2relating to insurance; requiring school districts to obtain employee health 1.3coverage through the public employees insurance program; appropriating money;1.4amending Minnesota Statutes 2008, sections 43A.316, subdivisions 9, 10, by 1.5adding subdivisions; 62E.02, subdivision 23; 62E.10, subdivision 1; 62E.11, 1.6subdivision 5; 297I.05, subdivision 5; 297I.15, subdivision 3.1.7BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:1.8    Section 1. Minnesota Statutes 2008, section 43A.316, is amended by adding a 1.9subdivision to read:1.10    Subd. 3a.Health improvement programs.The commissioner, with the approval 1.11of the school employee insurance committee, is authorized to plan, develop, purchase, 1.12administer, and evaluate disease management and other programs, strategies, and 1.13incentives to improve the health and health outcomes of members.1.14    Sec. 2. Minnesota Statutes 2008, section 43A.316, subdivision 9, is amended to read:1.15    Subd. 9. Insurance trust fund.(a) The insurance trust fund in the state treasury 1.16consists of deposits of the premiums received from employers participating in the 1.17program and transfers before July 1, 1994, from the excess contributions holding account 1.18established by section 
         353.65, subdivision 7. All money in the fund is appropriated to 1.19the commissioner to pay insurance premiums, approved claims, refunds, administrative 1.20costs, and other related service costs, including costs incurred under chapters 62E and 1.21297I in connection with the school employee insurance program. Premiums paid by 1.22employers to the fund are exempt from the taxes imposed by chapter 297I, except as 1.23described in paragraph (b). The commissioner shall reserve an amount of money to cover 1.24the estimated costs of claims incurred but unpaid. The State Board of Investment shall 2.1invest the money according to section 
         11A.24. Investment income and losses attributable 2.2to the fund must be credited to the fund. 2.3(b) Notwithstanding paragraph (a), premium revenues collected from the school 2.4employee insurance program, described in subdivisions 12 and 13, are not exempt from 2.5the taxes imposed under section 297I.05, subdivision 5, paragraph (b).2.6    Sec. 3. Minnesota Statutes 2008, section 43A.316, subdivision 10, is amended to read:2.7    Subd. 10. Exemption.(a) The public employee insurance program and, where 2.8applicable, the employers participating in it are exempt from chapters 60A, 62A, 62C, 2.962D, 62E, and 62H, section 
         471.617, subdivisions 2 and 3, and the bidding requirements 2.10of section 
         471.6161. 2.11(b) Notwithstanding paragraph (a), the school employee insurance program, 2.12described in subdivisions 12 and 13, is a contributing member of the Minnesota 2.13Comprehensive Health Association and must pay assessments made by the association on 2.14the premium revenue attributed to the school employee insurance program, prorated as 2.15provided in section 62E.11, subdivision 5, paragraph (b).2.16    Sec. 4. Minnesota Statutes 2008, section 43A.316, is amended by adding a subdivision 2.17to read:2.18    Subd. 11.Definitions.(a) For purposes of subdivisions 11 to 16, the terms defined 2.19in this subdivision have the meanings given.2.20(b) "Eligible employee" means an employee of a school employer, a dependent of 2.21such an employee, a retiree, or other person, who is eligible for health insurance coverage 2.22under the school employer's plan.2.23(c) "School Employee Insurance Committee" means the committee created in 2.24subdivision 14.2.25(d) "School employer" means a school district as defined in section  120A.05, service 2.26cooperative as defined in section  123A.21, intermediate district as defined in section 2.27136D.01, Cooperative Center for Vocational Education as defined in section 123A.22, 2.28regional management information center as defined in section  123A.23, or an education 2.29unit organized under a joint powers agreement under section 471.59. 2.30    Sec. 5. Minnesota Statutes 2008, section 43A.316, is amended by adding a subdivision 2.31to read:2.32    Subd. 12.School employee insurance program.The commissioner shall develop 2.33and administer within the public employees insurance program a separately rated and 3.1administered program for eligible employees of school employers, to be called the 3.2school employee insurance program. The initial offerings shall be the PEIP Advantage, 3.3Advantage Value, and Advantage HSA plans offered by the public employee insurance 3.4program. Health coverage offered through the school employee insurance program shall 3.5be made available beginning January 1, 2011.3.6    Sec. 6. Minnesota Statutes 2008, section 43A.316, is amended by adding a subdivision 3.7to read:3.8    Subd. 13.Enrollment; school employee insurance program.(a) A school 3.9employer that provides health coverage to eligible employees or contributes money to pay 3.10for all or part of the cost of health coverage for eligible employees, must purchase such 3.11coverage through the school employee insurance program under subdivision 12. School 3.12employers described in paragraph (b) may opt out as described in paragraphs (b) to (e).3.13(b) Each exclusive representative of employees of a school employer which, on 3.14January 1, 2010, was individually self-insured or self-insured as a group shall determine 3.15whether the employees it represents will participate in the school employee insurance 3.16program, in the same manner described in subdivision 5, paragraph (b). Paragraphs (c), 3.17(d), and (e) below apply only to school employees of the school employers described in 3.18this paragraph.3.19(c) School employees not represented by an exclusive representative may enter 3.20the school employee insurance program in the same manner described in subdivision 5, 3.21paragraph (c).3.22(d) School employees who do not enter the program upon first becoming eligible 3.23for participation are ineligible to participate for four years and must be pooled and rated 3.24separately from the other enrollees in the school employee insurance program for the 3.25first four years after entering the program. This paragraph does not apply to a school 3.26employee upon later becoming a member of a school employee group that has not 3.27declined participation.3.28(e) The decision of an exclusive representative of school employees or, in the case of 3.29unorganized employees, the decision of a school district, to enter into the school employee 3.30insurance program is irrevocable and applies to all future years.3.31(f) Health coverage provided under the school employee insurance program to a 3.32retired employee of a school district, or to a dependent of the retired employee, must not 3.33be reduced as compared to the coverage to which the retired employee or dependent was 3.34entitled prior to enrollment in the school employee insurance program.4.1    Sec. 7. Minnesota Statutes 2008, section 43A.316, is amended by adding a subdivision 4.2to read:4.3    Subd. 14.School Employee Insurance Committee.(a) Notwithstanding any other 4.4provision of law, all plan design decisions, including all pilot or demonstration programs 4.5in which school employees participate, must first be developed by the School Employee 4.6Insurance Committee in consultation with the commissioner or the commissioner's 4.7designee and other consultants as the committee sees fit. This paragraph does not apply to 4.8the initial offerings specified in subdivision 12.4.9(b) The committee must be composed of 14 members who represent school 4.10district employees and employers in equal number. The employee representatives shall 4.11be appointed as follows: four shall be appointed by Education Minnesota, one shall be 4.12appointed by the Service Employees International Union, one shall be appointed by the 4.13American Federation of State, County, and Municipal Employees, and one shall be 4.14appointed by the Minnesota School Employees Association. The seven school employer 4.15representatives who serve on the School Employee Insurance Committee must be 4.16appointed by the Minnesota School Boards Association. Members of the committee shall 4.17be appointed no later than August 1, 2009, and shall serve at the will of the appointing 4.18organization.4.19(c) The School Employee Insurance Committee members are eligible for 4.20compensation and expense reimbursement under section 15.0575, subdivision 3. In 4.21addition, the actual salary lost by a committee member or cost charged by an employer of 4.22a committee member for time missed while performing the duties of a committee member 4.23must be reimbursed to the committee member.4.24    Sec. 8. Minnesota Statutes 2008, section 43A.316, is amended by adding a subdivision 4.25to read:4.26    Subd. 15.Reinsurance.The commissioner may, on behalf of the program, 4.27participate in an insured or self-insured reinsurance pool.4.28    Sec. 9. Minnesota Statutes 2008, section 43A.316, is amended by adding a subdivision 4.29to read:4.30    Subd. 16.Nonidentifiable aggregate claims data from past coverage.Upon 4.31request by the commissioner, entities that are providing or have provided coverage to 4.32eligible employees of school employers within two years before the effective date of 4.33this section, shall provide to the commissioner at no charge nonidentifiable aggregate 4.34claims data for that coverage. The information must include data relating to employee 5.1group benefit sets, demographics, and claims experience. Notwithstanding section 13.203, 5.2Minnesota service cooperatives must comply with this subdivision.5.3    Sec. 10. Minnesota Statutes 2008, section 62E.02, subdivision 23, is amended to read:5.4    Subd. 23. Contributing member. "Contributing member" means those companies 5.5regulated under chapter 62A and offering, selling, issuing, or renewing policies or 5.6contracts of accident and health insurance; health maintenance organizations regulated 5.7under chapter 62D; nonprofit health service plan corporations regulated under chapter 5.862C; community integrated service networks regulated under chapter 62N; fraternal 5.9benefit societies regulated under chapter 64B; the Minnesota employees insurance 5.10program established in section 
         43A.317, effective July 1, 1993; and joint self-insurance 5.11plans regulated under chapter 62H; and the school employee insurance program created 5.12under section 43A.316. For the purposes of determining liability of contributing members 5.13pursuant to section 
         62E.11 payments received from or on behalf of Minnesota residents 5.14for coverage by a health maintenance organization or, a community integrated service 5.15network, or the school employee insurance program shall be considered to be accident 5.16and health insurance premiums.  5.17    Sec. 11. Minnesota Statutes 2008, section 62E.10, subdivision 1, is amended to read:5.18    Subdivision 1. Creation and membership; tax exemption.(a) There is established 5.19a Comprehensive Health Association to promote the public health and welfare of the state 5.20of Minnesota with membership consisting of all insurers; self-insurers; fraternals; joint 5.21self-insurance plans regulated under chapter 62H; the Minnesota employees insurance 5.22program established in section 
         43A.317, effective July 1, 1993; the school employee 5.23insurance program created under section 43A.316, subdivision 12; health maintenance 5.24organizations; and community integrated service networks licensed or authorized to do 5.25business in this state. 5.26(b) The Comprehensive Health Association is exempt from the taxes imposed under 5.27chapter 297I and any other laws of this state and all property owned by the association 5.28is exempt from taxation.  5.29    Sec. 12. Minnesota Statutes 2008, section 62E.11, subdivision 5, is amended to read:5.30    Subd. 5. Allocation of losses.(a) Each contributing member of the association shall 5.31share the losses due to claims expenses of the comprehensive health insurance plan for 5.32plans issued or approved for issuance by the association, and shall share in the operating 5.33and administrative expenses incurred or estimated to be incurred by the association 6.1incident to the conduct of its affairs. Claims expenses of the state plan which exceed 6.2the premium payments allocated to the payment of benefits shall be the liability of the 6.3contributing members. Contributing members shall share in the claims expense of the 6.4state plan and operating and administrative expenses of the association in an amount equal 6.5to the ratio of the contributing member's total accident and health insurance premium, 6.6received from or on behalf of Minnesota residents as divided by the total accident and 6.7health insurance premium, received by all contributing members from or on behalf of 6.8Minnesota residents, as determined by the commissioner. Payments made by the state 6.9to a contributing member for medical assistance, MinnesotaCare, or general assistance 6.10medical care services according to chapters 256, 256B, and 256D shall be excluded when 6.11determining a contributing member's total premium.6.12    (b) In making the allocation of losses provided in paragraph (a) in each future year, 6.13the association's assessment against the school employee insurance program must be 6.14based on premiums received by the school employee insurance program in that future year 6.15from the school employers that, on May 1, 2009, were receiving health care coverage 6.16from a contributing member of the association. The association shall assess the premiums 6.17paid in each future year by those employers at the same rate as premiums paid to other 6.18members of the association. For purposes of this calculation, premiums of the program 6.19used must be net of rate credits and retroactive rate refunds on the same basis as the 6.20premiums of other association members.6.21    Sec. 13. Minnesota Statutes 2008, section 297I.05, subdivision 5, is amended to read:6.22    Subd. 5. Health maintenance organizations, nonprofit health service plan 6.23corporations, and community integrated service networks, and the school employee 6.24insurance program. (a) A tax is imposed on health maintenance organizations, 6.25community integrated service networks, and nonprofit health care service plan 6.26corporations. The rate of tax is equal to one percent of gross premiums less return 6.27premiums on all direct business received by the organization, network, or corporation or 6.28its agents in Minnesota, in cash or otherwise, in the calendar year.6.29(b) A tax is imposed on the school employee insurance program created under 6.30section 43A.316, subdivision 12. The rate of tax imposed for each year shall be the 6.31rate specified in paragraph (a) and shall be assessed upon gross premiums less return 6.32premiums received by the school employee insurance program in that calendar year from 6.33school employers that, on May 1, 2009, were receiving health care coverage from an 6.34entity that is required to pay the tax under paragraph (a). The commissioner shall assess 7.1the premiums paid in each year by those employers at the same rate as premiums paid by 7.2entities taxed under paragraph (a).7.3(c) The commissioner shall deposit all revenues, including penalties and interest, 7.4collected under this chapter from health maintenance organizations, community integrated 7.5service networks, and nonprofit health service plan corporations, and the school employee 7.6insurance program in the health care access fund. Refunds of overpayments of tax 7.7imposed by this subdivision must be paid from the health care access fund. There is 7.8annually appropriated from the health care access fund to the commissioner the amount 7.9necessary to make any refunds of the tax imposed under this subdivision.7.10    Sec. 14. Minnesota Statutes 2008, section 297I.15, subdivision 3, is amended to read:7.11    Subd. 3. Public employees insurance program. Premiums paid to the public 7.12employees insurance program under section 
         43A.316 are exempt from the taxes imposed 7.13under this chapter, except for premiums paid to the school employee insurance program as 7.14provided in section 297I.05, subdivision 5, paragraph (b).7.15    Sec. 15. APPROPRIATION.7.16    (a) $425,000 is appropriated from the insurance trust fund under Minnesota Statutes, 7.17section 43A.316, subdivision 9, to the commissioner of Minnesota Management and 7.18Budget for fiscal year 2010 and $541,000 for fiscal year 2011 for the administrative 7.19responsibilities created in this act.7.20    (b) The commissioner of management and budget shall impose an enrollment 7.21fee upon the premium charged for the first three months of coverage under the school 7.22employee insurance program created in this act in the amount of $106,000 to cover the 7.23costs incurred by the commissioner under paragraph (a). The commissioner shall deposit 7.24the enrollment fees in the insurance trust fund.7.25    Sec. 16. EFFECTIVE DATE.7.26Sections 1 to 15 are effective for coverage to begin January 1, 2011.