SF 3936
1st Engrossment - 94th Legislature (2025 - 2026)
Posted on 04/08/2026 09:46 a.m.
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A bill for an act
relating to health insurance; extending reinsurance assessment authority; requiring
the commissioner of commerce to apply for a waiver continuation; amending
Minnesota Statutes 2025 Supplement, sections 62E.23, subdivisions 1a, 2, 3;
62E.24, subdivisions 1, 2.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
Section 1.
Minnesota Statutes 2025 Supplement, section 62E.23, subdivision 1a, is amended
to read:
Subd. 1a.
deleted text begin 2028deleted text end Assessment on group health carriers.
(a) An assessment is imposed
deleted text begin indeleted text end new text begin eachnew text end calendar year deleted text begin 2028deleted text end on group health carriers operating under the Minnesota premium
security plan deleted text begin indeleted text end new text begin during the previousnew text end benefit year deleted text begin 2027deleted text end . deleted text begin This is a onetime assessment.
deleted text end
(b) By May 1deleted text begin , 2028deleted text end new text begin each yearnew text end , the association must provide each group health carrier
with an estimate of the carrier's assessment under paragraph (a).
(c) By June 30deleted text begin , 2028deleted text end new text begin each yearnew text end , the association must notify each group health carrier of
the carrier's assessment amount under paragraph (a). The association must determine each
carrier's assessment amount, in consultation with the commissioner, based on the group
health carrier's portion of the total premiums for group health plans written in Minnesota
for new text begin the previous new text end benefit year deleted text begin 2027deleted text end . The association must establish the assessment amount
for each group health plan so that the aggregate assessment amount collected from group
health plans under this subdivision equals the amount necessary for the appropriations and
transfers under section 62E.25, subdivision 1.
(d) Subject to paragraph (e), each group health carrier must pay the assessment under
paragraph (a) to the association by August 1deleted text begin , 2028deleted text end new text begin each yearnew text end . A group health plan must pay
the assessment in the manner determined by the commissioner.
(e) A group health carrier may apply to the commissioner to defer all or part of the
assessment imposed under paragraph (a). The application must be submitted to the
commissioner by May 15deleted text begin , 2028deleted text end new text begin of the calendar year after the applicable benefit yearnew text end . The
commissioner may defer all or part of the assessment if the commissioner determines the
payment of the assessment places the group health carrier in a financially impaired condition.
The commissioner may deny an application for deferral under this paragraph. No later than
June 15deleted text begin , 2028deleted text end new text begin of the calendar year after the applicable benefit yearnew text end , the commissioner must
notify the association and the group health carrier whether the assessment deferral is approved
or denied. If the commissioner approves the deferral request, the notice must include the
amount of and due date for the deferred portion of the assessment. If all or part of the
assessment is deferred, the association must include the amount deferred in the other group
health carriers' assessments in a proportionate manner consistent with this subdivision. The
group health carrier that receives a deferral is liable to the association for the amount deferred
and is prohibited from receiving or becoming entitled to a reinsurance payment under the
Minnesota premium security plan until the group health carrier has paid the deferred
assessment.
(f) If the association determines the assessment imposed under paragraph (a) exceeds
or is less than the amount necessary to operate and administer the Minnesota premium
security plan and issue reinsurance payments, the association must require group health
carriers to pay an additional amount or the association must issue a refund to the group
health carriers. The association must determine the accuracy of the assessment deleted text begin by May 30,
2029deleted text end new text begin within two years of the assessmentnew text end .
(g) By August 15deleted text begin , 2028deleted text end new text begin of the year after the applicable benefit yearnew text end , the association must
remit the assessments collected under this subdivision to the commissioner for deposit in
the premium security plan account created under section 62E.25.
Sec. 2.
Minnesota Statutes 2025 Supplement, section 62E.23, subdivision 2, is amended
to read:
Subd. 2.
Payment parameters.
(a) The board must design and adjust the payment
parameters to ensure the payment parameters:
(1) will stabilize or reduce premium rates in the individual market;
(2) will increase participation in the individual market;
(3) will improve access to health care providers and services for those in the individual
market;
(4) mitigate the impact high-risk individuals have on premium rates in the individual
market;
(5) take into account any federal funding available for the plan;
(6) deleted text begin for benefit year 2027,deleted text end take into account the assessment under subdivision 1a;
(7) ensure the premium security plan account created under section 62E.25, subdivision
1, has sufficient money to ensure MNsure's stable operation after taking into account the
Minnesota premium security plan's effect on MNsure's funding; and
(8) take into account the total amount available to fund the plan.
(b) The attachment point for the plan is the threshold amount for claims costs incurred
by an eligible health carrier for an enrolled individual's covered benefits in a benefit year,
beyond which the claims costs for benefits are eligible for reinsurance payments. The
attachment point shall be set by the board at $50,000 or more, but not exceeding the
reinsurance cap.
(c) The coinsurance rate for the plan is the rate at which the association will reimburse
an eligible health carrier for claims incurred for an enrolled individual's covered benefits
in a benefit year above the attachment point and below the reinsurance cap. The coinsurance
rate shall be set by the board at a rate between 50 and 80 percent.
(d) The reinsurance cap is the threshold amount for claims costs incurred by an eligible
health carrier for an enrolled individual's covered benefits, after which the claims costs for
benefits are no longer eligible for reinsurance payments. The reinsurance cap shall be set
by the board at $250,000 or less.
(e) The board may adjust the payment parameters to the extent necessary to secure
federal approval of the state innovation waiver request in Laws 2017, chapter 13, article 1,
section 8.
(f) For purposes of paragraph (a), clause (7), the association must consult with the
commissioner of management and budget and the board of directors of MNsure to determine
the amount of funding necessary to ensure MNsure's stable operation.
Sec. 3.
Minnesota Statutes 2025 Supplement, section 62E.23, subdivision 3, is amended
to read:
Subd. 3.
Operation.
(a) The board shall propose to the commissioner the payment
parameters for the next benefit year by January 15 of the year before the applicable benefit
year. The commissioner shall approve or reject the payment parameters no later than 14
days following the board's proposal. If the commissioner fails to approve or reject the
payment parameters within 14 days following the board's proposal, the proposed payment
parameters are final and effective.
(b) If the amount in the premium security plan account in section 62E.25, subdivision
1, is not anticipated to be adequate to fully fund the approved payment parameters as of
July 1 of the year before the applicable benefit year, the board, in consultation with the
commissioner and the commissioner of management and budget, shall propose payment
parameters within the available appropriations ordeleted text begin , for benefit year 2027,deleted text end assess group health
carriers to obtain the necessary funding. The commissioner must permit an eligible health
carrier to revise an applicable rate filing based on the final payment parameters for the next
benefit year.
(c) Notwithstanding paragraph (a), the payment parameters for benefit years 2023 through
2027 are:
(1) an attachment point of $50,000;
(2) a coinsurance rate of 80 percent; and
(3) a reinsurance cap of $250,000.
Sec. 4.
Minnesota Statutes 2025 Supplement, section 62E.24, subdivision 1, is amended
to read:
Subdivision 1.
Accounting.
The board must keep an accounting for each benefit year
of all:
(1) funds appropriated for reinsurance payments and administrative and operational
expenses;
(2) requests for reinsurance payments received from eligible health carriers;
(3) deleted text begin for benefit year 2027,deleted text end assessments collected and deferred under section 62E.23,
subdivision 1a;
(4) reinsurance payments made to eligible health carriers; and
(5) administrative and operational expenses incurred for the plan.
Sec. 5.
Minnesota Statutes 2025 Supplement, section 62E.24, subdivision 2, is amended
to read:
Subd. 2.
Reports.
(a) The board must submit to the commissioner and to the chairs and
ranking minority members of the legislative committees with jurisdiction over commerce
and health and make available to the public quarterly reports on plan operations and an
annual report summarizing the plan operations for each benefit year. All reports must be
made public by posting the report on the Minnesota Comprehensive Health Association
website. The annual summary must be made available by November 1 of the year following
the applicable benefit year or 60 calendar days following the final disbursement of
reinsurance payments for the applicable benefit year, whichever is later.
(b) The reports must include information about:
(1) the reinsurance parameters used;
(2) the metal levels affected;
(3) the number of claims payments estimated and submitted for payment per products
offered on-exchange and off-exchange and per eligible health carrier;
(4) the estimated reinsurance payments by plan type based on carrier-submitted templates;
(5) funds appropriated for reinsurance payments and administrative and operational
expenses for each year, including: (i) the federal and state contributions received; (ii)
investment income; (iii) deleted text begin for benefit year 2027,deleted text end assessments collected under section 62E.23,
subdivision 1a; and (iv) any other revenue or funds received;
(6) the total amount of reinsurance payments made to each eligible health carrier; and
(7) administrative and operational expenses incurred for the plan, including the total
amount incurred and as a percentage of the plan's operational budget.
Sec. 6. new text begin CONTINUATION OF STATE INNOVATION WAIVER.
new text end
new text begin Subdivision 1. new text end
new text begin Waiver application submission. new text end
new text begin
The commissioner of commerce must
apply to the Secretary of the United States Department of Health and Human Services under
United States Code, title 42, section 18052, for continuation of the state innovation waiver
previously granted to implement the Minnesota premium security plan under Minnesota
Statutes, section 62E.23, for benefit years beginning January 1, 2028, and in subsequent
benefit years, to maximize federal funding. The commissioner must submit the application
by December 31, 2026. The waiver application must clearly state that operation of the
Minnesota premium security plan after the 2027 benefit year is contingent on approval of
the waiver request. The commissioner of commerce shall reapply for the waiver as necessary
to continue the operation of the Minnesota premium security plan under Minnesota Statutes,
section 62E.23.
new text end
new text begin Subd. 2. new text end
new text begin Notification. new text end
new text begin
The commissioner must notify the chairs and ranking minority
members of the legislative committees with jurisdiction over health and human services
and insurance, and the board of directors of the Minnesota Comprehensive Health
Association, regarding (1) the commissioner's intent to submit a waiver application, and
(2) federal action taken with respect to the waiver request.
new text end