SF 4562
Introduction - 94th Legislature (2025 - 2026)
Posted on 03/19/2026 09:07 a.m.
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A bill for an act
relating to insurance; eliminating requirements necessary for a health carrier to
discontinue individual health plans; establishing a state exception for a health
carrier's uniform modification of coverage under an individual market health plan;
amending Minnesota Statutes 2024, section 62A.65, by adding a subdivision;
Minnesota Statutes 2025 Supplement, section 62A.65, subdivisions 2, 2a.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
Section 1.
Minnesota Statutes 2025 Supplement, section 62A.65, subdivision 2, is amended
to read:
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 is prohibited from refusing to renew a Minnesota resident's
individual health plan unless:
(1) the enrollee has failed to pay premiums in accordance with the health plan's terms,
including any timeliness requirements;
(2) the enrollee has performed an act or practice that constitutes fraud or made an
intentional misrepresentation of material fact under the health plan's terms;
(3) the enrollee no longer lives in the area where the deleted text begin issuerdeleted text end new text begin health carriernew text end is authorized
to operate;
(4) a health carrier discontinues an individual health plan under subdivision 2a; or
(5) a health carrier discontinues issuing new individual health plans and refuses to renew
all of the health carrier's existing individual health plans issued in Minnesota as provided
under subdivision 8.
Sec. 2.
Minnesota Statutes 2025 Supplement, section 62A.65, subdivision 2a, is amended
to read:
Subd. 2a.
Discontinuing individual health plan.
deleted text begin (a)deleted text end In order to discontinue a particular
type of individual health plan in Minnesota for purposes of subdivision 2, clause (4), a health
carrier must:
deleted text begin
(1) provide written notice to the commissioner that approves the individual health plan's
policy forms and filings, in a form and manner approved by the commissioner, regarding
the health carrier's intent to discontinue a particular type of individual health plan in
Minnesota. The notice must be provided no later than May 1 of the year before the date the
individual health plan intends to discontinue the particular type of individual health plan;
deleted text end
deleted text begin (2)deleted text end new text begin (1)new text end provide written notice to each deleted text begin individualdeleted text end new text begin policyholdernew text end enrolled in the individual
health plan no later than 90 days before the date the coverage is discontinued;
deleted text begin (3)deleted text end new text begin (2)new text end offer to each individual covered by the individual health plan that the health
carrier intends to discontinue the option to purchase on a guaranteed issue basis any other
individual health plan currently offered by the health carrier for individuals in the individual
market; and
deleted text begin (4)deleted text end new text begin (3)new text end act uniformly without regard to any health status factor of a covered individual
or a dependent of a covered individual who may become eligible for coverage.
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(b) Subject to paragraph (d), the commissioner may disapprove a health carrier
discontinuing a particular type of individual health plan within 60 days after receiving notice
under paragraph (a) if the commissioner determines discontinuing the plan is not in Minnesota
policyholders' best interest. When making the determination under this paragraph, the
commissioner may consider the plan's enrollment size, the availability of comparable
individual health plan options offered by the health carrier in Minnesota, or any other factor
the commissioner deems relevant.
deleted text end
deleted text begin
(c) A health carrier may appeal the commissioner's determination made under paragraph
(b) to disapprove the health carrier's plan to discontinue a particular type of individual health
plan in Minnesota. An appeal under this paragraph is subject to the contested case procedures
under chapter 14 and must be made within 30 days of the date the commissioner makes a
written determination under paragraph (b).
deleted text end
deleted text begin
(d) A health carrier may discontinue an individual health plan without commissioner
approval if the individual health plan is not a catastrophic or platinum-level health plan, as
defined in United States Code, title 42, section 18022, and the plan:
deleted text end
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(1) has fewer than 25 enrollees; or
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(2) is a grandfathered plan, as defined in section 62A.011, subdivision 1b.
deleted text end
Sec. 3.
Minnesota Statutes 2024, section 62A.65, is amended by adding a subdivision to
read:
new text begin Subd. 2b. new text end
new text begin Exception for uniform modification of coverage. new text end
new text begin
(a) A health carrier may
modify the health plan for a product, as defined under Code of Federal Regulations, title
45, section 144.103, offered to an individual in the individual market if the modification is
effective uniformly for all individuals with that product. A health carrier may modify the
health plan for a product under this paragraph only at the time coverage is renewed.
new text end
new text begin
(b) For purposes of paragraph (a), modifications made uniformly and solely pursuant to
applicable federal or state requirements are considered a uniform modification of coverage
if the modification is:
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(1) made within a reasonable time period after the federal or state requirement is imposed
or modified; and
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(2) directly related to the federal or state requirement that is imposed or modified.
new text end
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(c) Other types of modifications made uniformly are considered a uniform modification
of coverage if the health plan for the product in the individual market meets all of the
following criteria:
new text end
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(1) the product is offered by the same health carrier or, if the health carrier is a member
of a controlled group, as described in Code of Federal Regulations, title 45, section 147.106,
paragraph (d)(4), another health carrier that is a member of the controlled group;
new text end
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(2) the product is offered as the same product network type, which includes but is not
limited to a health maintenance organization, preferred provider organization, exclusive
provider organization, point of service, or indemnity;
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(3) the product continues to cover at least a majority of the same service area;
new text end
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(4) within the product, each health plan has the same cost-sharing structure as before
the modification, except for any variation in cost-sharing solely related to changes in cost
and utilization of medical care or to maintain the same metal level, as defined under section
62K.06, subdivision 4; and
new text end
new text begin
(5) the product provides the same covered benefits, except for any changes in benefits
that cumulatively impact the plan-adjusted index rate, as described in Code of Federal
Regulations, title 45, section 156.80, paragraph (d)(2), for any health plan within the product
within an allowable variation of plus or minus two percentage points, not including changes
pursuant to applicable federal or state requirements.
new text end