HF 4333

Introduction - 94th Legislature (2025 - 2026)

Posted on 04/22/2026 05:02 p.m.

A bill for an act
relating to insurance; establishing a supplemental health insurance product to cover
short-term home health and nursing care; providing civil penalties; amending
Minnesota Statutes 2024, sections 62A.135, subdivision 1; 62A.46, subdivision
2; 72A.13, subdivision 1; 256B.0913, subdivision 4; proposing coding for new
law in Minnesota Statutes, chapter 62A.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

Section 1.

Minnesota Statutes 2024, section 62A.135, subdivision 1, is amended to read:

Subdivision 1.

Definitions.

For purposes of this section, the following terms have the
meanings given deleted text begin them deleted text end :

deleted text begin (a) deleted text end new text begin (1) new text end "fixed indemnity policy" is a policy form, other than an accidental death and
dismemberment policy, a disability income policy, or a long-term care policy as defined in
section 62A.46, subdivision 2, that pays a predetermined, specified, fixed benefit for services
provided. new text begin Fixed indemnity policy includes short-term home health and nursing care insurance
under section 62A.70. new text end Claim costs under these forms are generally not subject to inflation,
although they may be subject to changes in the utilization of health care services. For policy
forms providing both expense-incurred and fixed benefits, the policy form is a fixed
indemnity policy if 50 percent or more of the total claims are for predetermined, specified,
fixed benefits;

deleted text begin (b) deleted text end new text begin (2) new text end "guaranteed renewable" means that, during the renewal period (to a specified
age) renewal cannot be declined nor coverage changed by the insurer for any reason other
than nonpayment of premiums, fraud, or misrepresentation, but the insurer can revise rates
on a class basis upon approval by the commissioner;

deleted text begin (c) deleted text end new text begin (3) new text end "noncancelable" means that, during the renewal period (to a specified age) renewal
cannot be declined nor coverage changed by the insurer for any reason other than nonpayment
of premiums, fraud, or misrepresentation and that rates cannot be revised by the insurer.
This includes policies that are guaranteed renewable to a specified age, such as 60 or 65, at
guaranteed rates; and

deleted text begin (d) deleted text end new text begin (4) new text end "average annualized premium" means the average of the estimated annualized
premium per covered person based on the anticipated distribution of business using all
significant criteria having a price difference, such as age, sex, amount, dependent status,
mode of payment, and rider frequency. For filing of rate revisions, the amount is the
anticipated average assuming the revised rates have fully taken effect.

Sec. 2.

Minnesota Statutes 2024, section 62A.46, subdivision 2, is amended to read:

Subd. 2.

Long-term care policy.

new text begin (a) new text end "Long-term care policy" means an individual or
group policy, certificate, subscriber contract, or other evidence of coverage that provides
benefits for prescribed long-term care, including nursing facility services or home care
services, or both nursing facility services and home care services, pursuant to the
requirements of sections 62A.46 to 62A.56. new text begin Long-term care policy does not include
short-term home health and nursing care insurance under section 62A.70.
new text end

new text begin (b) new text end Sections 62A.46, 62A.48, and 62A.52 to 62A.56 do not apply to a long-term care
policy issued to deleted text begin (a) deleted text end new text begin (1) new text end an employer or employers or to the trustee of a fund established by
an employer where only employees or retirees, and dependents of employees or retirees,
are eligible for coverage or deleted text begin (b) deleted text end new text begin (2) new text end to a labor union or similar employee organization. deleted text begin The
associations exempted from the requirements of sections 62A.3099 to 62A.44 under 62A.31,
subdivision 1, clause (c) shall not be subject to the provisions of sections 62A.46 to 62A.56
until July 1, 1988.
deleted text end

Sec. 3.

new text begin [62A.70] SHORT-TERM HOME HEALTH AND NURSING CARE
INSURANCE.
new text end

new text begin Subdivision 1. new text end

new text begin Definitions. new text end

new text begin (a) For purposes of this section, the following terms have
the meanings given.
new text end

new text begin (b) "Activities of daily living" has the meaning given in section 62S.01, subdivision 2.
new text end

new text begin (c) "Cognitive impairment" has the meaning given in section 62S.01, subdivision 9.
new text end

new text begin (d) "Free-look period" means a period with a duration of at least 30 days, beginning the
date the policy, certificate, contract, or other evidence of coverage is issued and delivered
to the insured, during which an insured may cancel the policy, certificate, contract, or other
evidence of coverage and receive a full refund of all paid insurance premiums.
new text end

new text begin (e) "Home health agency" has the meaning given in section 62A.46, subdivision 10.
new text end

new text begin (f) "Insured" means a person covered under a short-term home health and nursing care
insurance policy.
new text end

new text begin (g) "Nursing facility" has the meaning given in section 62A.46, subdivision 3.
new text end

new text begin (h) "Plan of care" has the meaning given in section 62A.46, subdivision 8.
new text end

new text begin (i) "Qualified insurer" means an entity licensed under chapter 62A or 62C.
new text end

new text begin (j) "Short-term home health and nursing care insurance" means an individual or group
policy, certificate, subscriber contract, or other evidence of coverage that provides benefits
for short-term home health services or short-term nursing care services. Short-term home
health and nursing care insurance does not include:
new text end

new text begin (1) a long-term care policy, as defined in section 62A.46, subdivision 2;
new text end

new text begin (2) long-term care insurance, as defined in section 62S.01, subdivision 18;
new text end

new text begin (3) Medicare supplement policies, as defined in section 62A.3099, subdivision 18; or
new text end

new text begin (4) major medical, disability income, or hospital confinement indemnity policies.
new text end

new text begin (k) "Short-term home health services" means one or more of the following services to
care for and treat an insured that are provided by a home health agency in a noninstitutional
setting pursuant to a written diagnosis or assessment and plan of care:
new text end

new text begin (1) nursing and related personal care services under the direction of a registered nurse,
including the services of a home health aide;
new text end

new text begin (2) physical therapy;
new text end

new text begin (3) speech therapy;
new text end

new text begin (4) respiratory therapy;
new text end

new text begin (5) occupational therapy;
new text end

new text begin (6) nutritional services provided by a licensed dietitian;
new text end

new text begin (7) homemaker services, meal preparation, and similar nonmedical services;
new text end

new text begin (8) medical social services; and
new text end

new text begin (9) other similar medical services and health-related support services.
new text end

new text begin (l) "Short-term nursing care services" means services to care for and treat an insured
that are provided by a nursing facility pursuant to a written diagnosis or assessment and
plan of care.
new text end

new text begin (m) "Waiting period" means a specified time period that an insured must wait before
some or all of the insured's coverage becomes effective.
new text end

new text begin Subd. 2. new text end

new text begin Short-term home health and nursing care insurance approval. new text end

new text begin (a) A qualified
insurer may offer, issue, deliver, and renew short-term home health and nursing care
insurance if the insurance meets the requirements of this section.
new text end

new text begin (b) Short-term home health and nursing care insurance may be offered, issued, delivered,
or renewed only by a qualified insurer.
new text end

new text begin (c) Short-term home health and nursing care insurance must not be offered, issued,
delivered, or renewed until the short-term home health and nursing care insurance is approved
by the commissioner as necessary under sections 62A.02 and 62A.135.
new text end

new text begin Subd. 3. new text end

new text begin Policy requirements. new text end

new text begin (a) Short-term home health and nursing care insurance
must provide benefits upon:
new text end

new text begin (1) cognitive impairment; or
new text end

new text begin (2) the insured's inability to perform at least two activities of daily living without
substantial assistance.
new text end

new text begin (b) Short-term home health and nursing care insurance must not provide coverage for a
period exceeding 360 days.
new text end

new text begin (c) Short-term home health and nursing care insurance must provide a free-look period.
new text end

new text begin (d) Short-term home health and nursing care insurance must not be canceled due to an
insured's deterioration in health status or use of benefits.
new text end

new text begin (e) An insurer may deny the renewal of a policy, certificate, contract, or other evidence
of coverage of short-term home health and nursing care insurance only for:
new text end

new text begin (1) nonpayment of a premium by the insured;
new text end

new text begin (2) fraud or misrepresentation by the insured;
new text end

new text begin (3) termination of the insurer's authority to transact business in the state; or
new text end

new text begin (4) the insured's exhaustion of the maximum benefit period.
new text end

new text begin (f) Upon the conversion or replacement by an insurer of a policy, certificate, contract,
or other evidence of coverage containing a waiting period, the insurer is prohibited from
establishing a waiting period that differs from the original waiting period.
new text end

new text begin Subd. 4. new text end

new text begin Required disclosures. new text end

new text begin Short-term home health and nursing care insurance must
not be offered or issued without providing the following written disclosures:
new text end

new text begin (1) a statement, in bold text, that the policy, certificate, contract, or other evidence of
coverage is supplemental health insurance; is not long-term care insurance; and is not a
policy under the Minnesota partnership for long-term care program;
new text end

new text begin (2) a clear and understandable explanation of the free-look period; and
new text end

new text begin (3) a clear and understandable explanation of all renewability and continuity provisions.
new text end

Sec. 4.

Minnesota Statutes 2024, section 72A.13, subdivision 1, is amended to read:

Subdivision 1.

Penalties.

Any company, corporation, association, society, or other
insurer, or any officer or agent thereof, which or who solicits, issues or delivers to any
person in this state any policy in violation of the provisions of sections 60A.06, subdivision
3 deleted text begin or deleted text end new text begin , new text end 62A.01 to 62A.10, new text begin or 62A.70 new text end may be punished by a fine of not more than $200 for
each offense, and the commissioner may revoke the license of any company, corporation,
association, society, or other insurer of another state or country, or of the agent thereof,
which or who willfully violates any provision of sections 60A.06, subdivision 3 deleted text begin or deleted text end new text begin , new text end 62A.01
to 62A.10 new text begin , or 62A.70 new text end .

Sec. 5.

Minnesota Statutes 2024, section 256B.0913, subdivision 4, is amended to read:

Subd. 4.

Eligibility for funding for services for nonmedical assistance recipients.

(a)
Funding for services under the alternative care program is available to persons who meet
the following criteria:

(1) the person is a citizen of the United States or a United States national;

(2) the person has been determined by a community assessment under section 256B.0911
to be a person who would require the level of care provided in a nursing facility, as
determined under section 256B.0911, subdivision 26, but for the provision of services under
the alternative care program;

(3) the person is age 65 or older;

(4) the person would be eligible for medical assistance within 135 days of admission to
a nursing facility;

(5) the person is not ineligible for the payment of long-term care services by the medical
assistance program due to an asset transfer penalty under section 256B.0595 or equity
interest in the home exceeding $500,000 as stated in section 256B.056;

(6) the person needs long-term care services that are not funded through other state or
federal funding, or other health insurance or other third-party insurance such as long-term
care insurance new text begin . For purposes of this clause, short-term home health and nursing care insurance
under section 62A.70 does not constitute health or other third-party insurance new text end ;

(7) except for individuals described in clause (8), the monthly cost of the alternative
care services funded by the program for this person does not exceed 75 percent of the
monthly limit described under section 256S.18. This monthly limit does not prohibit the
alternative care client from payment for additional services, but in no case may the cost of
additional services purchased under this section exceed the difference between the client's
monthly service limit defined under section 256S.04, and the alternative care program
monthly service limit defined in this paragraph. If care-related supplies and equipment or
environmental modifications and adaptations are or will be purchased for an alternative
care services recipient, the costs may be prorated on a monthly basis for up to 12 consecutive
months beginning with the month of purchase. If the monthly cost of a recipient's other
alternative care services exceeds the monthly limit established in this paragraph, the annual
cost of the alternative care services shall be determined. In this event, the annual cost of
alternative care services shall not exceed 12 times the monthly limit described in this
paragraph;

(8) for individuals assigned a case mix classification A as described under section
256S.18, with (i) no dependencies in activities of daily living, or (ii) up to two dependencies
in bathing, dressing, grooming, walking, and eating when the dependency score in eating
is three or greater as determined by an assessment performed under section 256B.0911, the
monthly cost of alternative care services funded by the program cannot exceed $593 per
month for all new participants enrolled in the program on or after July 1, 2011. This monthly
limit shall be applied to all other participants who meet this criteria at reassessment. This
monthly limit shall be increased annually as described in section 256S.18. This monthly
limit does not prohibit the alternative care client from payment for additional services, but
in no case may the cost of additional services purchased exceed the difference between the
client's monthly service limit defined in this clause and the limit described in clause (7) for
case mix classification A;

(9) the person is making timely payments of the assessed monthly fee. A person is
ineligible if payment of the fee is over 60 days past due, unless the person agrees to:

(i) the appointment of a representative payee;

(ii) automatic payment from a financial account;

(iii) the establishment of greater family involvement in the financial management of
payments; or

(iv) another method acceptable to the lead agency to ensure prompt fee payments; and

(10) for a person participating in consumer-directed community supports, the person's
monthly service limit must be equal to the monthly service limits in clause (7), except that
a person assigned a case mix classification L must receive the monthly service limit for
case mix classification A.

(b) The lead agency may extend the client's eligibility as necessary while making
arrangements to facilitate payment of past-due amounts and future premium payments.
Following disenrollment due to nonpayment of a monthly fee, eligibility shall not be
reinstated for a period of 30 days.

(c) Alternative care funding under this subdivision is not available for a person who is
a medical assistance recipient or who would be eligible for medical assistance without a
spenddown or waiver obligation. A person whose initial application for medical assistance
and the elderly waiver program is being processed may be served under the alternative care
program for a period up to 60 days. If the individual is found to be eligible for medical
assistance, medical assistance must be billed for services payable under the federally
approved elderly waiver plan and delivered from the date the individual was found eligible
for the federally approved elderly waiver plan. Notwithstanding this provision, alternative
care funds may not be used to pay for any service the cost of which: (i) is payable by medical
assistance; (ii) is used by a recipient to meet a waiver obligation; or (iii) is used to pay a
medical assistance income spenddown for a person who is eligible to participate in the
federally approved elderly waiver program under the special income standard provision.

(d) Alternative care funding is not available for a person who resides in a licensed nursing
home, certified boarding care home, hospital, or intermediate care facility, except for case
management services which are provided in support of the discharge planning process for
a nursing home resident or certified boarding care home resident to assist with a relocation
process to a community-based setting.

(e) Alternative care funding is not available for a person whose income is greater than
the maintenance needs allowance under section 256S.05, but equal to or less than 120 percent
of the federal poverty guideline effective July 1 in the fiscal year for which alternative care
eligibility is determined, who would be eligible for the elderly waiver with a waiver
obligation.