1st Engrossment - 84th Legislature (2005 - 2006) Posted on 12/15/2009 12:00am
1.1 A bill for an act 1.2 relating to insurance; regulating agency terminations, 1.3 coverages, fees, forms, disclosures, reports, 1.4 information security, and premiums; amending Minnesota 1.5 Statutes 2004, sections 59A.12, subdivision 2; 60A.14, 1.6 subdivision 1; 60A.171, subdivision 11; 60A.23, 1.7 subdivision 8; 60A.966; 60A.969; 62A.136; 62A.31, 1.8 subdivision 1h; 62A.315; 62A.316; 62E.12; 62E.13, 1.9 subdivision 2; 62L.03, subdivision 3; 62Q.471; 65A.29, 1.10 subdivision 11; 65B.48, subdivision 3; 72A.20, 1.11 subdivisions 13, 36; 72A.201, subdivisions 3, 4; 1.12 79.211, by adding a subdivision; 79.40; 79.56, 1.13 subdivisions 1, 3; 79.62, subdivision 3; 79A.03, 1.14 subdivision 9; 79A.04, subdivisions 2, 10; 79A.06, 1.15 subdivision 5; 79A.12, subdivision 2; 79A.22, 1.16 subdivision 11, by adding a subdivision; 176.191, 1.17 subdivision 3; proposing coding for new law in 1.18 Minnesota Statutes, chapters 60A; 65A; 65B; repealing 1.19 Minnesota Statutes 2004, sections 61A.072, subdivision 1.20 2; 62E.03. 1.21 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 1.22 Section 1. Minnesota Statutes 2004, section 59A.12, 1.23 subdivision 2, is amended to read: 1.24 Subd. 2. In the event that a premium is subject to an 1.25 audit to determine the final premium amount, the gross unearned 1.26 premium will be calculated based upon thedepositaudited 1.27 premium and the insurer shall return whatever gross unearned 1.28 premiums are duebased upon the deposit rather than the actual1.29unearned premiumunder the contract to the finance company for 1.30 the account of the insured or insureds within 60 days after 1.31 receipt of the notice of cancellation. 1.32 Sec. 2. Minnesota Statutes 2004, section 60A.14, 1.33 subdivision 1, is amended to read: 2.1 Subdivision 1. [FEES OTHER THAN EXAMINATION FEES.] In 2.2 addition to the fees and charges provided for examinations, the 2.3 following fees must be paid to the commissioner for deposit in 2.4 the general fund: 2.5 (a) by township mutual fire insurance companies; 2.6 (1) for filing certificate of incorporation $25 and 2.7 amendments thereto, $10; 2.8 (2) for filing annual statements, $15; 2.9 (3) for each annual certificate of authority, $15; 2.10 (4) for filing bylaws $25 and amendments thereto, $10; 2.11 (b) by other domestic and foreign companies including 2.12 fraternals and reciprocal exchanges; 2.13 (1) for filing certified copy of certificate of articles of 2.14 incorporation, $100; 2.15 (2) for filing annual statement, $225; 2.16 (3) for filing certified copy of amendment to certificate 2.17 or articles of incorporation, $100; 2.18 (4) for filing bylaws, $75 or amendments thereto, $75; 2.19 (5) for each company's certificate of authority, $575, 2.20 annually; 2.21 (c) the following general fees apply: 2.22 (1) for each certificate, including certified copy of 2.23 certificate of authority, renewal, valuation of life policies, 2.24 corporate condition or qualification, $25; 2.25 (2) for each copy of paper on file in the commissioner's 2.26 office 50 cents per page, and $2.50 for certifying the same; 2.27 (3) for license to procure insurance in unadmitted foreign 2.28 companies, $575; 2.29 (4) for valuing the policies of life insurance companies, 2.30 one cent per $1,000 of insurance so valued, provided that the 2.31 fee shall not exceed $13,000 per year for any company. The 2.32 commissioner may, in lieu of a valuation of the policies of any 2.33 foreign life insurance company admitted, or applying for 2.34 admission, to do business in this state, accept a certificate of 2.35 valuation from the company's own actuary or from the 2.36 commissioner of insurance of the state or territory in which the 3.1 company is domiciled; 3.2 (5) for receiving and filing certificates of policies by 3.3 the company's actuary, or by the commissioner of insurance of 3.4 any other state or territory, $50; 3.5 (6) for each appointment of an agent filed with the 3.6 commissioner, $10; 3.7 (7) for filing forms and rates,$75$90 per filing, 3.8whichor $75 per filing when submitted via electronic filing 3.9 system. Filing fees may be paid on a quarterly basis in 3.10 response to an invoice. Billing and payment may be made 3.11 electronically; 3.12 (8) for annual renewal of surplus lines insurer license, 3.13 $300;3.14(9) $250 filing fee for a large risk alternative rating3.15option plan that meets the $250,000 threshold requirement. 3.16 The commissioner shall adopt rules to define filings that 3.17 are subject to a fee. 3.18 Sec. 3. Minnesota Statutes 2004, section 60A.171, 3.19 subdivision 11, is amended to read: 3.20 Subd. 11. Upon termination of an agency, a company is 3.21 prohibited from soliciting business in the notice of nonrenewal 3.22 required by section 60A.37. If termination of an agency 3.23 contract is the ground for nonrenewal of a policy of homeowner's 3.24 insurance, as defined in section 65A.27, subdivision 4, the 3.25 company must provide notice to the policyholder that the policy 3.26 is not being renewed due to the termination of the company's 3.27 contract with the agency. If the agency is unable to replace 3.28 the homeowner's insurance policy with a suitable policy from 3.29 another insurer, the agent must notify the policyholder of the 3.30 policyholder's right to renew with the company terminating the 3.31 agency contract. The company must renew the policy if the 3.32 insured or the insured's agent makes a written request for the 3.33 renewal before the renewal date. 3.34 Sec. 4. Minnesota Statutes 2004, section 60A.23, 3.35 subdivision 8, is amended to read: 3.36 Subd. 8. [SELF-INSURANCE OR INSURANCE PLAN ADMINISTRATORS 4.1 WHO ARE VENDORS OF RISK MANAGEMENT SERVICES.] (1) [SCOPE.] This 4.2 subdivision applies to any vendor of risk management services 4.3 and to any entity which administers, for compensation, a 4.4 self-insurance or insurance plan. This subdivision does not 4.5 apply (a) to an insurance company authorized to transact 4.6 insurance in this state, as defined by section 60A.06, 4.7 subdivision 1, clauses (4) and (5); (b) to a service plan 4.8 corporation, as defined by section 62C.02, subdivision 6; (c) to 4.9 a health maintenance organization, as defined by section 62D.02, 4.10 subdivision 4; (d) to an employer directly operating a 4.11 self-insurance plan for its employees' benefits; (e) to an 4.12 entity which administers a program of health benefits 4.13 established pursuant to a collective bargaining agreement 4.14 between an employer, or group or association of employers, and a 4.15 union or unions; or (f) to an entity which administers a 4.16 self-insurance or insurance plan if a licensed Minnesota insurer 4.17 is providing insurance to the plan and if the licensed insurer 4.18 has appointed the entity administering the plan as one of its 4.19 licensed agents within this state. 4.20 (2) [DEFINITIONS.] For purposes of this subdivision the 4.21 following terms have the meanings given them. 4.22 (a) "Administering a self-insurance or insurance plan" 4.23 means (i) processing, reviewing or paying claims, (ii) 4.24 establishing or operating funds and accounts, or (iii) otherwise 4.25 providing necessary administrative services in connection with 4.26 the operation of a self-insurance or insurance plan. 4.27 (b) "Employer" means an employer, as defined by section 4.28 62E.02, subdivision 2. 4.29 (c) "Entity" means any association, corporation, 4.30 partnership, sole proprietorship, trust, or other business 4.31 entity engaged in or transacting business in this state. 4.32 (d) "Self-insurance or insurance plan" means a plan 4.33 providing life, medical or hospital care, accident, sickness or 4.34 disability insurance for the benefit of employees or members of 4.35 an association, or a plan providing liability coverage for any 4.36 other risk or hazard, which is or is not directly insured or 5.1 provided by a licensed insurer, service plan corporation, or 5.2 health maintenance organization. 5.3 (e) "Vendor of risk management services" means an entity 5.4 providing for compensation actuarial, financial management, 5.5 accounting, legal or other services for the purpose of designing 5.6 and establishing a self-insurance or insurance plan for an 5.7 employer. 5.8 (3) [LICENSE.] No vendor of risk management services or 5.9 entity administering a self-insurance or insurance plan may 5.10 transact this business in this state unless it is licensed to do 5.11 so by the commissioner. An applicant for a license shall state 5.12 in writing the type of activities it seeks authorization to 5.13 engage in and the type of services it seeks authorization to 5.14 provide. The license may be granted only when the commissioner 5.15 is satisfied that the entity possesses the necessary 5.16 organization, background, expertise, and financial integrity to 5.17 supply the services sought to be offered. The commissioner may 5.18 issue a license subject to restrictions or limitations upon the 5.19 authorization, including the type of services which may be 5.20 supplied or the activities which may be engaged in. The license 5.21 fee is$1,000$1,500 for the initial application and 5.22$1,000$1,500 for eachtwo-yearthree-year renewal. All 5.23 licenses are for a period oftwothree years. 5.24 (4) [REGULATORY RESTRICTIONS; POWERS OF THE COMMISSIONER.] 5.25 To assure that self-insurance or insurance plans are financially 5.26 solvent, are administered in a fair and equitable fashion, and 5.27 are processing claims and paying benefits in a prompt, fair, and 5.28 honest manner, vendors of risk management services and entities 5.29 administering insurance or self-insurance plans are subject to 5.30 the supervision and examination by the commissioner. Vendors of 5.31 risk management services, entities administering insurance or 5.32 self-insurance plans, and insurance or self-insurance plans 5.33 established or operated by them are subject to the trade 5.34 practice requirements of sections 72A.19 to 72A.30. In lieu of 5.35 an unlimited guarantee from a parent corporation for a vendor of 5.36 risk management services or an entity administering insurance or 6.1 self-insurance plans, the commissioner may accept a surety bond 6.2 in a form satisfactory to the commissioner in an amount equal to 6.3 120 percent of the total amount of claims handled by the 6.4 applicant in the prior year. If at any time the total amount of 6.5 claims handled during a year exceeds the amount upon which the 6.6 bond was calculated, the administrator shall immediately notify 6.7 the commissioner. The commissioner may require that the bond be 6.8 increased accordingly. 6.9 No contract entered into after July 1, 2001, between a 6.10 licensed vendor of risk management services and a group 6.11 authorized to self-insure for workers' compensation liabilities 6.12 under section 79A.03, subdivision 6, may take effect until it 6.13 has been filed with the commissioner, and either (1) the 6.14 commissioner has approved it or (2) 60 days have elapsed and the 6.15 commissioner has not disapproved it as misleading or violative 6.16 of public policy. 6.17 (5) [RULEMAKING AUTHORITY.] To carry out the purposes of 6.18 this subdivision, the commissioner may adopt rules pursuant to 6.19 sections 14.001 to 14.69. These rules may: 6.20 (a) establish reporting requirements for administrators of 6.21 insurance or self-insurance plans; 6.22 (b) establish standards and guidelines to assure the 6.23 adequacy of financing, reinsuring, and administration of 6.24 insurance or self-insurance plans; 6.25 (c) establish bonding requirements or other provisions 6.26 assuring the financial integrity of entities administering 6.27 insurance or self-insurance plans; or 6.28 (d) establish other reasonable requirements to further the 6.29 purposes of this subdivision. 6.30 Sec. 5. Minnesota Statutes 2004, section 60A.966, is 6.31 amended to read: 6.32 60A.966 [APPROVAL OF VIATICAL SETTLEMENTS CONTRACT FORMS.] 6.33 A viatical settlement provider or broker may not use a 6.34 viatical settlement contract form in this state unless it has 6.35 been filed with and approved by the commissioner. A viatical 6.36 settlement contract form filed with the commissioner is 7.1 considered to have been approved if it has not been disapproved 7.2 within 60 days of the filing. The commissioner shall disapprove 7.3 a viatical settlement contract form if, in the commissioner's 7.4 opinion, the contract or contract provisions are unreasonable, 7.5 contrary to the interests of the public, or otherwise misleading 7.6 or unfair to the policy owner. 7.7 Sec. 6. Minnesota Statutes 2004, section 60A.969, is 7.8 amended to read: 7.9 60A.969 [DISCLOSURE.] 7.10 A viatical settlement provider or a broker shall disclose 7.11 the following information to the viator no later than the 7.12 datethe viatical settlement contract is signed by all7.13partiesan application is given to the viator: 7.14 (1) possible alternatives to viatical settlement contracts 7.15 for persons with catastrophic or life threatening illnesses, 7.16 including accelerated benefits offered by the issuer of the life 7.17 insurance policy; 7.18 (2) the fact that some or all of the proceeds of the 7.19 viatical settlement may be taxable and that assistance should be 7.20 sought from a personal tax advisor; 7.21 (3) the fact that the viatical settlement may be subject to 7.22 the claims of creditors; 7.23 (4) the fact that receipt of a viatical settlement may 7.24 adversely affect the recipients' eligibility for Medicaid or 7.25 other government benefits or entitlements and that advice should 7.26 be obtained from the appropriate agencies; 7.27 (5) the policy owner's right to rescind a viatical 7.28 settlement contract within 30 days of the date it is executed by 7.29 all parties or 15 days of the receipt of the viatical settlement 7.30 proceeds by the viator, whichever is less, as provided in 7.31 section 60A.970, subdivision 3; and 7.32 (6) the date by which the funds will be available to the 7.33 viator and the source of the funds. 7.34 Sec. 7. [60A.98] [DEFINITIONS.] 7.35 Subdivision 1. [SCOPE.] For purposes of sections 60A.98 7.36 and 60A.981, the terms defined in this section have the meanings 8.1 given them. 8.2 Subd. 2. [CUSTOMER.] "Customer" means a consumer who has a 8.3 continuing relationship with a licensee under which the licensee 8.4 provides one or more insurance products or services to the 8.5 consumer that are to be used primarily for personal, family, or 8.6 household purposes. 8.7 Subd. 3. [CUSTOMER INFORMATION.] "Customer information" 8.8 means nonpublic personal information about a customer, whether 8.9 in paper, electronic, or other form, that is maintained by or on 8.10 behalf of the licensee. 8.11 Subd. 4. [CUSTOMER INFORMATION SYSTEMS.] "Customer 8.12 information systems" means the electronic or physical methods 8.13 used to access, collect, store, use, transmit, protect, or 8.14 dispose of customer information. 8.15 Subd. 5. [LICENSEE.] "Licensee" means all licensed 8.16 insurers, producers, and other persons licensed or required to 8.17 be licensed, authorized or required to be authorized, or 8.18 registered or required to be registered pursuant to the 8.19 insurance laws of this state, except that "licensee" does not 8.20 include a purchasing group or an ineligible insurer in regard to 8.21 the surplus line insurance conducted pursuant to sections 8.22 60A.195 to 60A.209. 8.23 Subd. 6. [NONPUBLIC FINANCIAL INFORMATION.] "Nonpublic 8.24 financial information" means: 8.25 (1) personally identifiable financial information; and 8.26 (2) any list, description, or other grouping of consumers, 8.27 and publicly available information pertaining to them, that is 8.28 derived using any personally identifiable financial information 8.29 that is not publicly available. 8.30 Subd. 7. [NONPUBLIC PERSONAL HEALTH 8.31 INFORMATION.] "Nonpublic personal health information" means 8.32 health information: 8.33 (1) that identifies an individual who is the subject of the 8.34 information; or 8.35 (2) with respect to which there is a reasonable basis to 8.36 believe that the information could be used to identify an 9.1 individual. 9.2 Subd. 8. [NONPUBLIC PERSONAL INFORMATION.] "Nonpublic 9.3 personal information" means nonpublic financial information and 9.4 nonpublic personal health information. 9.5 Subd. 9. [PERSONALLY IDENTIFIABLE FINANCIAL 9.6 INFORMATION.] "Personally identifiable financial information" 9.7 means any information: 9.8 (1) a consumer provides to a licensee to obtain an 9.9 insurance product or service from the licensee; 9.10 (2) about a consumer resulting from a transaction involving 9.11 an insurance product or service between a licensee and a 9.12 consumer; or 9.13 (3) the licensee otherwise obtains about a consumer in 9.14 connection with providing an insurance product or service to 9.15 that consumer. 9.16 Subd. 10. [SERVICE PROVIDER.] "Service provider" means a 9.17 person that maintains, processes, or otherwise is permitted 9.18 access to customer information through its provision of services 9.19 directly to the licensee. 9.20 Sec. 8. [60A.981] [INFORMATION SECURITY PROGRAM.] 9.21 Subdivision 1. [GENERAL REQUIREMENTS.] Each licensee shall 9.22 implement a comprehensive written information security program 9.23 that includes administrative, technical, and physical safeguards 9.24 for the protection of customer information. The administrative, 9.25 technical, and physical safeguards included in the information 9.26 security program must be appropriate to the size and complexity 9.27 of the licensee and the nature and scope of its activities. 9.28 Subd. 2. [OBJECTIVES.] A licensee's information security 9.29 program must be designed to: 9.30 (1) ensure the security and confidentiality of customer 9.31 information; 9.32 (2) protect against any anticipated threats or hazards to 9.33 the security or integrity of the information; and 9.34 (3) protect against unauthorized access to or use of the 9.35 information that could result in substantial harm or 9.36 inconvenience to any customer. 10.1 Subd. 3. [EXAMPLES OF METHODS OF DEVELOPMENT AND 10.2 IMPLEMENTATION.] The following actions and procedures are 10.3 examples of methods of implementation of the requirements of 10.4 subdivisions 1 and 2. These examples are nonexclusive 10.5 illustrations of actions and procedures that licensees may 10.6 follow to implement subdivisions 1 and 2: 10.7 (1) the licensee: 10.8 (i) identifies reasonably foreseeable internal or external 10.9 threats that could result in unauthorized disclosure, misuse, 10.10 alteration, or destruction of customer information or customer 10.11 information systems; 10.12 (ii) assesses the likelihood and potential damage of these 10.13 threats, taking into consideration the sensitivity of customer 10.14 information; and 10.15 (iii) assesses the sufficiency of policies, procedures, 10.16 customer information systems, and other safeguards in place to 10.17 control risks; 10.18 (2) the licensee: 10.19 (i) designs its information security program to control the 10.20 identified risks, commensurate with the sensitivity of the 10.21 information, as well as the complexity and scope of the 10.22 licensee's activities; 10.23 (ii) trains staff, as appropriate, to implement the 10.24 licensee's information security program; and 10.25 (iii) regularly tests or otherwise regularly monitors the 10.26 key controls, systems, and procedures of the information 10.27 security program. The frequency and nature of these tests or 10.28 other monitoring practices are determined by the licensee's risk 10.29 assessment; 10.30 (3) the licensee: 10.31 (i) exercises appropriate due diligence in selecting its 10.32 service providers; and 10.33 (ii) requires its service providers to implement 10.34 appropriate measures designed to meet the objectives of this 10.35 regulation, and, where indicated by the licensee's risk 10.36 assessment, takes appropriate steps to confirm that its service 11.1 providers have satisfied these obligations; and 11.2 (4) the licensee monitors, evaluates, and adjusts, as 11.3 appropriate, the information security program in light of any 11.4 relevant changes in technology, the sensitivity of its customer 11.5 information, internal or external threats to information, and 11.6 the licensee's own changing business arrangements, such as 11.7 mergers and acquisitions, alliances and joint ventures, 11.8 outsourcing arrangements, and changes to customer information 11.9 systems. 11.10 Sec. 9. [60A.982] [UNFAIR TRADE PRACTICES.] 11.11 A violation of sections 60A.98 and 60A.981 is considered to 11.12 be a violation of sections 72A.17 to 72A.32. 11.13 Sec. 10. Minnesota Statutes 2004, section 62A.136, is 11.14 amended to read: 11.15 62A.136 [DENTAL AND VISION PLAN COVERAGE.] 11.16 The following provisions do not apply to health plans as 11.17 defined in section 62A.011, subdivision 3, clause (6), providing 11.18 dental or vision coverage only: sections 62A.041; 62A.0411; 11.19 62A.047; 62A.149; 62A.151; 62A.152; 62A.154; 62A.155; 62A.17, 11.20 subdivision 6; 62A.21, subdivision 2b; 62A.26; 62A.28; 62A.285; 11.21 62A.30; 62A.304; 62A.3093; and 62E.16. 11.22 Sec. 11. Minnesota Statutes 2004, section 62A.31, 11.23 subdivision 1h, is amended to read: 11.24 Subd. 1h. [LIMITATIONS ON DENIALS, CONDITIONS, AND PRICING 11.25 OF COVERAGE.] No health carrier issuing Medicare-related 11.26 coverage in this state may impose preexisting condition 11.27 limitations or otherwise deny or condition the issuance or 11.28 effectiveness of any such coverage available for sale in this 11.29 state, nor may it discriminate in the pricing of such coverage, 11.30 because of the health status, claims experience, receipt of 11.31 health care, medical condition, or age of an applicant where an 11.32 application for such coverage is submitted prior to or during 11.33 the six-month period beginning with the first day of the month 11.34 in which an individual first enrolled for benefits under 11.35 Medicare Part B. This subdivision applies to each 11.36 Medicare-related coverage offered by a health carrier regardless 12.1 of whether the individual has attained the age of 65 years. If 12.2 an individual who is enrolled in Medicare Part B due to 12.3 disability status is involuntarily disenrolled due to loss of 12.4 disability status, the individual is eligible for another 12.5 six-month enrollment period provided under this subdivision 12.6 beginning the first day of the month in which the individual 12.7 later becomes eligible for and enrolls again in Medicare Part 12.8 B. An individual who is or was previously enrolled in Medicare 12.9 Part B due to disability status is eligible for another 12.10 six-month enrollment period under this subdivision beginning the 12.11 first day of the month in which the individual has attained the 12.12 age of 65 years and either maintains enrollment in, or enrolls 12.13 again in, Medicare Part B. If an individual enrolled in 12.14 Medicare Part B voluntarily disenrolls from Medicare Part B 12.15 because the individual becomesreemployed and isenrolled under 12.16 an employee welfare benefit plan, the individual is eligible for 12.17 another six-month enrollment period, as provided in this 12.18 subdivision, beginning the first day of the month in which the 12.19 individual later becomes eligible for and enrolls again in 12.20 Medicare Part B. 12.21 Sec. 12. Minnesota Statutes 2004, section 62A.315, is 12.22 amended to read: 12.23 62A.315 [EXTENDED BASIC MEDICARE SUPPLEMENT PLAN; 12.24 COVERAGE.] 12.25 The extended basic Medicare supplement plan must have a 12.26 level of coverage so that it will be certified as a qualified 12.27 plan pursuant to section 62E.07, and will provide: 12.28 (1) coverage for all of the Medicare Part A inpatient 12.29 hospital deductible and coinsurance amounts, and 100 percent of 12.30 all Medicare Part A eligible expenses for hospitalization not 12.31 covered by Medicare; 12.32 (2) coverage for the daily co-payment amount of Medicare 12.33 Part A eligible expenses for the calendar year incurred for 12.34 skilled nursing facility care; 12.35 (3) coverage for the coinsurance amount or in the case of 12.36 hospital outpatient department services paid under a prospective 13.1 payment system, the co-payment amount, of Medicare eligible 13.2 expenses under Medicare Part B regardless of hospital 13.3 confinement, and the Medicare Part B deductible amount; 13.4 (4) 80 percent of the usual and customary hospital and 13.5 medical expenses and supplies described in section 62E.06, 13.6 subdivision 1, not to exceed any charge limitation established 13.7 by the Medicare program or state law, the usual and customary 13.8 hospital and medical expenses and supplies, described in section 13.9 62E.06, subdivision 1, while in a foreign country, and 13.10 prescription drug expenses, not covered by Medicare; 13.11 (5) coverage for the reasonable cost of the first three 13.12 pints of blood, or equivalent quantities of packed red blood 13.13 cells as defined under federal regulations under Medicare parts 13.14 A and B, unless replaced in accordance with federal regulations; 13.15 (6) 100 percent of the cost of immunizations not otherwise 13.16 covered under Part D of the Medicare program and routine 13.17 screening procedures for cancer, including mammograms and pap 13.18 smears; 13.19 (7) preventive medical care benefit: coverage for the 13.20 following preventive health services not covered by Medicare: 13.21 (i) an annual clinical preventive medical history and 13.22 physical examination that may include tests and services from 13.23 clause (ii) and patient education to address preventive health 13.24 care measures; 13.25 (ii)any one or a combination of the followingpreventive 13.26 screening tests or preventive services, the selection and 13.27 frequency of which isconsidereddetermined to be medically 13.28 appropriate:by the attending physician. 13.29(A) fecal occult blood test and/or digital rectal13.30examination;13.31(B) dipstick urinalysis for hematuria, bacteriuria, and13.32proteinuria;13.33(C) pure tone (air only) hearing screening test13.34administered or ordered by a physician;13.35(D) serum cholesterol screening every five years;13.36(E) thyroid function test;14.1(F) diabetes screening;14.2(iii) any other tests or preventive measures determined14.3appropriate by the attending physician.14.4 Reimbursement shall be for the actual charges up to 100 14.5 percent of the Medicare-approved amount for each service as if 14.6 Medicare were to cover the service as identified in American 14.7 Medical Association current procedural terminology (AMA CPT) 14.8 codes to a maximum of $120 annually under this benefit. This 14.9 benefit shall not include payment for any procedure covered by 14.10 Medicare; 14.11 (8) at-home recovery benefit: coverage for services to 14.12 provide short-term at-home assistance with activities of daily 14.13 living for those recovering from an illness, injury, or surgery: 14.14 (i) for purposes of this benefit, the following definitions 14.15 shall apply: 14.16 (A) "activities of daily living" include, but are not 14.17 limited to, bathing, dressing, personal hygiene, transferring, 14.18 eating, ambulating, assistance with drugs that are normally 14.19 self-administered, and changing bandages or other dressings; 14.20 (B) "care provider" means a duly qualified or licensed home 14.21 health aide/homemaker, personal care aide, or nurse provided 14.22 through a licensed home health care agency or referred by a 14.23 licensed referral agency or licensed nurses registry; 14.24 (C) "home" means a place used by the insured as a place of 14.25 residence, provided that the place would qualify as a residence 14.26 for home health care services covered by Medicare. A hospital 14.27 or skilled nursing facility shall not be considered the 14.28 insured's place of residence; 14.29 (D) "at-home recovery visit" means the period of a visit 14.30 required to provide at-home recovery care, without limit on the 14.31 duration of the visit, except each consecutive four hours in a 14.32 24-hour period of services provided by a care provider is one 14.33 visit; 14.34 (ii) coverage requirements and limitations: 14.35 (A) at-home recovery services provided must be primarily 14.36 services that assist in activities of daily living; 15.1 (B) the insured's attending physician must certify that the 15.2 specific type and frequency of at-home recovery services are 15.3 necessary because of a condition for which a home care plan of 15.4 treatment was approved by Medicare; 15.5 (C) coverage is limited to: 15.6 (I) no more than the number and type of at-home recovery 15.7 visits certified as medically necessary by the insured's 15.8 attending physician. The total number of at-home recovery 15.9 visits shall not exceed the number of Medicare-approved home 15.10 health care visits under a Medicare-approved home care plan of 15.11 treatment; 15.12 (II) the actual charges for each visit up to a maximum 15.13 reimbursement of $100 per visit; 15.14 (III) $4,000 per calendar year; 15.15 (IV) seven visits in any one week; 15.16 (V) care furnished on a visiting basis in the insured's 15.17 home; 15.18 (VI) services provided by a care provider as defined in 15.19 this section; 15.20 (VII) at-home recovery visits while the insured is covered 15.21 under the policy or certificate and not otherwise excluded; 15.22 (VIII) at-home recovery visits received during the period 15.23 the insured is receiving Medicare-approved home care services or 15.24 no more than eight weeks after the service date of the last 15.25 Medicare-approved home health care visit; 15.26 (iii) coverage is excluded for: 15.27 (A) home care visits paid for by Medicare or other 15.28 government programs; and 15.29 (B) care provided by unpaid volunteers or providers who are 15.30 not care providers. 15.31 Sec. 13. Minnesota Statutes 2004, section 62A.316, is 15.32 amended to read: 15.33 62A.316 [BASIC MEDICARE SUPPLEMENT PLAN; COVERAGE.] 15.34 (a) The basic Medicare supplement plan must have a level of 15.35 coverage that will provide: 15.36 (1) coverage for all of the Medicare part A inpatient 16.1 hospital coinsurance amounts, and 100 percent of all Medicare 16.2 part A eligible expenses for hospitalization not covered by 16.3 Medicare, after satisfying the Medicare part A deductible; 16.4 (2) coverage for the daily co-payment amount of Medicare 16.5 part A eligible expenses for the calendar year incurred for 16.6 skilled nursing facility care; 16.7 (3) coverage for the coinsurance amount, or in the case of 16.8 outpatient department services paid under a prospective payment 16.9 system, the co-payment amount, of Medicare eligible expenses 16.10 under Medicare part B regardless of hospital confinement, 16.11 subject to the Medicare part B deductible amount; 16.12 (4) 80 percent of the hospital and medical expenses and 16.13 supplies incurred during travel outside the United States as a 16.14 result of a medical emergency; 16.15 (5) coverage for the reasonable cost of the first three 16.16 pints of blood, or equivalent quantities of packed red blood 16.17 cells as defined under federal regulations under Medicare parts 16.18 A and B, unless replaced in accordance with federal regulations; 16.19 (6) 100 percent of the cost of immunizations not otherwise 16.20 covered under part D of the Medicare program and routine 16.21 screening procedures for cancer screening including mammograms 16.22 and pap smears; and 16.23 (7) 80 percent of coverage for all physician prescribed 16.24 medically appropriate and necessary equipment and supplies used 16.25 in the management and treatment of diabetes not otherwise 16.26 covered under Part D of the Medicare program. Coverage must 16.27 include persons with gestational, type I, or type II diabetes. 16.28 (b) Only the following optional benefit riders may be added 16.29 to this plan: 16.30 (1) coverage for all of the Medicare part A inpatient 16.31 hospital deductible amount; 16.32 (2) a minimum of 80 percent of eligible medical expenses 16.33 and supplies not covered by Medicare part B, not to exceed any 16.34 charge limitation established by the Medicare program or state 16.35 law; 16.36 (3) coverage for all of the Medicare part B annual 17.1 deductible; 17.2 (4) coverage for at least 50 percent, or the equivalent of 17.3 50 percent, of usual and customary prescription drug expenses; 17.4 (5)coverage for the followingpreventivehealth services17.5 medical care benefit coverage for the following preventative 17.6 health services not covered by Medicare: 17.7 (i) an annual clinical preventive medical history and 17.8 physical examination that may include tests and services from 17.9 clause (ii) and patient education to address preventive health 17.10 care measures; 17.11 (ii)any one or a combination of the followingpreventive 17.12 screening tests or preventive services, the selection and 17.13 frequency of which isconsidereddetermined to be medically 17.14 appropriate:by the attending physician. 17.15(A) fecal occult blood test and/or digital rectal17.16examination;17.17(B) dipstick urinalysis for hematuria, bacteriuria, and17.18proteinuria;17.19(C) pure tone (air only) hearing screening test,17.20administered or ordered by a physician;17.21(D) serum cholesterol screening every five years;17.22(E) thyroid function test;17.23(F) diabetes screening;17.24(iii) any other tests or preventive measures determined17.25appropriate by the attending physician.17.26 Reimbursement shall be for the actual charges up to 100 17.27 percent of the Medicare-approved amount for each service, as if 17.28 Medicare were to cover the service as identified in American 17.29 Medical Association current procedural terminology (AMA CPT) 17.30 codes, to a maximum of $120 annually under this benefit. This 17.31 benefit shall not include payment for a procedure covered by 17.32 Medicare; 17.33 (6) coverage for services to provide short-term at-home 17.34 assistance with activities of daily living for those recovering 17.35 from an illness, injury, or surgery: 17.36 (i) For purposes of this benefit, the following definitions 18.1 apply: 18.2 (A) "activities of daily living" include, but are not 18.3 limited to, bathing, dressing, personal hygiene, transferring, 18.4 eating, ambulating, assistance with drugs that are normally 18.5 self-administered, and changing bandages or other dressings; 18.6 (B) "care provider" means a duly qualified or licensed home 18.7 health aide/homemaker, personal care aid, or nurse provided 18.8 through a licensed home health care agency or referred by a 18.9 licensed referral agency or licensed nurses registry; 18.10 (C) "home" means a place used by the insured as a place of 18.11 residence, provided that the place would qualify as a residence 18.12 for home health care services covered by Medicare. A hospital 18.13 or skilled nursing facility shall not be considered the 18.14 insured's place of residence; 18.15 (D) "at-home recovery visit" means the period of a visit 18.16 required to provide at-home recovery care, without limit on the 18.17 duration of the visit, except each consecutive four hours in a 18.18 24-hour period of services provided by a care provider is one 18.19 visit; 18.20 (ii) Coverage requirements and limitations: 18.21 (A) at-home recovery services provided must be primarily 18.22 services that assist in activities of daily living; 18.23 (B) the insured's attending physician must certify that the 18.24 specific type and frequency of at-home recovery services are 18.25 necessary because of a condition for which a home care plan of 18.26 treatment was approved by Medicare; 18.27 (C) coverage is limited to: 18.28 (I) no more than the number and type of at-home recovery 18.29 visits certified as necessary by the insured's attending 18.30 physician. The total number of at-home recovery visits shall 18.31 not exceed the number of Medicare-approved home care visits 18.32 under a Medicare-approved home care plan of treatment; 18.33 (II) the actual charges for each visit up to a maximum 18.34 reimbursement of $40 per visit; 18.35 (III) $1,600 per calendar year; 18.36 (IV) seven visits in any one week; 19.1 (V) care furnished on a visiting basis in the insured's 19.2 home; 19.3 (VI) services provided by a care provider as defined in 19.4 this section; 19.5 (VII) at-home recovery visits while the insured is covered 19.6 under the policy or certificate and not otherwise excluded; 19.7 (VIII) at-home recovery visits received during the period 19.8 the insured is receiving Medicare-approved home care services or 19.9 no more than eight weeks after the service date of the last 19.10 Medicare-approved home health care visit; 19.11 (iii) Coverage is excluded for: 19.12 (A) home care visits paid for by Medicare or other 19.13 government programs; and 19.14 (B) care provided by family members, unpaid volunteers, or 19.15 providers who are not care providers; 19.16 (7) coverage for at least 50 percent, or the equivalent of 19.17 50 percent, of usual and customary prescription drug expenses to 19.18 a maximum of $1,200 paid by the issuer annually under this 19.19 benefit. An issuer of Medicare supplement insurance policies 19.20 that elects to offer this benefit rider shall also make 19.21 available coverage that contains the rider specified in clause 19.22 (4). 19.23 Sec. 14. Minnesota Statutes 2004, section 62E.12, is 19.24 amended to read: 19.25 62E.12 [MINIMUM BENEFITS OF COMPREHENSIVE HEALTH INSURANCE 19.26 PLAN.] 19.27 (a) The association through its comprehensive health 19.28 insurance plan shall offer policies which provide the benefits 19.29 of a number one qualified plan and a number two qualified plan, 19.30 except that the maximum lifetime benefit on these plans shall be 19.31 $2,800,000; and an extended basic Medicare supplement plan and a 19.32 basic Medicare supplement plan as described in sections 62A.31 19.33 to 62A.44. The association may also offer a plan that is 19.34 identical to a number one and number two qualified plan except 19.35 that it has a $2,000 annual deductible and a $2,800,000 maximum 19.36 lifetime benefit. The association, subject to the approval of 20.1 the commissioner, may also offer plans that are identical to the 20.2 number one or number two qualified plan, except that they have 20.3 annual deductibles of $5,000 and $10,000, respectively; have 20.4 limitations on total annual out-of-pocket expenses equal to 20.5 those annual deductibles and therefore cover 100 percent of the 20.6 allowable cost of covered services in excess of those annual 20.7 deductibles; and have a $2,800,000 maximum lifetime 20.8 benefit. The association, subject to approval of the 20.9 commissioner, may also offer plans that meet all other 20.10 requirements of state law except those that are inconsistent 20.11 with high deductible health plans as defined in sections 220 and 20.12 223 of the Internal Revenue Code and supporting regulations. As 20.13 of January 1, 2006, the association shall no longer be required 20.14 to offer an extended basic Medicare supplement plan. 20.15 (b) The requirement that a policy issued by the association 20.16 must be a qualified plan is satisfied if the association 20.17 contracts with a preferred provider network and the level of 20.18 benefits for services provided within the network satisfies the 20.19 requirements of a qualified plan. If the association uses a 20.20 preferred provider network, payments to nonparticipating 20.21 providers must meet the minimum requirements of section 72A.20, 20.22 subdivision 15. 20.23 (c) The association shall offer health maintenance 20.24 organization contracts in those areas of the state where a 20.25 health maintenance organization has agreed to make the coverage 20.26 available and has been selected as a writing carrier. 20.27 (d) Notwithstanding the provisions of section 62E.06 and 20.28 unless those charges are billed by a provider that is part of 20.29 the association's preferred provider network, the state plan 20.30 shall exclude coverage of services of a private duty nurse other 20.31 than on an inpatient basis and any charges for treatment in a 20.32 hospital located outside of the state of Minnesota in which the 20.33 covered person is receiving treatment for a mental or nervous 20.34 disorder, unless similar treatment for the mental or nervous 20.35 disorder is medically necessary, unavailable in Minnesota and 20.36 provided upon referral by a licensed Minnesota medical 21.1 practitioner. 21.2 Sec. 15. Minnesota Statutes 2004, section 62E.13, 21.3 subdivision 2, is amended to read: 21.4 Subd. 2. [SELECTION OF WRITING CARRIER.] The association 21.5 may select policies and contracts, or parts thereof, submitted 21.6 by a member or members of the association, or by the association 21.7 or others, to develop specifications for bids from any entity 21.8 which wishes to be selected as a writing carrier to administer 21.9 the state plan. The selection of the writing carrier shall be 21.10 based upon criteria established by the board of directors of the 21.11 association and approved by the commissioner. The criteria 21.12 shall outline specific qualifications that an entity must 21.13 satisfy in order to be selected and, at a minimum, shall include 21.14 the entity's proven ability to handle large group accident and 21.15 health insurance cases, efficient claim paying capacity, and the 21.16 estimate of total charges for administering the plan. The 21.17 association may select separate writing carriers for the two 21.18 types of qualified plans and the $2,000, $5,000, and $10,000 21.19 deductible plans, thequalifiedMedicare supplementplanplans, 21.20 and the health maintenance organization contract. 21.21 Sec. 16. Minnesota Statutes 2004, section 62L.03, 21.22 subdivision 3, is amended to read: 21.23 Subd. 3. [MINIMUM PARTICIPATION AND CONTRIBUTION.] (a) A 21.24 small employer that has at least 75 percent of its eligible 21.25 employees who have not waived coverage participating in a health 21.26 benefit plan and that contributes at least 50 percent toward the 21.27 cost of coverage of each eligible employee must be guaranteed 21.28 coverage on a guaranteed issue basis from any health carrier 21.29 participating in the small employer market. The participation 21.30 level of eligible employees must be determined at the initial 21.31 offering of coverage and at the renewal date of coverage. A 21.32 health carrier must not increase the participation requirements 21.33 applicable to a small employer at any time after the small 21.34 employer has been accepted for coverage. For the purposes of 21.35 this subdivision, waiver of coverage includes only waivers due 21.36 to: (1) coverage under another group health plan; (2) coverage 22.1 under Medicare Parts A and B; (3) coverage under MCHA permitted 22.2 under section 62E.141; or (4) coverage under medical assistance 22.3 under chapter 256B or general assistance medical care under 22.4 chapter 256D or MinnesotaCare under chapter 256L. 22.5 (b) If a small employer does not satisfy the contribution 22.6 or participation requirements under this subdivision, a health 22.7 carrier may voluntarily issue or renew individual health plans, 22.8 or a health benefit plan which must fully comply with this 22.9 chapter. A health carrier that provides a health benefit plan 22.10 to a small employer that does not meet the contribution or 22.11 participation requirements of this subdivision must maintain 22.12 this information in its files for audit by the commissioner. A 22.13 health carrier may not offer an individual health plan, 22.14 purchased through an arrangement between the employer and the 22.15 health carrier, to any employee unless the health carrier also 22.16 offers the individual health plan, on a guaranteed issue basis, 22.17 to all other employees of the same employer. 22.18 (c) Nothing in this section obligates a health carrier to 22.19 issue coverage to a small employer that currently offers 22.20 coverage through a health benefit plan from another health 22.21 carrier, unless the new coverage will replace the existing 22.22 coverage and not serve as one of two or more health benefit 22.23 plans offered by the employer. This paragraph does not apply if 22.24 the small employer will meet the required participation level 22.25 with respect to the new coverage. 22.26 Sec. 17. Minnesota Statutes 2004, section 62Q.471, is 22.27 amended to read: 22.28 62Q.471 [EXCLUSION FOR SUICIDE ATTEMPTS PROHIBITED.] 22.29 (a) No health plan may exclude or reduce coverage for 22.30 health care for an enrollee who is otherwise covered under the 22.31 health plan on the basis that the need for the health care arose 22.32 out of a suicide or suicide attempt by the enrollee. 22.33 (b) For purposes of this section, "health plan" has the 22.34 meaning given in section 62Q.01, subdivision 3, but includes the 22.35 coverages described in section 62A.011, clauses (4), (6), 22.36 and (7)andthrough (10). 23.1 Sec. 18. Minnesota Statutes 2004, section 65A.29, 23.2 subdivision 11, is amended to read: 23.3 Subd. 11. [NONRENEWAL.] Every insurer shall establish a 23.4 plan that sets out the minimum number and amount of claims 23.5 during an experience period that may result in a 23.6 nonrenewal. For purposes of the plan, the insurer may not 23.7 consider as a claim the insured's inquiry about a hypothetical 23.8 claim, or the insured's inquiry to the insured's agent regarding 23.9 a potential claim. 23.10 No homeowner's insurance policy may be nonrenewed based on 23.11 the insured's loss experience unless the insurer has sent a 23.12 written notice that any future losses may result in nonrenewal 23.13 due to loss experience. 23.14 Any nonrenewal of a homeowner's insurance policy must, at a 23.15 minimum, comply with the requirements of subdivision 8 and the 23.16 rules adopted by the commissioner. 23.17 Sec. 19. [65A.297] [ACTIVE DUTY MEMBER OF ARMED SERVICES 23.18 RESERVE OR NATIONAL GUARD; USE IN UNDERWRITING PROHIBITED.] 23.19 No insurer, including the Minnesota FAIR plan, shall refuse 23.20 to renew, decline to offer or write, reduce the limits of, 23.21 cancel, or charge differential rates for equivalent coverage for 23.22 any coverage in a homeowner's policy because the dwelling is 23.23 vacant if the vacancy is caused solely by the insured being 23.24 called to active duty as a member of the armed services reserve 23.25 or the National Guard. 23.26 Sec. 20. [65B.286] [SNOWMOBILE AUXILIARY LIGHTING SYSTEM 23.27 DISCOUNT.] 23.28 Subdivision 1. [DEFINITION.] For the purposes of this 23.29 section, the term "auxiliary hazard warning lighting system" 23.30 means a system installed by the manufacturer of a snowmobile as 23.31 original equipment or installed in a snowmobile by the 23.32 manufacturer or an authorized dealer of that manufacturer as an 23.33 aftermarket system that does the following when activated: 23.34 (1) a yellow light emitting diode (L.E.D.) light on the 23.35 front of the snowmobile that flashes at least once per second 23.36 and is visable at least one-half mile in front of the 24.1 snowmobile; and 24.2 (2) a red light emitting diode (L.E.D.) light on the rear 24.3 of the snowmobile that flashes at least once per second and is 24.4 visable at least one-half mile from behind the snowmobile. 24.5 Subd. 2. [REQUIRED REDUCTION.] An insurer must provide an 24.6 appropriate premium reduction of at least five percent on a 24.7 policy insuring the snowmobile, or on that portion of a policy 24.8 insuring a snowmobile that is issued, delivered, or renewed in 24.9 this state, to the insured whose snowmobile is equipped with an 24.10 authorized auxiliary hazard warning lighting system. The 24.11 premium reduction required by this subdivision applies to every 24.12 snowmobile of the insured that is equipped with an auxiliary 24.13 hazard warning lighting system. 24.14 Sec. 21. Minnesota Statutes 2004, section 65B.48, 24.15 subdivision 3, is amended to read: 24.16 Subd. 3. Self-insurance, subject to approval of the 24.17 commissioner, is effected by filing with the commissioner in 24.18 satisfactory form: 24.19 (1) a continuing undertaking by the owner or other 24.20 appropriate person to pay tort liabilities or basic economic 24.21 loss benefits, or both, and to perform all other obligations 24.22 imposed by sections 65B.41 to 65B.71; 24.23 (2) evidence that appropriate provision exists for prompt 24.24 administration of all claims, benefits, and obligations provided 24.25 by sections 65B.41 to 65B.71; 24.26 (3) evidence that reliable financial arrangements, 24.27 deposits, or commitments exist providing assurance, 24.28 substantially equivalent to that afforded by a policy of 24.29 insurance complying with sections 65B.41 to 65B.71, for payment 24.30 of tort liabilities, basic economic loss benefits, and all other 24.31 obligations imposed by sections 65B.41 to 65B.71; and 24.32 (4) a nonrefundable initial application fee 24.33 of$1,500$2,500 andan annuala renewal fee of$400$1,200 24.34 for political subdivisions and$500$1,500 for nonpolitical 24.35 entities every three years. 24.36 Sec. 22. Minnesota Statutes 2004, section 72A.20, 25.1 subdivision 13, is amended to read: 25.2 Subd. 13. [REFUSAL TO RENEW.] Refusing to renew, declining 25.3 to offer or write, or charging differential rates for an 25.4 equivalent amount of homeowner's insurance coverage, as defined 25.5 by section 65A.27, for property located in a town or statutory 25.6 or home rule charter city, in which the insurer offers to sell 25.7 or writes homeowner's insurance, solely because: 25.8 (a) of the geographic area in which the property is 25.9 located; 25.10 (b) of the age of the primary structure sought to be 25.11 insured; 25.12 (c) the insured or prospective insured was denied coverage 25.13 of the property by another insurer, whether by cancellation, 25.14 nonrenewal or declination to offer coverage, for a reason other 25.15 than those specified in section 65A.01, subdivision 3a, clauses 25.16 (a) to (e);or25.17 (d) the property of the insured or prospective insured has 25.18 been insured under the Minnesota FAIR Plan Act, shall constitute 25.19 an unfair method of competition and an unfair and deceptive act 25.20 or practice; or 25.21 (e) the insured has inquired about coverage for a 25.22 hypothetical claim or has made an inquiry to the insured's agent 25.23 regarding a potential claim. 25.24 This subdivision prohibits an insurer from filing or 25.25 charging different rates for different zip code areas within the 25.26 same town or statutory or home rule charter city. 25.27 This subdivision shall not prohibit the insurer from 25.28 applying underwriting or rating standards which the insurer 25.29 applies generally in all other locations in the state and which 25.30 are not specifically prohibited by clauses (a) to(d)(e). Such 25.31 underwriting or rating standards shall specifically include but 25.32 not be limited to standards based upon the proximity of the 25.33 insured property to an extraordinary hazard or based upon the 25.34 quality or availability of fire protection services or based 25.35 upon the density or concentration of the insurer's risks. 25.36 Clause (b) shall not prohibit the use of rating standards based 26.1 upon the age of the insured structure's plumbing, electrical, 26.2 heating or cooling system or other part of the structure, the 26.3 age of which affects the risk of loss. Any insurer's failure to 26.4 comply with section 65A.29, subdivisions 2 to 4, either (1) by 26.5 failing to give an insured or applicant the required notice or 26.6 statement or (2) by failing to state specifically a bona fide 26.7 underwriting or other reason for the refusal to write shall 26.8 create a presumption that the insurer has violated this 26.9 subdivision. 26.10 Sec. 23. Minnesota Statutes 2004, section 72A.20, 26.11 subdivision 36, is amended to read: 26.12 Subd. 36. [LIMITATIONS ON THE USE OF CREDIT INFORMATION.] 26.13 (a) No insurer or group of affiliated insurers may reject, 26.14 cancel, or nonrenew a policy of private passenger motor vehicle 26.15 insurance as defined under section 65B.01 or a policy of 26.16 homeowner's insurance as defined under section 65A.27, for any 26.17 person in whole or in part on the basis of credit information, 26.18 including a credit reporting product known as a "credit score" 26.19 or "insurance score," without consideration and inclusion of any 26.20 other applicable underwriting factor. 26.21 (b) If credit information, credit scoring, or insurance 26.22 scoring is to be used in underwriting, the insurer must disclose 26.23 to the consumer that credit information will be obtained and 26.24 used as part of the insurance underwriting process. 26.25 (c) Insurance inquiries and non-consumer-initiated 26.26 inquiries must not be used as part of the credit scoring or 26.27 insurance scoring process. 26.28 (d) If a credit score, insurance score, or other credit 26.29 information relating to a consumer, with respect to the types of 26.30 insurance referred to in paragraph (a), is adversely impacted or 26.31 cannot be generated because of the absence of a credit history, 26.32 the insurer must exclude the use of credit as a factor in the 26.33 decision to reject, cancel, or nonrenew. 26.34 (e) Insurers must upon the request of a policyholder 26.35 reevaluate the policyholder's score. Any change in premium 26.36 resulting from the reevaluation must be effective upon the 27.1 renewal of the policy. An insurer is not required to reevaluate 27.2 a policyholder's score pursuant to this paragraph more than 27.3 twice in any given calendar year. 27.4 (f) Insurers must upon request of the applicant or 27.5 policyholder provide reasonable underwriting exceptions based 27.6 upon prior credit histories for persons whose credit information 27.7 is unduly influenced by expenses related to a catastrophic 27.8 injury or illness, temporary loss of employment, or the death of 27.9 an immediate family member. The insurer may require reasonable 27.10 documentation of these events prior to granting an exception. 27.11(f)(g) A credit scoring or insurance scoring methodology 27.12 must not be used by an insurer if the credit scoring or 27.13 insurance scoring methodology incorporates the gender, race, 27.14 nationality, or religion of an insured or applicant. 27.15(g)(h) Insurers that employ a credit scoring or insurance 27.16 scoring system in underwriting of coverage described in 27.17 paragraph (a) must have on file with the commissioner: 27.18 (1) the insurer's credit scoring or insurance scoring 27.19 methodology; and 27.20 (2) information that supports the insurer's use of a credit 27.21 score or insurance score as an underwriting criterion. 27.22(h)(i) Insurers described in paragraph (g) shall file the 27.23 required information with the commissioner within 120 days of 27.24 August 1, 2002, or prior to implementation of a credit scoring 27.25 or insurance scoring system by the insurer, if that date is 27.26 later. 27.27(i)(j) Information provided by, or on behalf of, an 27.28 insurer to the commissioner under this subdivision is trade 27.29 secret information under section 13.37. 27.30 Sec. 24. Minnesota Statutes 2004, section 72A.201, 27.31 subdivision 3, is amended to read: 27.32 Subd. 3. [DEFINITIONS.] For the purposes of this section, 27.33 the following terms have the meanings given them. 27.34 (1) [ACCIDENT AND SICKNESS INSURANCE.] "Accident and 27.35 sickness insurance" means any policy covering the kind of 27.36 insurance described in section 60A.06, subdivision 1, clause 28.1 (5)(a). 28.2 (2) [ADJUSTER OR ADJUSTERS.] "Adjuster" or "adjusters" is 28.3 as defined in section 72B.02. 28.4(2)(3) [AGENT.] "Agent" means insurance agents or 28.5 insurance agencies licensed pursuant to sections 60K.30 to 28.6 60K.56, and representatives of these agents or agencies. 28.7(3)(4) [CLAIM.] "Claim" means a request or demand made 28.8 with an insurer for the payment of funds or the provision of 28.9 services under the terms of any policy, certificate, contract of 28.10 insurance, binder, or other contracts of temporary insurance. 28.11 The term does not include a claim under a health insurance 28.12 policy made by a participating provider with an insurer in 28.13 accordance with the participating provider's service agreement 28.14 with the insurer which has been filed with the commissioner of 28.15 commerce prior to its use. 28.16(4)(5) [CLAIM SETTLEMENT.] "Claim settlement" means all 28.17 activities of an insurer related directly or indirectly to the 28.18 determination of the extent of liabilities due or potentially 28.19 due under coverages afforded by the policy, and which result in 28.20 claim payment, claim acceptance, compromise, or other 28.21 disposition. 28.22(5)(6) [CLAIMANT.] "Claimant" means any individual, 28.23 corporation, association, partnership, or other legal entity 28.24 asserting a claim against any individual, corporation, 28.25 association, partnership, or other legal entity which is insured 28.26 under an insurance policy or insurance contract of an insurer. 28.27(6)(7) [COMPLAINT.] "Complaint" means a communication 28.28 primarily expressing a grievance. 28.29(7)(8) [INSURANCE POLICY.] "Insurance policy" means any 28.30 evidence of coverage issued by an insurer including all 28.31 policies, contracts, certificates, riders, binders, and 28.32 endorsements which provide or describe coverage. The term 28.33 includes any contract issuing coverage under a self-insurance 28.34 plan, group self-insurance plan, or joint self-insurance 28.35 employee health plans. 28.36(8)(9) [INSURED.] "Insured" means an individual, 29.1 corporation, association, partnership, or other legal entity 29.2 asserting a right to payment under their insurance policy or 29.3 insurance contract arising out of the occurrence of the 29.4 contingency or loss covered by the policy or contract. The term 29.5 does not apply to a person who acquires rights under a mortgage. 29.6(9)(10) [INSURER.] "Insurer" includes any individual, 29.7 corporation, association, partnership, reciprocal exchange, 29.8 Lloyds, fraternal benefits society, self-insurer, surplus line 29.9 insurer, self-insurance administrator, and nonprofit service 29.10 plans under the jurisdiction of the Department of Commerce. 29.11(10)(11) [INVESTIGATION.] "Investigation" means a 29.12 reasonable procedure adopted by an insurer to determine whether 29.13 to accept or reject a claim. 29.14(11)(12) [NOTIFICATION OF CLAIM.] "Notification of claim" 29.15 means any communication to an insurer by a claimant or an 29.16 insured which reasonably apprises the insurer of a claim brought 29.17 under an insurance contract or policy issued by the insurer. 29.18 Notification of claim to an agent of the insurer is notice to 29.19 the insurer. 29.20(12)(13) [PROOF OF LOSS.] "Proof of loss" means the 29.21 necessary documentation required from the insured to establish 29.22 entitlement to payment under a policy. 29.23(13)(14) [SELF-INSURANCE ADMINISTRATOR.] "Self-insurance 29.24 administrator" means any vendor of risk management services or 29.25 entities administering self-insurance plans, licensed pursuant 29.26 to section 60A.23, subdivision 8. 29.27(14)(15) [SELF-INSURED OR SELF-INSURER.] "Self-insured" or 29.28 "self-insurer" means any entity authorized pursuant to section 29.29 65B.48, subdivision 3; chapter 62H; section 176.181, subdivision 29.30 2; Laws of Minnesota 1983, chapter 290, section 171; section 29.31 471.617; or section 471.981 and includes any entity which, for a 29.32 fee, employs the services of vendors of risk management services 29.33 in the administration of a self-insurance plan as defined by 29.34 section 60A.23, subdivision 8, clause (2), subclauses (a) and 29.35 (d). 29.36 Sec. 25. Minnesota Statutes 2004, section 72A.201, 30.1 subdivision 4, is amended to read: 30.2 Subd. 4. [STANDARDS FOR CLAIM FILING AND HANDLING.] The 30.3 following acts by an insurer, an adjuster, a self-insured, or a 30.4 self-insurance administrator constitute unfair settlement 30.5 practices: 30.6 (1) except for claims made under ahealth insurancepolicy 30.7 of accident and sickness insurance, after receiving notification 30.8 of claim from an insured or a claimant, failing to acknowledge 30.9 receipt of the notification of the claim within ten business 30.10 days, and failing to promptly provide all necessary claim forms 30.11 and instructions to process the claim, unless the claim is 30.12 settled within ten business days. The acknowledgment must 30.13 include the telephone number of the company representative who 30.14 can assist the insured or the claimant in providing information 30.15 and assistance that is reasonable so that the insured or 30.16 claimant can comply with the policy conditions and the insurer's 30.17 reasonable requirements. If an acknowledgment is made by means 30.18 other than writing, an appropriate notation of the 30.19 acknowledgment must be made in the claim file of the insurer and 30.20 dated. An appropriate notation must include at least the 30.21 following information where the acknowledgment is by telephone 30.22 or oral contact: 30.23 (i) the telephone number called, if any; 30.24 (ii) the name of the person making the telephone call or 30.25 oral contact; 30.26 (iii) the name of the person who actually received the 30.27 telephone call or oral contact; 30.28 (iv) the time of the telephone call or oral contact; and 30.29 (v) the date of the telephone call or oral contact; 30.30 (2) failing to reply, within ten business days of receipt, 30.31 to all other communications about a claim from an insured or a 30.32 claimant that reasonably indicate a response is requested or 30.33 needed; 30.34 (3) unless provided otherwise by law or in the policy, 30.35 failing to complete its investigation and inform the insured or 30.36 claimant of acceptance or denial of a claim within 30 business 31.1 days after receipt of notification of claim unless the 31.2 investigation cannot be reasonably completed within that time. 31.3 In the event that the investigation cannot reasonably be 31.4 completed within that time, the insurer shall notify the insured 31.5 or claimant within the time period of the reasons why the 31.6 investigation is not complete and the expected date the 31.7 investigation will be complete. For claims made under ahealth31.8 policy of accident and sickness insurance the notification of 31.9 claim must be in writing; 31.10 (4) where evidence of suspected fraud is present, the 31.11 requirement to disclose their reasons for failure to complete 31.12 the investigation within the time period set forth in clause (3) 31.13 need not be specific. The insurer must make this evidence 31.14 available to the Department of Commerce if requested; 31.15 (5) failing to notify an insured who has made a 31.16 notification of claim of all available benefits or coverages 31.17 which the insured may be eligible to receive under the terms of 31.18 a policy and of the documentation which the insured must supply 31.19 in order to ascertain eligibility; 31.20 (6) unless otherwise provided by law or in the policy, 31.21 requiring an insured to give written notice of loss or proof of 31.22 loss within a specified time, and thereafter seeking to relieve 31.23 the insurer of its obligations if the time limit is not complied 31.24 with, unless the failure to comply with the time limit 31.25 prejudices the insurer's rights and then only if the insurer 31.26 gave prior notice to the insured of the potential prejudice; 31.27 (7) advising an insured or a claimant not to obtain the 31.28 services of an attorney or an adjuster, or representing that 31.29 payment will be delayed if an attorney or an adjuster is 31.30 retained by the insured or the claimant; 31.31 (8) failing to advise in writing an insured or claimant who 31.32 has filed a notification of claim known to be unresolved, and 31.33 who has not retained an attorney, of the expiration of a statute 31.34 of limitations at least 60 days prior to that expiration. For 31.35 the purposes of this clause, any claim on which the insurer has 31.36 received no communication from the insured or claimant for a 32.1 period of two years preceding the expiration of the applicable 32.2 statute of limitations shall not be considered to be known to be 32.3 unresolved and notice need not be sent pursuant to this clause; 32.4 (9) demanding information which would not affect the 32.5 settlement of the claim; 32.6 (10) unless expressly permitted by law or the policy, 32.7 refusing to settle a claim of an insured on the basis that the 32.8 responsibility should be assumed by others; 32.9 (11) failing, within 60 business days after receipt of a 32.10 properly executed proof of loss, to advise the insured of the 32.11 acceptance or denial of the claim by the insurer. No insurer 32.12 shall deny a claim on the grounds of a specific policy 32.13 provision, condition, or exclusion unless reference to the 32.14 provision, condition, or exclusion is included in the denial. 32.15 The denial must be given to the insured in writing with a copy 32.16 filed in the claim file; 32.17 (12) denying or reducing a claim on the basis of an 32.18 application which was altered or falsified by the agent or 32.19 insurer without the knowledge of the insured; 32.20 (13) failing to notify the insured of the existence of the 32.21 additional living expense coverage when an insured under a 32.22 homeowners policy sustains a loss by reason of a covered 32.23 occurrence and the damage to the dwelling is such that it is not 32.24 habitable; 32.25 (14) failing to inform an insured or a claimant that the 32.26 insurer will pay for an estimate of repair if the insurer 32.27 requested the estimate and the insured or claimant had 32.28 previously submitted two estimates of repair. 32.29 Sec. 26. Minnesota Statutes 2004, section 79.211, is 32.30 amended by adding a subdivision to read: 32.31 Subd. 4. [EXPERIENCE MODIFICATION FACTOR REVISION FOR 32.32 CERTAIN CLOSED CLAIMS.] An insurer or an employer insured under 32.33 a workers' compensation policy subject to an experience rating 32.34 plan may request in writing of the data service organization 32.35 computing the policy's experience modification factor that the 32.36 most recent factor be revised if each of the following criteria 33.1 is met: 33.2 (1) a workers' compensation claim under that policy is 33.3 closed between the normal valuation date for that claim and the 33.4 next time that valuation is used in experience modification 33.5 factor on the policy; 33.6 (2) the data service organization receives a revised unit 33.7 statistical report containing data on the closed claim in a form 33.8 consistent with its filed unit statistical plan; and 33.9 (3) inclusion of the closed claim in the experience 33.10 modification factor calculation would impact that factor by five 33.11 percentage points or more. 33.12 Sec. 27. Minnesota Statutes 2004, section 79.40, is 33.13 amended to read: 33.14 79.40 [PREMIUM INCLUSION IN RATEMAKING.] 33.15 Premiums charged members by the reinsurance association 33.16 shall be recognized in the ratemaking procedures for insurance 33.17 ratesin the same manner as assessments for the special33.18compensation fund. 33.19 Sec. 28. Minnesota Statutes 2004, section 79.56, 33.20 subdivision 1, is amended to read: 33.21 Subdivision 1. [PREFILING OF RATES.] (a) Each insurer 33.22 shall file with the commissioner a complete copy of its rates 33.23 and rating plan, and all changes and amendments thereto, and 33.24 such supporting data and information that the commissioner may 33.25 by rule require, at least 60 days prior to its effective date. 33.26 The commissioner shall advise an insurer within 30 days of the 33.27 filing if its submission is not accompanied with such supporting 33.28 data and information that the commissioner by rule may require. 33.29 The commissioner may extend the filing review period and 33.30 effective date for an additional 30 days if an insurer, after 33.31 having been advised of what supporting data and information is 33.32 necessary to complete its filing, does not provide such 33.33 information within 15 days of having been so notified. If any 33.34 rate or rating plan filing or amendment thereto is not 33.35 disapproved by the commissioner within the filing review period, 33.36 the insurer may implement it. For the period August 1, 1995, to 34.1 December 31, 1995, the filing shall be made at least 90 days 34.2 prior to the effective date and the department shall advise an 34.3 insurer within 60 days of such filing if the filing is 34.4 insufficient under this section. 34.5 (b) A rating plan or rates are not subject to the 34.6 requirements of paragraph (a), where the insurer files a 34.7 certification verifying that it will use the mutually agreed 34.8 upon rating plan or rates only to write a specific employer that 34.9 generates $250,000 in annual written workers' compensation 34.10 premiums before the application of any large deductible rating 34.11 plan. The certification must be refiled upon each renewal of 34.12 the employer's policy. The $250,000 threshold includes premiums 34.13 generated in any state. The designation and certification must 34.14 be submitted in substantially the following form: 34.15 Name and address of insurer:................................. 34.16 Name and address of insured employer:........................ 34.17 Policy period:............................................... 34.18 I certify that the employer named above generates $250,000 or 34.19 more in annual countrywide written workers' compensation 34.20 premiums, and that the calculation of this threshold is based on 34.21 the rates and rating plans that have been approved by the 34.22 appropriate state regulatory authority. The filing of this 34.23 certification authorizes the use of this rate or rating plan 34.24 only for the named employer. 34.25 Name of responsible officer:................................. 34.26 Title:....................................................... 34.27 Signature:................................................... 34.28 Sec. 29. Minnesota Statutes 2004, section 79.56, 34.29 subdivision 3, is amended to read: 34.30 Subd. 3. [PENALTIES.](a)Any insurer using a rate or a 34.31 rating plan which has not been filed or certified under 34.32 subdivision 1 shall be subject to a fine of up to $100 for each 34.33 day the failure to file continues. The commissioner may, after 34.34 a hearing on the record, find that the failure is willful. A 34.35 willful failure to meet filing requirements shall be punishable 34.36 by a fine of up to $500 for each day during which a willful 35.1 failure continues. These penalties shall be in addition to any 35.2 other penalties provided by law. 35.3(b) Notwithstanding this subdivision, an employer that35.4generates $250,000 in annual written workers' compensation35.5premium under the rates and rating plan of an insurer before the35.6application of any large deductible rating plans, may be written35.7by that insurer using rates or rating plans that are not subject35.8to disapproval but which have been filed. For the purposes of35.9this paragraph, written workers' compensation premiums generated35.10from states other than Minnesota are included in calculating the35.11$250,000 threshold for large risk alternative rating option35.12plans.35.13 Sec. 30. Minnesota Statutes 2004, section 79.62, 35.14 subdivision 3, is amended to read: 35.15 Subd. 3. [ISSUANCE.] The commissioner, upon finding that 35.16 the applicant organization is qualified to provide the services 35.17 required and proposed, or has contracted with a licensed data 35.18 service organization to purchase these services which are 35.19 required by this chapter but are not provided directly by the 35.20 applicant, and that all requirements of law are met, shall issue 35.21 a license. Each license is subject to annual renewal effective 35.22 June 30. Each new or renewal license application must be 35.23 accompanied by a fee of$50$1,000. 35.24 Sec. 31. Minnesota Statutes 2004, section 79A.03, 35.25 subdivision 9, is amended to read: 35.26 Subd. 9. [FILING REPORTS.] (a) Incurred losses, paid and 35.27 unpaid, specifying indemnity and medical losses by 35.28 classification, payroll by classification, and current estimated 35.29 outstanding liability for workers' compensation shall be 35.30 reported to the commissioner by each self-insurer on a calendar 35.31 year basis, in a manner and on forms available from the 35.32 commissioner. Payroll information must be filed by April 1 of 35.33 the following year. 35.34 (b) Each self-insurer shall, under oath, attest to the 35.35 accuracy of each report submitted pursuant to paragraph (a). 35.36 Upon sufficient cause, the commissioner shall require the 36.1 self-insurer to submit a certified audit of payroll and claim 36.2 records conducted by an independent auditor approved by the 36.3 commissioner, based on generally accepted accounting principles 36.4 and generally accepted auditing standards, and supported by an 36.5 actuarial review and opinion of the future contingent 36.6 liabilities. The basis for sufficient cause shall include the 36.7 following factors: where the losses reported appear 36.8 significantly different from similar types of businesses; where 36.9 major changes in the reports exist from year to year, which are 36.10 not solely attributable to economic factors; or where the 36.11 commissioner has reason to believe that the losses and payroll 36.12 in the report do not accurately reflect the losses and payroll 36.13 of that employer. If any discrepancy is found, the commissioner 36.14 shall require changes in the self-insurer's or workers' 36.15 compensation service company record-keeping practices. 36.16 (c) An annual status report due August 1 by each 36.17 self-insurer shall be filed in a manner and on forms prescribed 36.18 by the commissioner. 36.19 (d) Each individual self-insurer shall, within four months 36.20 after the end of its fiscal year, annually file with the 36.21 commissioner its latest 10K report required by the Securities 36.22 and Exchange Commission. If an individual self-insurer does not 36.23 prepare a 10K report, it shall file an annual certified 36.24 financial statement, together with such other financial 36.25 information as the commissioner may require to substantiate data 36.26 in the financial statement. 36.27 (e) Each member of the group shall, withinsevensix months 36.28 after the end of each fiscal year for that group,filesubmit to 36.29 a certified public accountant designated by the group, the most 36.30 recent annual financial statement, reviewed by a certified 36.31 public accountant in accordance with the Statements on Standards 36.32 for Accounting and Review Services, Volume 2, the American 36.33 Institute of Certified Public Accountants Professional 36.34 Standards, or audited in accordance with generally accepted 36.35 auditing standards, together with such other financial 36.36 information the commissioner may require. In addition, the 37.1 group shall file with the commissioner, within seven months 37.2 after the end of each fiscal year for that group, combining 37.3 financial statements of the group members, compiled by a 37.4 certified public accountant in accordance with the Statements on 37.5 Standards for Accounting and Review Services, Volume 2, the 37.6 American Institute of Certified Public Accountants Professional 37.7 Standards. The combining financial statements shall include, 37.8 but not be limited to, a balance sheet, income statement, 37.9 statement of changes in net worth, and statement of cash flow. 37.10 Each combining financial statement shall include a column for 37.11 each individual group member along with a total column. Each 37.12 combined statement shall have a statement from the certified 37.13 public accountant confirming that each member has submitted the 37.14 required financial statement as defined in this section. The 37.15 certified public accountant shall notify the commissioner if any 37.16 statement is qualified or otherwise conditional. The 37.17 commissioner may require additional financial information from 37.18 any group member. 37.19 Where a group has 50 or more members, the group shall file, 37.20 in lieu of the combining financial statements, a combined 37.21 financial statement showing only the total column for the entire 37.22 group's balance sheet, income statement, statement of changes in 37.23 net worth, and statement of cash flow. Additionally, the group 37.24 shall disclose, for each member, the total assets, net worth, 37.25 revenue, and income for the most recent fiscal year. The 37.26 combining and combined financial statements may omit all 37.27 footnote disclosures. 37.28 (f) In addition to the financial statements required by 37.29 paragraphs (d) and (e), interim financial statements or 10Q 37.30 reports required by the Securities and Exchange Commission may 37.31 be required by the commissioner upon an indication that there 37.32 has been deterioration in the self-insurer's financial 37.33 condition, including a worsening of current ratio, lessening of 37.34 net worth, net loss of income, the downgrading of the company's 37.35 bond rating, or any other significant change that may adversely 37.36 affect the self-insurer's ability to pay expected losses. Any 38.1 self-insurer that files an 8K report with the Securities and 38.2 Exchange Commission shall also file a copy of the report with 38.3 the commissioner within 30 days of the filing with the 38.4 Securities and Exchange Commission. 38.5 Sec. 32. Minnesota Statutes 2004, section 79A.04, 38.6 subdivision 2, is amended to read: 38.7 Subd. 2. [MINIMUM DEPOSIT.] The minimum deposit is 110 38.8 percent of the private self-insurer's estimated future 38.9 liability. The deposit may be used to secure payment of all 38.10 administrative and legal costs, and unpaid assessments required 38.11 by section 79A.12, subdivision 2, relating to or arising from 38.12 its or other employers' self-insuring. As used in this section, 38.13 "private self-insurer" includes both current and former members 38.14 of the self-insurers' security fund; and "private self-insurers' 38.15 estimated future liability" means the private self-insurers' 38.16 total of estimated future liability as determined by an 38.17 Associate or Fellow of the Casualty Actuarial Society every year 38.18 for group member private self-insurers and, for a nongroup 38.19 member private self-insurer's authority to self-insure, every 38.20 year for the first five years. After the first five years, the 38.21 nongroup member's total shall be as determined by an Associate 38.22 or Fellow of the Casualty Actuarial Society at least every two 38.23 years, and each such actuarial study shall include a projection 38.24 of future losses during the period until the next scheduled 38.25 actuarial study, less payments anticipated to be made during 38.26 that time. 38.27 All data and information furnished by a private 38.28 self-insurer to an Associate or Fellow of the Casualty Actuarial 38.29 Society for purposes of determining private self-insurers' 38.30 estimated future liability must be certified by an officer of 38.31 the private self-insurer to be true and correct with respect to 38.32 payroll and paid losses, and must be certified, upon information 38.33 and belief, to be true and correct with respect to reserves. 38.34 The certification must be made by sworn affidavit. In addition 38.35 to any other remedies provided by law, the certification of 38.36 false data or information pursuant to this subdivision may 39.1 result in a fine imposed by the commissioner of commerce on the 39.2 private self-insurer up to the amount of $5,000, and termination 39.3 of the private self-insurers' authority to self-insure. The 39.4 determination of private self-insurers' estimated future 39.5 liability by an Associate or Fellow of the Casualty Actuarial 39.6 Society shall be conducted in accordance with standards and 39.7 principles for establishing loss and loss adjustment expense 39.8 reserves by the Actuarial Standards Board, an affiliate of the 39.9 American Academy of Actuaries. The commissioner may reject an 39.10 actuarial report that does not meet the standards and principles 39.11 of the Actuarial Standards Board, and may further disqualify the 39.12 actuary who prepared the report from submitting any future 39.13 actuarial reports pursuant to this chapter. Within 30 days 39.14 after the actuary has been served by the commissioner with a 39.15 notice of disqualification, an actuary who is aggrieved by the 39.16 disqualification may request a hearing to be conducted in 39.17 accordance with chapter 14. Based on a review of the actuarial 39.18 report, the commissioner of commerce may require an increase in 39.19 the minimum security deposit in an amount the commissioner 39.20 considers sufficient. 39.21 Estimated future liability is determined by first taking 39.22 the total amount of the self-insured's future liability of 39.23 workers' compensation claims and then deducting the total amount 39.24 which is estimated to be returned to the self-insurer from any 39.25 specific excess insurance coverage, aggregate excess insurance 39.26 coverage, and any supplementary benefits or second injury 39.27 benefits which are estimated to be reimbursed by the special 39.28 compensation fund. However, in the determination of estimated 39.29 future liability, the actuary for the self-insurer shall not 39.30 take a credit for any excess insurance or reinsurance which is 39.31 provided by a captive insurance company which is wholly owned by 39.32 the self-insurer. Supplementary benefits or second injury 39.33 benefits will not be reimbursed by the special compensation fund 39.34 unless the special compensation fund assessment pursuant to 39.35 section 176.129 is paid and the reports required thereunder are 39.36 filed with the special compensation fund. In the case of surety 40.1 bonds, bonds shall secure administrative and legal costs in 40.2 addition to the liability for payment of compensation reflected 40.3 on the face of the bond. In no event shall the security be less 40.4 than the last retention limit selected by the self-insurer with 40.5 the Workers' Compensation Reinsurance Association, provided that 40.6 the commissioner may allow former members to post less than the 40.7 Workers' Compensation Reinsurance Association retention level if 40.8 that amount is adequate to secure payment of the self-insurers' 40.9 estimated future liability, as defined in this subdivision, 40.10 including payment of claims, administrative and legal costs, and 40.11 unpaid assessments required by section 79A.12, subdivision 2. 40.12 The posting or depositing of security pursuant to this section 40.13 shall release all previously posted or deposited security from 40.14 any obligations under the posting or depositing and any surety 40.15 bond so released shall be returned to the surety. Any other 40.16 security shall be returned to the depositor or the person 40.17 posting the bond. 40.18 As a condition for the granting or renewing of a 40.19 certificate to self-insure, the commissioner may require a 40.20 private self-insurer to furnish any additional security the 40.21 commissioner considers sufficient to insure payment of all 40.22 claims under chapter 176. 40.23 Sec. 33. Minnesota Statutes 2004, section 79A.04, 40.24 subdivision 10, is amended to read: 40.25 Subd. 10. [NOTICE; OBLIGATION OF FUND.] In the event of 40.26 bankruptcy, insolvency, or certificate of default, the 40.27 commissioner shall immediately notify by certified mail the 40.28 commissioner of finance, the surety, the issuer of an 40.29 irrevocable letter of credit, and any custodian of the security 40.30 required in this chapter. At the time of notification, the 40.31 commissioner shall also call the security and transfer and 40.32 assign it to the self-insurers' security fund. The commissioner 40.33 shall also immediately notify by certified mail the 40.34 self-insurers' security fund, and order the security fund to 40.35 assume the insolvent self-insurers' obligations for which it is 40.36 liable under chapter 176. The security fund shall commence 41.1 payment of these obligations within 14 days of receipt of this 41.2 notification and order. Payments shall be made to claimants 41.3 whose entitlement to benefits can be ascertained by the security 41.4 fund, with or without proceedings before the Department of Labor 41.5 and Industry, the Office of Administrative Hearings, the 41.6 Workers' Compensation Court of Appeals, or the Minnesota Supreme 41.7 Court. Upon the assumption of obligations by the security fund 41.8 pursuant to the commissioner's notification and order, the 41.9 security fund has the right to immediate possession of any 41.10 posted or deposited security and the custodian, surety, or 41.11 issuer of any irrevocable letter of credit or the commissioner, 41.12 if in possession of it, shall turn over the security, proceeds 41.13 of the surety bond, or letter of credit to the security fund 41.14 together with the interest that has accrued since the date of 41.15 the self-insured employer's insolvency. The security fund has 41.16 the right to the immediate possession of all relevant workers' 41.17 compensation claim files and data of the self-insurer, and the 41.18 possessor of the files and data must turn the files and data, or 41.19 complete copies of them, over to the security fund within five 41.20 days of the notification provided under this subdivision. If 41.21 the possessor of the files and data fails to timely turn over 41.22 the files and data to the security fund, it is liable to the 41.23 security fund for a penalty of $500 per day for each day after 41.24 the five-day period has expired. The security fund is entitled 41.25 to recover its reasonable attorney fees and costs in any action 41.26 brought to obtain possession of the workers' compensation claim 41.27 files and data of the self-insurer, and for any action to 41.28 recover the penalties provided by this subdivision. The 41.29 self-insurers' security fund may administer payment of benefits 41.30 or it may retain a third-party administrator to do so. 41.31 Sec. 34. Minnesota Statutes 2004, section 79A.06, 41.32 subdivision 5, is amended to read: 41.33 Subd. 5. [PRIVATE EMPLOYERS WHO HAVE CEASED TO BE 41.34 SELF-INSURED.] (a) Private employers who have ceased to be 41.35 private self-insurers shall discharge their continuing 41.36 obligations to secure the payment of compensation which is 42.1 accrued during the period of self-insurance, for purposes of 42.2 Laws 1988, chapter 674, sections 1 to 21, by compliance with all 42.3 of the following obligations of current certificate holders: 42.4 (1) Filing reports with the commissioner to carry out the 42.5 requirements of this chapter; 42.6 (2) Depositing and maintaining a security deposit for 42.7 accrued liability for the payment of any compensation which may 42.8 become due, pursuant to chapter 176. However, if a private 42.9 employer who has ceased to be a private self-insurer purchases 42.10 an insurance policy from an insurer authorized to transact 42.11 workers' compensation insurance in this state which provides 42.12 coverage of all claims for compensation arising out of injuries 42.13 occurring during the entire period the employer was 42.14 self-insured, whether or not reported during that period, the 42.15 policy will: 42.16 (i) discharge the obligation of the employer to maintain a 42.17 security deposit for the payment of the claims covered under the 42.18 policy; 42.19 (ii) discharge any obligation which the self-insurers' 42.20 security fund has or may have for payment of all claims for 42.21 compensation arising out of injuries occurring during the period 42.22 the employer was self-insured, whether or not reported during 42.23 that period; and 42.24 (iii) discharge the obligations of the employer to pay any 42.25 future assessments to the self-insurers' security fund. 42.26 A private employer who has ceased to be a private 42.27 self-insurer may instead buy an insurance policy described 42.28 above, except that it covers only a portion of the period of 42.29 time during which the private employer was self-insured; 42.30 purchase of such a policy discharges any obligation that the 42.31 self-insurers' security fund has or may have for payment of all 42.32 claims for compensation arising out of injuries occurring during 42.33 the period for which the policy provides coverage, whether or 42.34 not reported during that period. 42.35 A policy described in this clause may not be issued by an 42.36 insurer unless it has previously been approved as to form and 43.1 substance by the commissioner; and 43.2 (3) Paying within 30 days all assessments of which notice 43.3 is sent by the security fund, for a period of seven years from 43.4 the last day its certificate of self-insurance was in effect. 43.5 Thereafter, the private employer who has ceased to be a private 43.6 self-insurer may either: (i) continue to pay within 30 days all 43.7 assessments of which notice is sent by the security fund until 43.8 it has no incurred liabilities for the payment of compensation 43.9 arising out of injuries during the period of self-insurance; or 43.10 (ii) pay the security fund a cash payment equal to four percent 43.11 of the net present value of all remaining incurred liabilities 43.12 for the payment of compensation under sections 176.101 and 43.13 176.111 as certified by a member of the casualty actuarial 43.14 society. Assessments shall be based on the benefits paid by the 43.15 employer during the calendar year immediately preceding the 43.16 calendar year in which the employer's right to self-insure is 43.17 terminated or withdrawn. 43.18 (b) With respect to a self-insurer who terminates its 43.19 self-insurance authority after April 1, 1998, that member shall 43.20 obtain and file with the commissioner an actuarial opinion of 43.21 its outstanding liabilities as determined by an associate or 43.22 fellow of the Casualty Actuarial Society within 120 days of the 43.23 date of its termination. If the actuarial opinion is not timely 43.24 filed, the self-insurers' security fund may, at its discretion, 43.25 engage the services of an actuary for this purpose. The expense 43.26 of this actuarial opinion must be assessed against and be the 43.27 obligation of the self-insurer. The commissioner may issue a 43.28 certificate of default against the self-insurer for failure to 43.29 pay this assessment to the self-insurers' security fund as 43.30 provided by section 79A.04, subdivision 9. The opinion must 43.31 separate liability for indemnity benefits from liability from 43.32 medical benefits, and must discount each up to four percent per 43.33 annum to net present value. Within 30 days after notification 43.34 of approval of the actuarial opinion by the commissioner, the 43.35 member shall pay to the security fund an amount equal to 120 43.36 percent of that discounted outstanding indemnity liability, 44.1 multiplied by the greater of the average annualized assessment 44.2 rate since inception of the security fund or the annual rate at 44.3 the time of the most recent assessment before termination. If 44.4 the payment is not made within 30 days of the notification, 44.5 interest on it at the rate prescribed by section 549.09 must be 44.6 paid by the former member to the security fund until the 44.7 principal amount is paid in full. 44.8 (c) A former member who terminated its self-insurance 44.9 authority before April 1, 1998, who has paid assessments to the 44.10 self-insurers' security fund for seven years, and whose 44.11 annualized assessment is $500 or less, may buy out of its 44.12 outstanding liabilities to the self-insurers' security fund by 44.13 an amount calculated as follows: 1.35 multiplied by the 44.14 indemnity case reserves at the time of the calculation, 44.15 multiplied by the then current self-insurers' security fund 44.16 annualized assessment rate. 44.17 (d) A former member who terminated its self-insurance 44.18 authority before April 1, 1998, and who is paying assessments 44.19 within the first seven years after ceasing to be self-insured 44.20 under paragraph (a), clause (3), may elect to buy out its 44.21 outstanding liabilities to the self-insurers' security fund by 44.22 obtaining and filing with the commissioner an actuarial opinion 44.23 of its outstanding liabilities as determined by an associate or 44.24 fellow of the Casualty Actuarial Society. The opinion must 44.25 separate liability for indemnity benefits from liability for 44.26 medical benefits, and must discount each up to four percent per 44.27 annum to net present value. Within 30 days after notification 44.28 of approval of the actuarial opinion by the commissioner, the 44.29 member shall pay to the security fund an amount equal to 120 44.30 percent of that discounted outstanding indemnity liability, 44.31 multiplied by the greater of the average annualized assessment 44.32 rate since inception of the security fund or the annual rate at 44.33 the time of the most recent assessment. 44.34 (e) A former member who has paid the security fund 44.35 according to paragraphs (b) to (d) and subsequently receives 44.36 authority from the commissioner to again self-insure shall be 45.1 assessed under section 79A.12, subdivision 2, only on indemnity 45.2 benefits paid on injuries that occurred after the former member 45.3 received authority to self-insure again; provided that the 45.4 member furnishes verified data regarding those benefits to the 45.5 security fund. 45.6 (f) In addition to proceedings to establish liabilities and 45.7 penalties otherwise provided, a failure to comply may be the 45.8 subject of a proceeding before the commissioner. An appeal from 45.9 the commissioner's determination may be taken pursuant to the 45.10 contested case procedures of chapter 14 within 30 days of the 45.11 commissioner's written determination. 45.12 Any current or past member of the self-insurers' security 45.13 fund is subject to service of process on any claim arising out 45.14 of chapter 176 or this chapter in the manner provided by section 45.15 5.25, or as otherwise provided by law. The issuance of a 45.16 certificate to self-insure to the private self-insured employer 45.17 shall be deemed to be the agreement that any process which is 45.18 served in accordance with this section shall be of the same 45.19 legal force and effect as if served personally within this state. 45.20 Sec. 35. Minnesota Statutes 2004, section 79A.12, 45.21 subdivision 2, is amended to read: 45.22 Subd. 2. [ASSESSMENT.] The security fund may assess each 45.23 of its members a pro rata share of the funding necessary to 45.24 carry out its obligation and the purposes of this chapter. 45.25 Total annual assessments in any calendar year shall not exceed 45.26 ten percent ofthe workers' compensation benefits paid under45.27sections 176.101 and 176.111 during the previouspaid indemnity 45.28 losses, as defined in section 176.129, made by the self-insured 45.29 employer during the preceding calendar year. The annual 45.30 assessment calculation shall not include supplementary benefits 45.31 paid which will be reimbursed by the special compensation fund. 45.32 Funds obtained by assessments pursuant to this subdivision may 45.33 only be used for the purposes of this chapter. The trustees 45.34 shall certify to the commissioner the collection and receipt of 45.35 all money from assessments, noting any delinquencies. The 45.36 trustees shall take any action deemed appropriate to collect any 46.1 delinquent assessments. 46.2 Sec. 36. Minnesota Statutes 2004, section 79A.22, 46.3 subdivision 11, is amended to read: 46.4 Subd. 11. [DISBURSEMENT OF FUND SURPLUS.] (a)One46.5hundredExcept as otherwise provided in paragraphs (b) and (c), 46.6 100 percent of any surplus money for a fund year in excess of 46.7 125 percent of the amount necessary to fulfill all obligations 46.8 under the Workers' Compensation Act, chapter 176, for that fund 46.9 year may be declared refundable toa membereligible members at 46.10 any time.The date shall be no earlier than 18 months following46.11the end of such fund year. The first disbursement of fund46.12surplus may not be made prior to the written approval of the46.13commissioner. There can be no more than one refund made in any46.1412-month period.46.15 (b) Except as otherwise provided in paragraph (c), for 46.16 groups that have been in existence for five years or more, 100 46.17 percent of any surplus money for a fund year in excess of 110 46.18 percent of the amount necessary to fulfill all obligations under 46.19 the Workers' Compensation Act, chapter 176, for that fund year 46.20 may be declared refundable to eligible members at any time. 46.21 (c) Excess surplus distributions under paragraphs (a) and 46.22 (b) may not be greater than the combined surplus of the group at 46.23 the time of the distribution. 46.24 (d) When all the claims of any one fund year have been 46.25 fully paid, as certified by an actuary, all surplus money from 46.26 that fund year may be declared refundable. 46.27(b)(e) The commercial self-insurance group shall give ten 46.28 days' prior notice to the commissioner of any refund.SaidThe 46.29 noticeshallmust be accompanied by a statement from the 46.30 commercial self-insurer group's certified public accountant 46.31 certifying that the proposed refund is in compliance 46.32 withparagraph (a)this subdivision. 46.33 Sec. 37. Minnesota Statutes 2004, section 79A.22, is 46.34 amended by adding a subdivision to read: 46.35 Subd. 14. [ALL STATES COVERAGE.] Policies issued by 46.36 commercial self-insurance groups pursuant to this chapter may 47.1 also provide workers' compensation coverage required under the 47.2 laws of states other than Minnesota, commonly known as "all 47.3 states coverage." The coverage must be provided to members of 47.4 the group which are temporarily performing work in another state. 47.5 Sec. 38. Minnesota Statutes 2004, section 176.191, 47.6 subdivision 3, is amended to read: 47.7 Subd. 3. [INSURER PAYMENT.] If a dispute exists as to 47.8 whether an employee's injury is compensable under this chapter 47.9 and the employee is otherwise covered by an insurer or entity 47.10 pursuant to chapters 62A, 62Cand, 62D, 62E, 62R, and 62T, that 47.11 insurer or entity shall pay any medical costs incurred by the 47.12 employee for the injury up to the limits of the applicable 47.13 coverage and shall make any disability payments otherwise 47.14 payable by that insurer or entity in the absence of or in 47.15 addition to workers' compensation liability. If the injury is 47.16 subsequently determined to be compensable pursuant to this 47.17 chapter, the workers' compensation insurer shall be ordered to 47.18 reimburse the insurer or entity that made the payments for all 47.19 payments made under this subdivision by the insurer or entity, 47.20 including interest at a rate of 12 percent a year. If a payment 47.21 pursuant to this subdivision exceeds the reasonable value as 47.22 permitted by sections 176.135 and 176.136, the provider shall 47.23 reimburse the workers' compensation insurer for all the excess 47.24 as provided by rules promulgated by the commissioner. 47.25 Sec. 39. [REPEALER.] 47.26 Minnesota Statutes 2004, sections 61A.072, subdivision 2; 47.27 and 62E.03 are repealed. 47.28 Sec. 40. [EFFECTIVE DATES.] 47.29 Sections 10, 15, 16, 18, 22, 23, 27, and 33 to 38 are 47.30 effective the day following final enactment. Section 19 is 47.31 effective the day following final enactment and applies to any 47.32 action taken by an insurer on or after that date. Sections 2, 47.33 4, 21, and 28 to 30 are effective July 1, 2005. The remaining 47.34 sections are effective August 1, 2005.