1.1 	A bill for an act
1.2 	relating to insurance; health; modifying requirements for health insurance 
1.3 	underwriting, renewability, and benefits; creating an individual health plan 
1.4 	reinsurance program; appropriating money;amending Minnesota Statutes 2016, 
1.5 	sections 13.7191, by adding a subdivision; 62A.65, subdivisions 3, 5; 62L.02, 
1.6 	subdivision 26; 62L.03, by adding a subdivision; 62L.08, subdivision 7, by adding 
1.7 	a subdivision; 62Q.18, subdivision 10; 297I.05, subdivision 5; proposing coding 
1.8 	for new law in Minnesota Statutes, chapters 62A; 62K; 62Q; proposing coding for 
1.9 	new law as Minnesota Statutes, chapter 62W; repealing Minnesota Statutes 2016, 
1.10 	sections 62A.65, subdivision 2; 62L.08, subdivision 4.
1.11 	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

1.12 	ARTICLE 1
1.13 	HEALTH INSURANCE REFORM

1.14 	Section 1. [62A.614] PREEXISTING CONDITIONS DISCLOSED AT TIME OF 
1.15 	APPLICATION.
1.16 	No insurer may cancel or rescind a health insurance policy for a preexisting condition 
1.17 	of which the application or other information provided by the insured reasonably gave the 
1.18 	insurer notice. No insurer may restrict coverage for a preexisting condition of which the 
1.19 	application or other information provided by the insured reasonably gave the insurer notice 
1.20 	unless the coverage is restricted at the time the policy is issued and the restriction is disclosed 
1.21 	in writing to the insured at the time the policy is issued.

2.1 	Sec. 2. Minnesota Statutes 2016, section 62A.65, subdivision 3, is amended to read:
2.2 		Subd. 3.Premium rate restrictions. No individual health plan may be offered, sold, 
2.3 	issued, or renewed to a Minnesota resident unless the premium rate charged is determined 
2.4 	in accordance with the following requirements:
2.5 	(a) Premium rates may vary based upon the ages of covered persons in accordance with 
2.6 	the provisions of the Affordable Care Act.
2.7 	(b) Premium rates may vary based upon geographic rating area. The commissioner shall 
2.8 	grant approval if the following conditions are met:
2.9 	(1) the areas are established in accordance with the Affordable Care Act;
2.10 	(2) each geographic region must be composed of no fewer than seven counties that create 
2.11 	a contiguous region; and
2.12 	(3) the health carrier provides actuarial justification acceptable to the commissioner for 
2.13 	the proposed geographic variations in premium rates for each area, establishing that the 
2.14 	variations are based upon differences in the cost to the health carrier of providing coverage
2.15 	must be no more than ten percent above and no more than 50 percent below the standard 
2.16 	rate charged to individuals for the same or similar coverage, adjusted pro rata for rating 
2.17 	periods of less than one year. The premium variations permitted by this paragraph must be 
2.18 	based only upon health status and claims experience. For purposes of this paragraph, health 
2.19 	status includes refraining from tobacco use or other actuarially valid lifestyle factors 
2.20 	associated with good health, provided that the lifestyle factor and its effect upon premium 
2.21 	rates have been determined by the commissioner to be actuarially valid and have been 
2.22 	approved by the commissioner. This paragraph does not prohibit use of a constant percentage 
2.23 	adjustment for factors permitted to be used under this paragraph.
2.24 	(c) Premium rates may vary based upon tobacco use, in accordance with the provisions 
2.25 	of the Affordable Care Act.
2.26 	(d) In developing its premiums for a health plan, a health carrier shall take into account 
2.27 	only the following factors:
2.28 	(1) actuarially valid differences in rating factors permitted under paragraphs (a), (b),
2.29 	and (c); and
2.30 	(2) actuarially valid geographic variations if approved by the commissioner as provided 
2.31 	in paragraph (b).
3.1 	(e) The state of Minnesota shall constitute a single geographic rating area for purposes 
3.2 	of setting premium rates.
3.3 	(f) The premium charged with respect to any particular individual health plan shall not 
3.4 	be adjusted more frequently than annually or January 1 of the year following initial 
3.5 	enrollment, except that the premium rates may be changed to reflect:
3.6 	(1) changes to the family composition of the policyholder;
3.7 	(2) changes in geographic rating area of the policyholder, as provided in paragraph (b);
3.8 	(3) (2) changes in age, as provided in paragraph (a);
3.9 	(4) (3) changes in tobacco use, as provided in paragraph (c);
3.10 	(5) (4) transfer to a new health plan, reunderwriting, or enhanced coverage as requested 
3.11 	by the policyholder; or
3.12 	(6) (5) other changes required by or otherwise expressly permitted by state or federal 
3.13 	law or regulations.
3.14 	(f) (g) All premium variations must be justified in initial rate filings and upon request 
3.15 	of the commissioner in rate revision filings. All rate variations are subject to approval by 
3.16 	the commissioner.
3.17 	(g) (h) The loss ratio must comply with the section 62A.021 requirements for individual 
3.18 	health plans.
3.19 	(h) (i) The rates must not be approved, unless the commissioner has determined that the 
3.20 	rates are reasonable. In determining reasonableness, the commissioner shall consider the 
3.21 	growth rates applied under section 62J.04, subdivision 1, paragraph (b), to the calendar year 
3.22 	or years that the proposed premium rate would be in effect and actuarially valid changes in 
3.23 	risks associated with the enrollee populations.
3.24 	(i) (j) A health carrier may, as part of a minimum lifetime loss ratio guarantee filing 
3.25 	under section 62A.02, subdivision 3a, include a rating practices guarantee as provided in 
3.26 	this paragraph. The rating practices guarantee must be in writing and must guarantee that 
3.27 	the policy form will be offered, sold, issued, and renewed only with premium rates and 
3.28 	premium rating practices that comply with subdivisions 2, 3, 4, and 5. The rating practices 
3.29 	guarantee must be accompanied by an actuarial memorandum that demonstrates that the 
3.30 	premium rates and premium rating system used in connection with the policy form will 
3.31 	satisfy the guarantee. The guarantee must guarantee refunds of any excess premiums to 
3.32 	policyholders charged premiums that exceed those permitted under subdivision 2, 3, 4, or 
4.1 	5. A health carrier that complies with this paragraph in connection with a policy form is 
4.2 	exempt from the requirement of prior approval by the commissioner under paragraphs (b), 
4.3 	(f), (g) and (h) (i).
4.4 	(j) (k) The commissioner may establish regulations to implement the provisions of this 
4.5 	subdivision.

4.6 	Sec. 3. Minnesota Statutes 2016, section 62A.65, subdivision 5, is amended to read:
4.7 		Subd. 5.Portability and conversion of coverage. (a) For plan years beginning on or 
4.8 	after January 1, 2014 2018, no individual health plan may be offered, sold, issued, or 
4.9 	renewed, to a Minnesota resident that contains a preexisting condition limitation, preexisting 
4.10 	condition exclusion, or exclusionary rider, unless the limitation or exclusion is permitted 
4.11 	under this subdivision or chapter 62L. An individual age 19 or older may be subjected to 
4.12 	an 18-month preexisting condition limitation during plan years beginning prior to January 
4.13 	1, 2014 who obtains coverage pursuant to this section may be subject to a preexisting 
4.14 	condition limitation during the first 12 months of coverage if the individual was diagnosed 
4.15 	or treated for that condition during the six months immediately preceding the date of 
4.16 	application for coverage was received, unless the individual has maintained continuous 
4.17 	coverage as defined in section 62L.02. The individual must not be subjected to an 
4.18 	exclusionary rider. During plan years beginning prior to January 1, 2014, An individual 
4.19 	who is age 19 or older and who has maintained continuous coverage may be subjected to 
4.20 	a onetime preexisting condition limitation of up to 12 months, with credit for time covered 
4.21 	under qualifying coverage as defined in section 62L.02, at the time that the individual first 
4.22 	is covered under an individual health plan by any health carrier. Credit must be given for 
4.23 	all qualifying coverage with respect to all preexisting conditions, regardless of whether the 
4.24 	conditions were preexisting with respect to any previous qualifying coverage. The individual 
4.25 	must not be subjected to an exclusionary rider. Thereafter, the individual who is age 19 or 
4.26 	older must not be subject to any preexisting condition limitation, preexisting condition 
4.27 	exclusion, or exclusionary rider under an individual health plan by any health carrier, except 
4.28 	an unexpired portion of a limitation under prior coverage, so long as the individual maintains 
4.29 	continuous coverage as defined in section 62L.02. The prohibition on preexisting condition 
4.30 	limitations for children age 18 or under does not apply to individual health plans that are 
4.31 	grandfathered plans. The prohibition on preexisting condition limitations for adults age 19 
4.32 	and over beginning for plan years on or after January 1, 2014, does not apply to individual 
4.33 	health plans that are grandfathered plans. An individual who has not maintained continuous 
4.34 	coverage may be subject to a new 12-month preexisting condition limitation after each break 
4.35 	in continuous coverage.
5.1 	(b) A health carrier must offer an individual health plan to any individual previously 
5.2 	covered under a group health plan issued by that health carrier, regardless of the size of the 
5.3 	group, so long as the individual maintained continuous coverage as defined in section 
5.4 	62L.02. If the individual has available any continuation coverage provided under sections 
5.5 	62A.146; 62A.148; 62A.17, subdivisions 1 and 2; 62A.20; 62A.21; 62C.142; 62D.101; or 
5.6 	62D.105, or continuation coverage provided under federal law, the health carrier need not 
5.7 	offer coverage under this paragraph until the individual has exhausted the continuation 
5.8 	coverage. The offer must not be subject to underwriting, except as permitted under this 
5.9 	paragraph. A health plan issued under this paragraph must be a qualified plan as defined in 
5.10 	section 62E.02 and must not contain any preexisting condition limitation, preexisting 
5.11 	condition exclusion, or exclusionary rider, except for any unexpired limitation or exclusion 
5.12 	under the previous coverage. The individual health plan must cover pregnancy on the same 
5.13 	basis as any other covered illness under the individual health plan. The offer of coverage 
5.14 	by the health carrier must inform the individual that the coverage, including what is covered 
5.15 	and the health care providers from whom covered care may be obtained, may not be the 
5.16 	same as the individual's coverage under the group health plan. The offer of coverage by the 
5.17 	health carrier must also inform the individual that the individual, if a Minnesota resident, 
5.18 	may be eligible to obtain coverage from (i) other private sources of health coverage, or (ii) 
5.19 	the Minnesota Comprehensive Health Association, without a preexisting condition limitation, 
5.20 	and must provide the telephone number used by that association for enrollment purposes. 
5.21 	The initial premium rate for the individual health plan must comply with subdivision 3. The 
5.22 	premium rate upon renewal must comply with subdivision 2. In no event shall the premium 
5.23 	rate exceed 100 percent of the premium charged for comparable individual coverage by the 
5.24 	Minnesota Comprehensive Health Association, and the premium rate must be less than that 
5.25 	amount if necessary to otherwise comply with this section. Coverage issued under this 
5.26 	paragraph must provide that it cannot be canceled or nonrenewed as a result of the health 
5.27 	carrier's subsequent decision to leave the individual, small employer, or other group market. 
5.28 	Section 72A.20, subdivision 28, applies to this paragraph.

5.29 	Sec. 4. [62K.16] TERMINATION OF COVERAGE DUE TO NONPAYMENT.
5.30 	(a) Notwithstanding section 62V.05, subdivision 5, a health carrier may terminate 
5.31 	coverage of enrollees due to the nonpayment of premiums regardless of whether the enrollee 
5.32 	is receiving advance premium tax credits under the Affordable Care Act if the enrollee has 
5.33 	previously paid at least one full month's premium during the benefit year. Prior to termination, 
5.34 	the health carrier must notify the enrollee of the premium payment delinquency, including 
5.35 	the amount of premium owed.
6.1 	(b) Termination of coverage for nonpayment of premiums under this section is effective 
6.2 	30 days following the date the premium was due.
6.3 	(c) The health carrier is not responsible for claims for services rendered to the enrollee 
6.4 	during the grace period described in paragraph (b).

6.5 	Sec. 5. Minnesota Statutes 2016, section 62L.02, subdivision 26, is amended to read:
6.6 		Subd. 26.Small employer. (a) "Small employer" means, with respect to a calendar year 
6.7 	and a plan year, a person, sole proprietorship, firm, corporation, partnership, association, 
6.8 	or other entity actively engaged in business in Minnesota, including a political subdivision 
6.9 	of the state, that employed an average of at least one, not including a sole proprietor, but 
6.10 	not more than 50 current employees on business days during the preceding calendar year 
6.11 	and that employs at least one current employee, not including a sole proprietor, on the first 
6.12 	day of the plan year. A small employer plan may be offered through a domiciled association 
6.13 	to self-employed individuals and small employers who are members of the association, even 
6.14 	if the self-employed individual or small employer has fewer than twoone current employees
6.15 	employee. Entities that are treated as a single employer under subsection (b), (c), (m), or 
6.16 	(o) of section 414 of the federal Internal Revenue Code are considered a single employer 
6.17 	for purposes of determining the number of current employees. Small employer status must 
6.18 	be determined on an annual basis as of the renewal date of the health benefit plan. The 
6.19 	provisions of this chapter continue to apply to an employer who no longer meets the 
6.20 	requirements of this definition until the annual renewal date of the employer's health benefit 
6.21 	plan. If an employer was not in existence throughout the preceding calendar year, the 
6.22 	determination of whether the employer is a small employer is based upon the average number 
6.23 	of current employees that it is reasonably expected that the employer will employ on business 
6.24 	days in the current calendar year. For purposes of this definition, the term employer includes 
6.25 	any predecessor of the employer. An employer that has more than 50 current employees 
6.26 	but has 50 or fewer employees, as "employee" is defined under United States Code, title 
6.27 	29, section 1002(6), is a small employer under this subdivision.
6.28 	(b) Where an association, as defined in section 62L.045, comprised of employers contracts 
6.29 	with a health carrier to provide coverage to its members who are small employers, the 
6.30 	association and health benefit plans it provides to small employers, are subject to section 
6.31 	62L.045, with respect to small employers in the association, even though the association 
6.32 	also provides coverage to its members that do not qualify as small employers.
6.33 	(c) If an employer has employees covered under a trust specified in a collective bargaining 
6.34 	agreement under the federal Labor-Management Relations Act of 1947, United States Code, 
7.1 	title 29, section 141, et seq., as amended, or employees whose health coverage is determined 
7.2 	by a collective bargaining agreement and, as a result of the collective bargaining agreement, 
7.3 	is purchased separately from the health plan provided to other employees, those employees 
7.4 	are excluded in determining whether the employer qualifies as a small employer. Those 
7.5 	employees are considered to be a separate small employer if they constitute a group that 
7.6 	would qualify as a small employer in the absence of the employees who are not subject to 
7.7 	the collective bargaining agreement.
7.8 	(d) Small group health plans offered through MNsure under chapter 62V to employees 
7.9 	of a small employer are not considered individual health plans, regardless of whether the 
7.10 	health plan is purchased using a defined contribution from the small employer.

7.11 	Sec. 6. Minnesota Statutes 2016, section 62L.03, is amended by adding a subdivision to 
7.12 	read:
7.13 		Subd. 4a.Preexisting conditions. Preexisting conditions may be excluded by a health 
7.14 	carrier for the first 12 months of coverage if the eligible employee was diagnosed or treated 
7.15 	for that condition during the six months immediately preceding the enrollment date, but 
7.16 	exclusionary riders must not be used. When calculating any length of preexisting condition 
7.17 	limitation, a health carrier shall credit the time period an eligible employee or dependent 
7.18 	was previously covered by qualifying coverage, provided that the individual maintains 
7.19 	continuous coverage. The credit must be given for all qualifying coverage with respect to 
7.20 	all preexisting conditions, regardless of whether the conditions were preexisting with respect 
7.21 	to any previous qualifying coverage. Section 60A.082, relating to replacement of group 
7.22 	coverage, and the rules adopted under that section apply to this chapter, and this chapter's 
7.23 	requirements are in addition to the requirements of that section and the rules adopted under 
7.24 	it.

7.25 	Sec. 7. Minnesota Statutes 2016, section 62L.08, is amended by adding a subdivision to 
7.26 	read:
7.27 		Subd. 1a.General premium variations. Each health carrier must offer premium rates 
7.28 	to small employers that are no more than 25 percent above and no more than 25 percent 
7.29 	below the standard rate charged to small employers for the same or similar coverage, adjusted 
7.30 	pro rata for rating periods of less than one year. The premium variations permitted by this 
7.31 	subdivision must be based only on health status, claims experience, industry of the employer, 
7.32 	and duration of coverage from the date of issue. For purposes of this subdivision, health 
7.33 	status includes refraining from tobacco use or other actuarially valid lifestyle factors 
8.1 	associated with good health, provided that the lifestyle factor and its effect upon premium 
8.2 	rates have been determined to be actuarially valid and approved by the commissioner. This 
8.3 	subdivision does not prohibit use of a constant percentage adjustment for factors permitted 
8.4 	to be used under this subdivision.

8.5 	Sec. 8. Minnesota Statutes 2016, section 62L.08, subdivision 7, is amended to read:
8.6 		Subd. 7. Premium rate development. (a) In developing its standard rates, rates, and 
8.7 	premiums, a health carrier may take into account only the following factors:
8.8 	(1) actuarially valid differences in benefit designs of health benefit plans; and
8.9 	(2) actuarially valid geographic variations if approved by the commissioner as provided 
8.10 	in subdivision 4 differences in the rating factors permitted in subdivisions 1a and 3.
8.11 	(b) All premium variations permitted under this section must be based upon actuarially 
8.12 	valid differences in expected cost to the health carrier of providing coverage. The variation 
8.13 	must be justified in initial rate filings and upon request of the commissioner in rate revision 
8.14 	filings. All premium variations are subject to approval by the commissioner.

8.15 	Sec. 9. Minnesota Statutes 2016, section 62Q.18, subdivision 10, is amended to read:
8.16 		Subd. 10.Guaranteed issue. (a) No health plan company shall offer, sell, or issue any 
8.17 	health plan that does not make coverage available on a guaranteed issue basis in accordance 
8.18 	with the Affordable Care Act.
8.19 	(b) Notwithstanding paragraph (a), a health plan company may offer, sell, or issue an 
8.20 	individual health plan that contains a preexisting condition limitation or exclusion as 
8.21 	permitted under section 62A.65, subdivision 5.

8.22 	Sec. 10. [62Q.461] CHOICE IN CONTRACEPTIVE COVERAGE.
8.23 		Subdivision 1.Applicability. This section applies to individual health plans and small 
8.24 	group health plans, as defined in section 62K.03, subdivision 12, offered, issued, or renewed 
8.25 	by a health plan company.
8.26 		Subd. 2.Requirement to provide enrollee choice. A health plan company must offer 
8.27 	a health plan option to enrollees that does not include coverage for contraceptive methods 
8.28 	that are abortifacients. For purposes of this requirement, "contraceptive methods that are 
8.29 	abortifacients" include hormonal and copper intrauterine devices, Plan B and Ella emergency 
8.30 	contraception (morning after pills), and other methods of contraception that prevent 
8.31 	implantation of the fertilized egg or affect the implanted embryo.

9.1 	Sec. 11. [62Q.678] HEALTH PLAN OPEN ENROLLMENT.
9.2 	(a) All health plans must be made available in the manner required by Code of Federal 
9.3 	Regulations, title 45, section 147.104.
9.4 	(b) In addition to the requirements of paragraph (a), any individual health plan:
9.5 	(1) must be made available for purchase at any time during the calendar year; and
9.6 	(2) is not retroactive from the date on which the application for coverage was received.

9.7 	Sec. 12. STATE INNOVATION WAIVER.
 9.8 		Subdivision 1.Submission of waiver application. The commissioner of commerce 
9.9 	must apply to the secretary of the Department of Health and Human Services under United 
9.10 	States Code, title 42, section 18052, for a state innovation waiver to implement the 
9.11 	requirements of article 1, sections 2 to 11 and 13, of this act for plan years beginning on or 
9.12 	after January 1, 2018.
9.13 		Subd. 2.Consultation. In developing the waiver application, the commissioner shall 
9.14 	consult with the commissioner of human services and the commissioner of health.
9.15 		Subd. 3.Application timelines; notification. The commissioner shall submit the waiver 
9.16 	application to the Secretary of Health and Human Services on or before July 5, 2017. The 
9.17 	commissioner shall make a draft application available for public review and comment by 
9.18 	June 1, 2017. The commissioner shall notify the chairs and ranking minority members of 
9.19 	the legislative committees with jurisdiction over health insurance and health care of any 
9.20 	federal actions regarding the waiver request.

9.21 	EFFECTIVE DATE. This section is effective the day following final enactment.

9.22 	Sec. 13.  REPEALER.
 9.23 	Minnesota Statutes 2016, sections 62A.65, subdivision 2; and 62L.08, subdivision 4,
9.24 	are repealed.

9.25 	Sec. 14. EFFECTIVE DATE.
 9.26 	Sections 1 to 11 and 13 are effective January 1, 2018, or upon the effective date of any 
9.27 	necessary federal waivers or law changes, whichever is later, and apply to health plans 
9.28 	offered, issued, or renewed on or after that date.

10.1 	ARTICLE 2
10.2 	REINSURANCE PROGRAM

10.3 	Section 1. Minnesota Statutes 2016, section 13.7191, is amended by adding a subdivision 
10.4 	to read:
10.5 		Subd. 23.Minnesota Health Reinsurance Association. Certain data maintained by the 
10.6 	Minnesota Health Reinsurance Association is classified under section 62W.05, subdivision 
10.7 	6.

10.8 	Sec. 2. [62W.01] CITATION.
10.9 	This chapter may be cited as the "Minnesota Health Reinsurance Association Act."

10.10 	Sec. 3. [62W.02] DEFINITIONS.
10.11 		Subdivision 1.Application. For the purposes of this chapter, the terms defined in this 
10.12 	section have the meanings given them.
10.13 		Subd. 2.Board. "Board" means the board of directors of the Minnesota Health 
10.14 	Reinsurance Association, as established under section 62W.05, subdivision 2.
10.15 		Subd. 3.Commissioner. "Commissioner" means the commissioner of commerce.
10.16 		Subd. 4.Eligible individual. "Eligible individual" means a natural person who has 
10.17 	received a diagnosis of one of the conditions in section 62W.06, subdivision 1, paragraph 
10.18 	(a), that qualifies claims for the person to be submitted by a member for reinsurance payments 
10.19 	under the program.
10.20 		Subd. 5.Health carrier. "Health carrier" means a health carrier as defined in section 
10.21 	62A.011, subdivision 2.
10.22 		Subd. 6.Health reinsurance program or program. "Health reinsurance program" or 
10.23 	"program" means the system of reinsurance created by this chapter.
10.24 		Subd. 7.Individual health plan. "Individual health plan" means a health plan as defined 
10.25 	in section 62A.011, subdivision 4.
10.26 		Subd. 8.Individual market. "Individual market" means the market for individual health 
10.27 	plans, as defined in section 62A.011, subdivision 5.
10.28 		Subd. 9.Member. "Member" means a health carrier offering, issuing, or renewing 
10.29 	individual health plans to a Minnesota resident.
11.1 		Subd. 10.Minnesota Health Reinsurance Association or association. "Minnesota 
11.2 	Health Reinsurance Association" or "association" means the association created under 
11.3 	section 62W.05, subdivision 1.
11.4 		Subd. 11.Reinsurance payments. "Reinsurance payments" means a payment made by 
11.5 	the association to a member according to the requirements of the program and this chapter.

11.6 	Sec. 4. [62W.03] DUTIES OF COMMISSIONER.
11.7 	The commissioner may:
11.8 	(1) formulate general policies to advance the purposes of this chapter;
11.9 	(2) supervise the creation of the Minnesota Health Reinsurance Association within the 
11.10 	limits described in section 62W.05;
11.11 	(3) appoint advisory committees;
11.12 	(4) conduct periodic audits to ensure the accuracy of the data submitted by members 
11.13 	and the association, and compliance of the association and members with requirements of 
11.14 	the plan of operation and this chapter;
11.15 	(5) contract with the federal government or any other unit of government to ensure 
11.16 	coordination of the program with other individual health plan reinsurance or subsidy 
11.17 	programs;
11.18 	(6) contract with health carriers and others for administrative services; and
11.19 	(7) adopt, amend, suspend, and repeal rules as reasonably necessary to carry out and 
11.20 	make effective the provisions and purposes of this chapter.

11.21 	Sec. 5. [62W.04] APPROVAL OF REINSURANCE PAYMENTS.
11.22 		Subdivision 1.Information submitted to commissioner. The association must submit 
11.23 	to the commissioner information regarding the reinsurance payments the association 
11.24 	anticipates making for the calendar year following the year in which the information is 
11.25 	submitted. The information must include historical reinsurance payment data, underlying 
11.26 	principles of the model used to calculate anticipated reinsurance payments, and any other 
11.27 	relevant information or data the association used to determine anticipated reinsurance 
11.28 	payments for the following calendar year. This information must be submitted to the 
11.29 	commissioner by August 30 of each year, for reinsurance payments anticipated to be made 
11.30 	in the calendar year following the year in which the information is submitted. By October 
12.1 	15 of each year the commissioner must approve or modify the anticipated reinsurance 
12.2 	payment schedule.
12.3 		Subd. 2.Modification by commissioner. The commissioner may modify the association's 
12.4 	anticipated reinsurance payment schedule, as described in subdivision 1, on the basis of the 
12.5 	following criteria:
12.6 	(1) whether the association is in compliance with the requirements of the plan of operation 
12.7 	and this chapter;
12.8 	(2) the degree to which the computations and conclusions take into consideration the 
12.9 	current and future individual market regulations;
12.10 	(3) the degree to which any sample used to compute the effect on premiums reasonably 
12.11 	reflects circumstances projected to exist in the individual market through the use of accepted 
12.12 	actuarial principles;
12.13 	(4) the degree to which the computations and conclusions take into consideration the 
12.14 	current and future health care needs and health condition demographics of Minnesota 
12.15 	residents purchasing individual health plans;
12.16 	(5) the actuarially projected effect of the reinsurance payments upon both total enrollment 
12.17 	in the individual market, and the nature of the risks assumed by the association;
12.18 	(6) the financial cost to the individual market, and entire health insurance market in this 
12.19 	state;
12.20 	(7) the projected cost of all reinsurance payments in relation to funding available for the 
12.21 	program; and
12.22 	(8) other relevant factors, as determined by the commissioner.

12.23 	Sec. 6. [62W.05] MINNESOTA HEALTH REINSURANCE ASSOCIATION.
12.24 		Subdivision 1.Creation; tax exemption. The Minnesota Health Reinsurance Association 
12.25 	is established to promote the stabilization and cost control of individual health plans in the 
12.26 	state. Membership in the association consists of all health carriers offering, issuing, or 
12.27 	renewing individual health plans in the state. The association is exempt from the taxes 
12.28 	imposed under chapter 297I and any other laws of this state and all property owned by the 
12.29 	association is exempt from taxation.
12.30 		Subd. 2.Board of directors; organization. (a) The board of directors of the association 
12.31 	shall be made up of 11 members as follows: six directors selected by members, subject to 
12.32 	approval by the commissioner, one of which must be a health actuary; five public directors 
13.1 	selected by the commissioner, four of whom must be individual health plan enrollees, and 
13.2 	one of whom must be a licensed insurance agent. At least two of the public directors must 
13.3 	reside outside of the seven-county metropolitan area.
13.4 	(b) In determining voting rights to elect directors at the member's meeting, each member 
13.5 	shall be entitled to vote in person or proxy. The vote shall be a weighted vote based upon 
13.6 	the member's cost of accident and health insurance premium, subscriber contract charges, 
13.7 	or health maintenance contract payment, derived from or on behalf of Minnesota residents 
13.8 	in the previous calendar year, in the individual market, as determined by the commissioner.
13.9 	(c) In approving directors of the board, the commissioner shall consider, among other 
13.10 	things, whether all types of members are fairly represented. Directors selected by members 
13.11 	may be reimbursed from the money of the association for expenses incurred by them as 
13.12 	directors, but shall not otherwise be compensated by the association for their services.
13.13 		Subd. 3.Membership. All members shall maintain their membership in the association 
13.14 	as a condition of participating in the individual market in this state.
13.15 		Subd. 4.Operation. The association shall submit its articles, bylaws, and operating 
13.16 	rules to the commissioner for approval; provided that the adoption and amendment of 
13.17 	articles, bylaws, and operating rules by the association and the approval by the commissioner 
13.18 	thereof shall be exempt from sections 14.001 to 14.69.
13.19 		Subd. 5.Open meetings. All meetings of the board and any committees shall comply 
13.20 	with the provisions of chapter 13D.
13.21 		Subd. 6.Data. The association and board are subject to chapter 13. Data received by 
13.22 	the association and board from a member that is data on individuals is private data on 
13.23 	individuals, as defined in section 13.02, subdivision 12.
13.24 		Subd. 7.Appeals. An appeal may be filed with the commissioner within 30 days after 
13.25 	notice of an action, ruling, or decision by the board. A final action or order of the 
13.26 	commissioner under this subdivision is subject to judicial review in the manner provided 
13.27 	by chapter 14. In lieu of the appeal to the commissioner, a person may seek judicial review 
13.28 	of the board's action.
13.29 		Subd. 8.Antitrust exemption. In the performance of their duties as members of the 
13.30 	association, the members shall be exempt from the provisions of sections 325D.49 to 
13.31 	325D.66.
13.32 		Subd. 9.General powers. The association may:
13.33 	(1) exercise the powers granted to insurers under the laws of this state;
14.1 	(2) sue or be sued;
14.2 	(3) establish administrative and accounting procedures for the operation of the association; 
14.3 	and
14.4 	(4) enter into contracts with insurers, similar associations in other states, or with other 
14.5 	persons for the performance of administrative functions including the functions provided 
14.6 	for section 62W.06.
14.7 		Subd. 10.Rulemaking. The association is exempt from the Administrative Procedure 
14.8 	Act. However, to the extent the association wishes to adopt rules, they may use the provisions 
14.9 	of section 14.386, paragraph (a), clauses (1) and (3). Section 14.386, paragraph (b), does 
14.10 	not apply to rules adopted under this subdivision.

14.11 	Sec. 7. [62W.06] ASSOCIATION; ADMINISTRATION OF PROGRAM.
14.12 		Subdivision 1.Acceptance of risk. (a) The association must accept a transfer to the 
14.13 	program from a member of the risk and cost associated with providing health coverage to 
14.14 	an eligible individual when the eligible individual discloses to the member in their application 
14.15 	for an individual health plan that they have received a diagnosis of at least one of the 
14.16 	conditions in paragraph (b).
14.17 	(b) The diagnosis necessary to qualify as an eligible individual are:
14.18 	(i) AIDS/HIV;
14.19 	(ii) Alzheimer's disease;
14.20 	(iii) amyotrophic lateral sclerosis (ALS);
14.21 	(iv) angina pectoris;
14.22 	(v) anorexia nervosa or bulimia;
14.23 	(vi) aortic aneurysm;
14.24 	(vii) ascites;
14.25 	(viii) chemical dependency;
14.26 	(ix) chronic pancreatitis;
14.27 	(x) chronic renal failure;
14.28 	(xi) cirrhosis of the liver;
14.29 	(xii) coronary insufficiency;
15.1 	(xiii) coronary occlusion;
15.2 	(xiv) Crohn's Disease (regional enteritis);
15.3 	(xv) cystic fibrosis;
15.4 	(xvi) dermatomyositis;
15.5 	(xvii) Friedreich's ataxia;
15.6 	(xviii) hemophilia;
15.7 	(xix) hepatitis C;
15.8 	(xx) history of major organ transplant;
15.9 	(xxi) Huntington Chorea;
15.10 	(xxii) hydrocephalus;
15.11 	(xxiii) insulin dependent diabetes;
15.12 	(xxiv) leukemia;
15.13 	(xxv) malignant lymphoma;
15.14 	(xxvi) malignant tumors;
15.15 	(xxvii) metastatic cancer;
15.16 	(xxviii) motor/sensory aphasia:
15.17 	(xxix) multiple sclerosis;
15.18 	(xxx) muscular dystrophy;
15.19 	(xxxi) myasthenia gravis;
15.20 	(xxxii) myocardial infarction;
15.21 	(xxxiii) myotonia;
15.22 	(xxxiv) open heart surgery;
15.23 	(xxxv) paraplegia;
15.24 	(xxxvi) Parkinson's Disease;
15.25 	(xxxvii) polyarteritis nodosa;
15.26 	(xxxviii) polycystic kidney;
15.27 	(xxxix) primary cardiomyopathy;
16.1 	(xl) progressive systemic sclerosis (Scleroderma);
16.2 	(xli) quadriplegia;
16.3 	(xlii) stroke;
16.4 	(xliii) syringomylia;
16.5 	(xliv) systemic lupus erythematosis (SLE); and
16.6 	(xlv) Wilson's disease.
16.7 		Subd. 2.Payment to members. (a) The association must reimburse members on a 
16.8 	quarterly basis for claims paid on behalf of an eligible individual whose risk and cost has 
16.9 	been transferred to the program.
16.10 	(b) Reinsurance payments related to any one eligible individual is limited to $5,000,000 
16.11 	over the lifetime of the individual, without consideration of whether the reinsurance payments 
16.12 	are made to one or more members.
16.13 		Subd. 3.Plan of operation. (a) The association, in consultation with the commissioners 
16.14 	of health and commerce, must create a plan of operation to administer the program. The 
16.15 	plan of operation must be updated as necessary by the board, in consultation with the 
16.16 	commissioners.
16.17 	(b) The plan of operation must include:
16.18 	(1) guidance to members regarding the use of diagnosis codes for the purposes of 
16.19 	identifying eligible individuals;
16.20 	(2) a description of the data a member submitting a reinsurance payment request must 
16.21 	provide to the association for the association to implement and administer the program. 
16.22 	This includes data necessary for the association to determine a member's eligibility for 
16.23 	reinsurance payments;
16.24 	(3) the manner and time period in which a member must provide the data described in 
16.25 	clause (3);
16.26 	(4) requirements for reports to be submitted by a member to the association;
16.27 	(5) requirements for the processing of reports received under section 62W.07, subdivision 
16.28 	2, clause (5), by the association;
16.29 	(6) requirements for conducting audits in compliance with section 62W.08; and
16.30 	(7) requirements for an annual actuarial study of this state's individual market to be 
16.31 	ordered by the association that:
17.1 	(i) measures the impact of the program;
17.2 	(ii) recommends funding levels for the program; and
17.3 	(iii) analyzes possible changes in the individual market and the impact of the changes.
17.4 		Subd. 4.Use of premium payments. The association must retain all premiums it receives 
17.5 	in excess of administrative and operational expenses and claims paid for eligible individuals 
17.6 	whose associated risk and cost has been transferred to the program, in that order. The 
17.7 	association must apply any excess premiums toward payment of future administrative and 
17.8 	operational expenses and claims incurred for eligible individuals whose associated risk and 
17.9 	cost has been transferred to the program.

17.10 	Sec. 8. [62W.07] MEMBERS; COMPLIANCE WITH PROGRAM.
17.11 		Subdivision 1.Transfer of risk. A member must transfer the risk and cost associated 
17.12 	with providing health coverage to an eligible individual to the program in compliance with 
17.13 	this section. A member must transfer the risk and cost of the eligible individual within ten 
17.14 	days of receiving a completed application for an individual health plan from the individual, 
17.15 	which application discloses that the individual, or a member of the individual's family if a 
17.16 	family policy is being requested, has been diagnosed with one of the conditions listed in 
17.17 	section 62W.06, subdivision 1, paragraph (b). Reinsurance by the program is effective as 
17.18 	the effective date of the individual health plan and continues until the eligible individual 
17.19 	ceases coverage with the member.
17.20 		Subd. 2.Reinsurance payments. (a) A member is eligible for reinsurance payments to 
17.21 	reimburse the member for the claims of an eligible individual if the member:
17.22 	(1) provides evidence to the association that the individual is an eligible individual;
17.23 	(2) is currently paying the claims of the eligible individual;
17.24 	(3) pays to the association, pursuant to paragraph (c), the premium the member receives 
17.25 	under an individual health plan for the eligible individual;
17.26 	(4) pays to the association, pursuant to paragraph (d), any pharmacy rebates the member 
17.27 	receives for health care services provided to the eligible individual; and
17.28 	(5) reports to the association payments applicable to the eligible individual that the 
17.29 	member collects relating to:
17.30 	(i) third-party liabilities;
17.31 	(ii) payments the member recovers for overpayment;
18.1 	(iii) payments for commercial reinsurance recoveries;
18.2 	(iv) estimated federal cost-sharing reduction payments made under United States Code, 
18.3 	title 42, section 18071; and
18.4 	(v) estimated advanced premium tax credits paid to the member on behalf of an eligible 
18.5 	individual made under United States Code, title 26, section 36B.
18.6 	(b) A member that has transferred the associated risk and cost of an eligible individual 
18.7 	to the program must submit to the program all data and information required by the 
18.8 	association, in a manner determined by the association.
18.9 	(c) A member must provide the program all premiums received for coverage under an 
18.10 	individual health plan from an eligible individual whose risk and associated cost has been 
18.11 	transferred to the program. A member must pay the association the separately identifiable 
18.12 	premium amount the member received under the individual health plan covering the eligible 
18.13 	individual within 30 days of the association accepting the risk and cost transferred to it with 
18.14 	respect to an eligible individual. If the eligible individual is covered under a family policy 
18.15 	providing health coverage and the eligible individual that has a separately identifiable 
18.16 	premium equal to $0, the member shall pay the association the highest separately identifiable 
18.17 	premium under the family policy. For each additional eligible individual covered under a 
18.18 	family policy who has a separately identifiable premium equal to $0, the member shall pay 
18.19 	the association the next highest separately identifiable premium under the family policy.
18.20 	(d) A member must pay the association a pharmacy rebate required to be paid pursuant 
18.21 	to paragraph (a), clause (4), within 30 days of receiving the pharmacy rebate.
18.22 	(e) Reinsurance payments for any one eligible individual are limited to $5,000,000 over 
18.23 	the lifetime of the individual, without consideration of whether the reinsurance payments 
18.24 	are made to one or more members.
18.25 		Subd. 3.Duties; members. (a) A member must comply with the plan of operation created 
18.26 	under section 62W.06, subdivision 3, in order to receive reinsurance payments under the 
18.27 	program.
18.28 	(b) A member must continue to administer and manage an eligible individual's individual 
18.29 	health plan in accordance with the terms of the individual health plan after the risk and cost 
18.30 	associated with the eligible individual has been transferred to the program.
18.31 	(c) A member may not vary premium rates based on whether the risk and cost associated 
18.32 	with an eligible individual has been transferred to the program.
19.1 	(d) After the risk and cost of an eligible individual has been transferred to the program, 
19.2 	the risk and cost will remain with the program for the benefit plan year.
19.3 	(e) For a claim to qualify for reinsurance payments from the program, a member must 
19.4 	submit claims incurred by an eligible individual whose risk and associated cost has been 
19.5 	transferred to the program within 12 months of the claim being incurred.

19.6 	Sec. 9. [62W.08] ACCOUNTS AND AUDITS.
19.7 		Subdivision 1.Reports and audits. (a) The association shall maintain its books, records, 
19.8 	accounts, and operations on a calendar-year basis.
19.9 	(b) The association shall conduct a final accounting with respect to each calendar year 
19.10 	after April 15 of the following calendar year.
19.11 	(c) Claims for eligible individuals whose associated risk and cost have been transferred 
19.12 	to the program that are incurred during a calendar year and are submitted for reimbursement 
19.13 	before April 15 of the following calendar year must be allocated to the calendar year in 
19.14 	which they are incurred. Claims submitted after April 15 following the calendar year in 
19.15 	which they are incurred must be allocated to a later calendar year in accordance with the 
19.16 	plan of operation.
19.17 	(d) If the total receipts of the reinsurance association fund with respect to a calendar 
19.18 	year are expected to be insufficient to pay all program expenses, claims for reimbursement, 
19.19 	and other disbursements allocable to that calendar year, all claims for reimbursement 
19.20 	allocable to that calendar year shall be reduced proportionately to the extent necessary to 
19.21 	prevent a deficit in the fund for that calendar year. Any reduction in claims for reimbursement 
19.22 	with respect to a calendar year must apply to all claims allocable to that calendar year without 
19.23 	regard to when those claims are submitted for reimbursement, and any reduction will be 
19.24 	applied to each claim in the same proportion.
19.25 	(e) The association must establish a process for auditing every member that transfers 
19.26 	the cost and associated risk of an eligible individual to the program. Audits may include 
19.27 	both an audit conducted in connection with commencement of a member's first transfer to 
19.28 	the program and periodic audits up to four times a year throughout a member's participation 
19.29 	in the program.
19.30 	(f) The association must engage an independent third-party auditor to perform a financial 
19.31 	and programmatic audit for each calendar year in accordance with generally accepted 
19.32 	auditing standards. The association shall provide a copy of the audit to the commissioner 
20.1 	at the time the association receives the audit, and publish a copy of the audit on the 
20.2 	association's Web site within 14 days of receiving the audit.
20.3 		Subd. 2.Annual settle-up. (a) The association shall establish a settle-up process with 
20.4 	respect to a calendar year to reflect adjustments made in establishing the final accounting 
20.5 	for that calendar year. The adjustments include, but are not limited to: (1) the crediting of 
20.6 	premiums received with respect to the cost and associated risks of an eligible person being 
20.7 	transferred after the end of the calendar year; (2) retroactive reductions or other adjustments 
20.8 	in reimbursements necessary to prevent a deficit in the reinsurance association fund for that 
20.9 	calendar year; and (3) retroactive reductions to prevent a windfall to a member as a result 
20.10 	of third party recoveries, recovery of overpayments, commercial reinsurance recoveries, 
20.11 	federal cost-sharing reductions made under United States Code, title 42, section 18071, 
20.12 	advanced premium tax credits paid under United States Code, title 26, section 36B, or risk 
20.13 	adjustments made under  United States Code, title 42, section 18063, for that calendar year. 
20.14 	The settle-up must occur after April 15 following the calendar year to which it relates.
20.15 	(b) With respect to the risk adjustment transfers as determined by the United States 
20.16 	Department of Health and Human Services, Centers for Medicare and Medicaid Services, 
20.17 	and Center for Consumer Information and Insurance Oversight:
20.18 	(1) the commissioner must review the risk adjustment transfers to determine the impact 
20.19 	the transfer of risk and associated cost of an eligible individual to the program has had, if 
20.20 	any;
20.21 	(2) the review must occur not later than 60 days after publication of the notice of final 
20.22 	risk adjustment transfers by the Center for Consumer Information and Insurance Oversight;
20.23 	(3) if the commissioner notifies a member of the amount of any risk adjustment transfer 
20.24 	it received that does not accurately reflect benefits provided under the program;
20.25 	(i) the member must pay that amount to the association within 30 days of receiving the 
20.26 	notice from the commissioner; and
20.27 	(ii) as appropriate, the commissioner must refund that amount to the member that made 
20.28 	the federal risk adjustment payment; and
20.29 	(4) a member must submit to the commissioner, in a form acceptable to the commissioner, 
20.30 	all data requested by the commissioner by March of the year following the year to which 
20.31 	the risk adjustment applies.

21.1 	Sec. 10. [62W.10] ASSESSMENT ON ISSUERS OF ACCIDENT AND HEALTH 
21.2 	INSURANCE POLICIES.
21.3 		Subdivision 1.Definitions. (a) For the purposes of this section, the following terms have 
21.4 	the meanings given them.
21.5 	(b) "Accident and health insurance policy" or "policy" means insurance or nonprofit 
21.6 	health service plan contracts providing benefits for hospital, surgical and medical care. 
21.7 	Policy does not include coverage which is:
21.8 	(1) limited to disability or income protection coverage;
21.9 	(2) automobile medical payment coverage;
21.10 	(3) supplemental to liability insurance;
21.11 	(4) designed solely to provide payments on a per diem, fixed indemnity, or nonexpense 
21.12 	incurred basis;
21.13 	(5) credit accident and health insurance issued pursuant to chapter 62B;
21.14 	(6) designed solely to provide dental or vision care;
21.15 	(7) blanket accident and sickness insurance as defined in section 62A.11; or
21.16 	(8) accident only coverage issued by licensed and tested insurance agents or solicitors 
21.17 	which provides reasonable benefits in relation to the cost of covered services.
21.18 	The provisions of clause (4) shall not apply to hospital indemnity coverage which is sold 
21.19 	by an insurer to an applicant who is not then currently covered by a qualified plan.
21.20 	(c) "Market member" means those companies regulated under chapter 62A and offering, 
21.21 	selling, issuing, or renewing policies or contracts of accident and health insurance; health 
21.22 	maintenance organizations regulated under chapter 62D; nonprofit health service plan 
21.23 	corporations regulated under chapter 62C; community integrated service networks regulated 
21.24 	under chapter 62N; fraternal benefit societies regulated under chapter 64B; the Minnesota 
21.25 	employees insurance program established in section 43A.317; and joint self-insurance plans 
21.26 	regulated under chapter 62H. For the purposes of determining liability of market members 
21.27 	pursuant to subdivision 2, payments received from or on behalf of Minnesota residents for 
21.28 	coverage by a health maintenance organization or community integrated service network 
21.29 	shall be considered to be accident and health insurance premiums.
21.30 		Subd. 2.Assessment. The association shall make an annual determination of each market 
21.31 	member's financial liability for the support of the program, in accordance with the 
21.32 	requirements of section 62W.11, if any, and may make an annual fiscal year-end assessment 
22.1 	if necessary. The association may also, subject to the approval of the commissioner, provide 
22.2 	for interim assessments against the market members whose aggregate assessments comprised 
22.3 	a minimum of 90 percent of the most recent prior annual assessment, in the event that the 
22.4 	association deems that methodology to be the most administratively efficient and 
22.5 	cost-effective means of assessment, and as may be necessary to ensure the financial capability 
22.6 	of the association in meeting the incurred or estimated claims expenses, and administrative 
22.7 	and operational costs of the program until the association's next annual fiscal year-end 
22.8 	assessment. Payment of an assessment shall be due within 30 days of receipt by a market 
22.9 	member of a written notice of a fiscal year-end or interim assessment. Failure by a market 
22.10 	member to tender to the association the assessment within 30 days shall be grounds for 
22.11 	termination of the market member's ability to issue accident and health insurance policies 
22.12 	in Minnesota. A market member which ceases to do accident and health insurance business 
22.13 	within the state shall remain liable for assessments through the calendar year during which 
22.14 	accident and health insurance business ceased. The association may decline to levy an 
22.15 	assessment against a market member if the assessment, as determined herein, would not 
22.16 	exceed $10.

22.17 	Sec. 11. [62W.11] FUNDING OF PROGRAM.
22.18 	(a) The reinsurance association fund account is created in the special revenue fund of 
22.19 	the state treasury. Funds in the account are appropriated to the association for the operation 
22.20 	of the program. Notwithstanding section 11A.20, all investment income and all investment 
22.21 	losses attributable to the investment of the reinsurance association account not currently 
22.22 	needed, shall be credited to the reinsurance association fund account.
22.23 	(b) The association shall fund the program using the following sources, in the following 
22.24 	order:
22.25 	(1) any federal funds available, whether through grants or otherwise;
22.26 	(2) the appropriation in section 13, which should be used by the association to cover the 
22.27 	claims, administrative, and operational costs of the program in an equal amount each year 
22.28 	until December 31, 2022;
22.29 	(3) the tax imposed on health maintenance organizations, community integrated service 
22.30 	networks, and nonprofit health care service plan corporations under section 297I.05, 
22.31 	subdivision 5; and
22.32 	(4) the assessment, if any, authorized by section 62W.10.
23.1 	(c) The program shall not exceed $....... in claims, administrative, and operational costs 
23.2 	per calendar year.

23.3 	Sec. 12. Minnesota Statutes 2016, section 297I.05, subdivision 5, is amended to read:
23.4 		Subd. 5.Health maintenance organizations, nonprofit health service plan 
23.5 	corporations, and community integrated service networks. (a) A tax is imposed on health 
23.6 	maintenance organizations, community integrated service networks, and nonprofit health 
23.7 	care service plan corporations. The rate of tax is equal to one percent of gross premiums 
23.8 	less return premiums on all direct business received by the organization, network, or 
23.9 	corporation or its agents in Minnesota, in cash or otherwise, in the calendar year.
23.10 	(b) The commissioner shall deposit all revenues, including penalties and interest, collected 
23.11 	under this chapter from health maintenance organizations, community integrated service 
23.12 	networks, and nonprofit health service plan corporations in the health care access reinsurance 
23.13 	association fund. Refunds of overpayments of tax imposed by this subdivision must be paid 
23.14 	from the health care access reinsurance association fund. There is annually appropriated 
23.15 	from the health care access reinsurance association fund to the commissioner the amount 
23.16 	necessary to make any refunds of the tax imposed under this subdivision.

23.17 	Sec. 13. APPROPRIATION.
 23.18 	$....... in fiscal year 2018 is appropriated from the health care access fund to the 
23.19 	commissioner of commerce for transfer to the reinsurance association fund account in the 
23.20 	special revenue fund for the purposes described in Minnesota Statutes, section 62W.10.

23.21 	Sec. 14. EFFECTIVE DATE.
 23.22 	Sections 1 to 13 are effective the day following final enactment and apply to individual 
23.23 	health plans providing coverage on or after January 1, 2018.

APPENDIX 

Repealed Minnesota Statutes: 17-2884 

62A.65 INDIVIDUAL MARKET REGULATION.Subd. 2.Guaranteed renewal. 
No individual health plan may be offered, sold, issued, or renewed to a Minnesota resident unless the health plan provides that the plan is guaranteed renewable at a premium rate that does not take into account the claims experience or any change in the health status of any covered person that occurred after the initial issuance of the health plan to the person. The premium rate upon renewal must also otherwise comply with this section. A health carrier must not refuse to renew an individual health plan, except for nonpayment of premiums, fraud, or misrepresentation. 

62L.08 RESTRICTIONS RELATING TO PREMIUM RATES.Subd. 4.Geographic premium variations. 
Premium rates may vary based on geographic rating areas set by the commissioner. The commissioner shall grant approval if the health carrier provides actuarial justification acceptable to the commissioner for the proposed geographic variations in rates.