SF 3784
Introduction - 94th Legislature (2025 - 2026)
Posted on 02/24/2026 10:01 a.m.
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A bill for an act
relating to health care; providing an alternative mechanism for prompt payment
of emergency room and ambulance charges incurred by patients enrolled in very
high deductible health plans; amending Minnesota Statutes 2024, sections 60A.23,
subdivision 8; 62Q.01, by adding a subdivision; 62Q.025, by adding a subdivision.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
Section 1.
Minnesota Statutes 2024, section 60A.23, subdivision 8, is amended to read:
Subd. 8.
Self-insurance or insurance plan administrators who are vendors of risk
management services.
deleted text begin (1) Scope.deleted text end new text begin (a)new text end This subdivision applies to any vendor of risk
management services and to any entity which administers, for compensation, a self-insurance
or insurance plan. This subdivision does not apply deleted text begin (a)deleted text end new text begin (1)new text end to an insurance company authorized
to transact insurance in this state, as defined by section 60A.06, subdivision 1, clauses (4)
and (5); deleted text begin (b)deleted text end new text begin (2)new text end to a service plan corporation, as defined by section 62C.02, subdivision 6;
deleted text begin (c)deleted text end new text begin (3)new text end to a health maintenance organization, as defined by section 62D.02, subdivision 4;
deleted text begin (d)deleted text end new text begin (4)new text end to an employer directly operating a self-insurance plan for its employees' benefits;
deleted text begin (e)deleted text end new text begin (5)new text end to an entity which administers a program of health benefits established pursuant to
a collective bargaining agreement between an employer, or group or association of employers,
and a union or unions; or deleted text begin (f)deleted text end new text begin (6)new text end to an entity which administers a self-insurance or insurance
plan if a licensed Minnesota insurer is providing insurance to the plan and if the licensed
insurer has appointed the entity administering the plan as one of its licensed agents within
this state.
deleted text begin (2) Definitions.deleted text end new text begin (b)new text end For purposes of this subdivision the following terms have the
meanings given them.
deleted text begin (a)deleted text end new text begin (1)new text end "Administering a self-insurance or insurance plan" means (i) processing, reviewing
or paying claims, (ii) establishing or operating funds and accounts, or (iii) otherwise providing
necessary administrative services in connection with the operation of a self-insurance or
insurance plan.
deleted text begin (b)deleted text end new text begin (2)new text end "Employer" means an employer, as defined by section 62E.02, subdivision 2.
deleted text begin (c)deleted text end new text begin (3)new text end "Entity" means any association, corporation, partnership, sole proprietorship,
trust, or other business entity engaged in or transacting business in this state.
deleted text begin (d)deleted text end new text begin (4)new text end "Self-insurance or insurance plan" means a plan for the benefit of employees or
members of an association providing life, medical or hospital care, accident, sickness or
disability insurance, or pharmacy benefits, or a plan providing liability coverage for any
other risk or hazard, which is or is not directly insured or provided by a licensed insurer,
service plan corporation, or health maintenance organization.
deleted text begin (e)deleted text end new text begin (5)new text end "Vendor of risk management services" means an entity providing for compensation
actuarial, financial management, accounting, legal or other services for the purpose of
designing and establishing a self-insurance or insurance plan for an employer.
deleted text begin (3) License.deleted text end new text begin (c)new text end No vendor of risk management services or entity administering a
self-insurance or insurance plan may transact this business in this state unless it is licensed
to do so by the commissioner. An applicant for a license shall state in writing the type of
activities it seeks authorization to engage in and the type of services it seeks authorization
to provide. The license may be granted only when the commissioner is satisfied that the
entity possesses the necessary organization, background, expertise, and financial integrity
to supply the services sought to be offered. The commissioner may issue a license subject
to restrictions or limitations upon the authorization, including the type of services which
may be supplied or the activities which may be engaged in. The license fee is $1,500 for
the initial application and $1,500 for each three-year renewal. All licenses are for a period
of three years.
deleted text begin (4) Regulatory restrictions; powers of the commissioner.deleted text end new text begin (d)new text end To deleted text begin assuredeleted text end new text begin ensurenew text end that
self-insurance or insurance plans are financially solvent, are administered in a fair and
equitable fashion, and are processing claims and paying benefits in a prompt, fair, and honest
manner, vendors of risk management services and entities administering insurance or
self-insurance plans are subject to the supervision and examination by the commissioner.
Vendors of risk management services, entities administering insurance or self-insurance
plans, and insurance or self-insurance plans established or operated by them are subject to
the trade practice requirements of sections 72A.19 to 72A.30. In lieu of an unlimited
guarantee from a parent corporation for a vendor of risk management services or an entity
administering insurance or self-insurance plans, the commissioner may accept a surety bond
in a form satisfactory to the commissioner in an amount equal to 120 percent of the total
amount of claims handled by the applicant in the prior year. If at any time the total amount
of claims handled during a year exceeds the amount upon which the bond was calculated,
the administrator shall immediately notify the commissioner. The commissioner may require
that the bond be increased accordingly.
new text begin (e) new text end No contract entered into after July 1, 2001, between a licensed vendor of risk
management services and a group authorized to self-insure for workers' compensation
liabilities under section 79A.03, subdivision 6, may take effect until it has been filed with
the commissioner, and either (1) the commissioner has approved it or (2) 60 days have
elapsed and the commissioner has not disapproved it as misleading or violative of public
policy.
new text begin
(f) An entity administering an insurance plan that consists of, includes, or is connected
with a very high deductible health plan (VHDHP) as defined in section 62Q.01, subdivision
8, must comply with section 62Q.025, subdivision 3. This requirement applies when the
entity is either:
new text end
new text begin
(1) acting under an assumption of responsibility under section 62Q.025, subdivision 3,
paragraph (b); or
new text end
new text begin
(2) performing under a contract that is subject to this subdivision.
new text end
new text begin
The entity must not enter into any contractual relationship or perform any services in
connection with a VHDHP that does not by its terms provide for compliance with section
62Q.025, subdivision 3, either by the health plan company or by an entity administering
the insurance plan under this subdivision.
new text end
deleted text begin (5) Rulemaking authority.deleted text end new text begin (g)new text end To carry out the purposes of this subdivision, the
commissioner may adopt rules pursuant to sections 14.001 to 14.69. These rules may:
deleted text begin (a)deleted text end new text begin (1)new text end establish reporting requirements for administrators of insurance or self-insurance
plans;
deleted text begin (b)deleted text end new text begin (2)new text end establish standards and guidelines to assure the adequacy of financing, reinsuring,
and administration of insurance or self-insurance plans;
deleted text begin (c)deleted text end new text begin (3)new text end establish bonding requirements or other provisions assuring the financial integrity
of entities administering insurance or self-insurance plans; or
deleted text begin (d)deleted text end new text begin (4)new text end establish other reasonable requirements to further the purposes of this subdivision.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective August 1, 2026, and applies to very high
deductible health plans offered, issued, sold, or renewed on or after that date.
new text end
Sec. 2.
Minnesota Statutes 2024, section 62Q.01, is amended by adding a subdivision to
read:
new text begin Subd. 8. new text end
new text begin Very high deductible health plan or VHDHP. new text end
new text begin
"Very high deductible health
plan" or "VHDHP" means a high deductible health plan that has an annual maximum
out-of-pocket expense that exceeds $3,000 for individual coverage or $6,000 for family
coverage.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective August 1, 2026, and applies to very high
deductible health plans offered, issued, sold, or renewed on or after that date.
new text end
Sec. 3.
Minnesota Statutes 2024, section 62Q.025, is amended by adding a subdivision to
read:
new text begin Subd. 3. new text end
new text begin Payment of emergency and ambulance charges. new text end
new text begin
(a) A very high deductible
health plan, as defined in section 62Q.01, subdivision 8; and a health plan company that
issues such a health plan, are subject to this subdivision as a condition of the privilege of
issuing a VHDHP granted under subdivisions 1 and 2.
new text end
new text begin
(b) A health plan company may contract with an entity administering an insurance plan,
as defined in section 60A.23, subdivision 8, to assume the health plan company's duties and
limitations under this subdivision. Under such a contract, the health plan company retains
ultimate responsibility for compliance with this subdivision.
new text end
new text begin
(c) If an enrollee in a plan described in paragraph (a) incurs charges for care provided
in a hospital emergency room or for ambulance service, as defined in section 144E.001,
subdivision 3, which are not payable under the plan at the time due to the enrollee not having
satisfied the annual deductible, the VHDHP must require that the health plan company that
issued the VHDHP pay those charges directly to the hospital or ambulance service licensee,
as defined in section 144E.001, subdivision 8, within 15 days after receiving notice from
the hospital or ambulance service licensee that the enrollee has not paid the charges within
30 days after the date of treatment.
new text end
new text begin
(d) A health plan company that complies with paragraph (c) may seek and obtain
reimbursement for those payments from its enrollee. The health plan company's collection
procedures must comply with the same restrictions that would apply to the health care
provider in collecting the charges from the patient. Upon written request of the health plan
company, the hospital or ambulance service licensee shall inform the health plan company
in writing of any special restrictions regarding collection procedures to which the provider
is subject, whether originating under contract or other agreement, law, or otherwise. No
health plan company may cancel, terminate, suspend, nonrenew, or otherwise limit or reduce
an enrollee's coverage, or coverage of the enrollee's family, as a means of collection or as
a penalty for failure to reimburse the health plan company for a payment made under this
subdivision.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective August 1, 2026, and applies to very high
deductible health plans offered, issued, sold, or renewed on or after that date.
new text end