HF 2831

as introduced - 84th Legislature (2005 - 2006) Posted on 12/15/2009 12:00am

A bill for an act
relating to insurance; reforming two employer health coverage pooling programs;
recodifying them; appropriating money; amending Minnesota Statutes 2004,
sections 43A.316; 43A.317.

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

Section 1.

Minnesota Statutes 2004, section 43A.316, is amended to read:

43A.316 PUBLIC EMPLOYEES INSURANCE PROGRAM.

Subdivision 1.

Intent.

The legislature finds that the creation of a statewide program
to provide public employees and other eligible persons with deleted text begin life insurance and deleted text end hospital,
medical, and dental benefit coverage deleted text begin through provider organizations deleted text end would result in a
deleted text begin greater utilization deleted text end new text begin more efficient use new text end of government resources and would advance the
health and welfare of the citizens of the state.

Subd. 2.

Definitions.

For the purpose of this section, the terms defined in this
subdivision have the meaning given them.

(a) Commissioner. "Commissioner" means the commissioner of deleted text begin employee relations deleted text end new text begin
commerce new text end .

(b) Employee. "Employee" means:

(1) a person who is a public employee within the definition of section 179A.03,
subdivision 14, who is insurance eligible and is employed by an eligible employer;

(2) an elected public official of an eligible employer who is insurance eligible;

(3) a person employed by a labor organization or employee association certified as
an exclusive representative of employees of an eligible employer or by another public
employer approved by the deleted text begin commissioner deleted text end new text begin board new text end , so long as the plan meets the requirements
of a governmental plan under United States Code, title 29, section 1002(32); or

(4) a person employed by a county or municipal hospital.

(c) Eligible employer. "Eligible employer" means:

(1) a public employer within the definition of section 179A.03, subdivision 15, that
is a town, county, city, school district as defined in section 120A.05, service cooperative
as defined in section 123A.21, intermediate district as defined in section 136D.01,
Cooperative Center for Vocational Education as defined in section 123A.22, regional
management information center as defined in section 123A.23, or an education unit
organized under the joint powers action, section 471.59; or

(2) an exclusive representative of employees, as defined in paragraph (b);

(3) a county or municipal hospital; or

(4) another public employer approved by the deleted text begin commissioner deleted text end new text begin board new text end .

(d) Exclusive representative. "Exclusive representative" means an exclusive
representative as defined in section 179A.03, subdivision 8.

(e) Labor-Management deleted text begin Committee deleted text end new text begin Board new text end . "Labor-Management deleted text begin Committee deleted text end new text begin
Board new text end " means the deleted text begin committee deleted text end new text begin board new text end established by subdivision 4.

(f) Program. "Program" means the statewide public employees insurance program
created by subdivision 3.

Subd. 3.

Public employee insurance program.

The deleted text begin commissioner deleted text end new text begin board new text end shall
be the administrator of the public employee insurance program and may determine its
funding arrangements. new text begin The board may contract with a qualified entity to perform the
administrative functions. new text end The deleted text begin commissioner deleted text end new text begin board new text end shall model the program after the plan
established in section 43A.18, subdivision 2, but may deleted text begin modify deleted text end new text begin adopt variations from new text end that
plan deleted text begin , in consultation with the Labor-Management Committee deleted text end . new text begin The variations may include
different deductibles, coinsurance, co-pays, or other enrollee cost-sharing provisions.
new text end

Subd. 4.

Labor-Management deleted text begin Committee deleted text end new text begin Board new text end .

The Labor-Management
deleted text begin Committee deleted text end new text begin Board new text end consists of ten members appointed by the deleted text begin commissioner deleted text end new text begin governor new text end .
The Labor-Management deleted text begin Committee deleted text end new text begin Board new text end must comprise five members who represent
employees, including at least one retired employee, and five members who represent
eligible employers. deleted text begin Committee deleted text end new text begin Board new text end members are eligible for expense reimbursement in
the same manner and amount as authorized by the commissioner's plan adopted under
section 43A.18, subdivision 2. deleted text begin The commissioner shall consult with the labor-management
committee in major decisions that affect the program. deleted text end The deleted text begin committee deleted text end new text begin board new text end shall deleted text begin study
issues deleted text end new text begin evaluate and make decisions new text end relating to the insurance program including, but not
limited to, flexible benefits, utilization review, quality assessment, and cost efficiency. The
deleted text begin committee deleted text end new text begin board new text end continues to exist while the program remains in operation.

Subd. 5.

Public employee participation.

(a) Participation in the program is subject
to the conditions in this subdivision.

(b) Each exclusive representative for an eligible employer determines whether the
employees it represents will participate in the program. The exclusive representative shall
give the employer notice of intent to participate at least 30 days before the expiration date
of the collective bargaining agreement preceding the collective bargaining agreement that
covers the date of entry into the program. The exclusive representative and the eligible
employer shall give notice to the deleted text begin commissioner deleted text end new text begin board new text end of the determination to participate
in the program at least 30 days before entry into the program. Entry into the program is
governed by a schedule established by the deleted text begin commissioner deleted text end new text begin board new text end .

(c) Employees not represented by exclusive representatives may become members
of the program upon a determination of an eligible employer to include these employees
in the program. Either all or none of the employer's unrepresented employees must
participate. The eligible employer shall give at least 30 days' notice to the deleted text begin commissioner deleted text end new text begin
board new text end before entering the program. Entry into the program is governed by a schedule
established by the deleted text begin commissioner deleted text end new text begin board new text end .

(d) Participation in the program is for a two-year term. Participation is automatically
renewed for an additional two-year term unless the exclusive representative, or the
employer for unrepresented employees, gives the deleted text begin commissioner deleted text end new text begin board new text end notice of
withdrawal at least 30 days before expiration of the participation period. A group that
withdraws must wait two years before rejoining. An exclusive representative, or employer
for unrepresented employees, may also withdraw if premiums increase 50 percent or
more from one insurance year to the next.

(e) The exclusive representative shall give the employer notice of intent to withdraw
deleted text begin to the commissioner deleted text end at least 30 days before the expiration date of a collective bargaining
agreement that includes the date on which the term of participation expires.

(f) Each participating eligible employer shall notify the deleted text begin commissioner deleted text end new text begin board new text end of new text begin the
new text end names of individuals who will be participating within two weeks deleted text begin of deleted text end new text begin after new text end the deleted text begin commissioner deleted text end
deleted text begin receiving deleted text end new text begin board receives new text end notice of the parties' intent to participate. The employer shall
also submit other information as required by the deleted text begin commissioner deleted text end new text begin board new text end for administration
of the program.

new text begin (g) An exclusive representative or employer that withdraws from the program must
pay to the board, for deposit into the insurance trust fund created in subdivision 9, an
assessment by the board for its pro rata share of any net losses accrued within the program
during the employer's participation in the program. The pro rata share is determined based
upon the premiums paid by that employer as a percentage of total premiums paid by all
employers in the program during that employer's participation, as determined by the
board. An employer that withdraws from the program under circumstances that do not
permit withdrawal under this subdivision is liable to the board for premiums payable by
the employer until the time that the employer is eligible to withdraw and the employer
shall pay those premiums voluntarily and no later than their due date. If the premiums or
pro rata assessments are not paid voluntarily, the board has authority to and shall collect
these premiums under any method permitted by law for a nongovernmental creditor of
the employer.
new text end

Subd. 6.

Coverage.

(a) deleted text begin By January 1, 1989, deleted text end The deleted text begin commissioner deleted text end new text begin board new text end shall
announce the benefits of the program. The program shall include employee hospital,
medical, new text begin and new text end dental deleted text begin , and life deleted text end insurance for employees and deleted text begin hospital and medical benefits for deleted text end
dependents. Health maintenance organization options and other delivery system options
may be provided if they are available, cost-effective, and capable of servicing the number
of people covered in the program. Participation in optional coverages may be provided
by collective bargaining agreements. For employees not represented by an exclusive
representative, the employer may offer the optional coverages to eligible employees and
their dependents provided in the program. new text begin Health coverage must include at least the
benefits required of a health plan company regulated under chapter 62A, 62C, or 62D.
new text end

(b) The deleted text begin commissioner, with the assistance of the deleted text end Labor-Management deleted text begin Committee, deleted text end new text begin
Board new text end shall periodically assess whether it is financially feasible for the program to offer or
to continue an individual retiree program that has competitive premium rates and benefits.
If the deleted text begin commissioner deleted text end new text begin board new text end determines it to be feasible to offer an individual retiree
program, the deleted text begin commissioner deleted text end new text begin board new text end shall announce the applicable benefits, premium rates,
and terms of participation. Eligibility to participate in the individual retiree program
is governed by subdivision 8, but applies to retirees of eligible employers that do not
participate in the program and to those retirees' dependents and surviving spouses.

Subd. 6a.

deleted text begin Chiropractic services deleted text end new text begin Choice of providers new text end .

All benefits provided by the
program deleted text begin or a successor program deleted text end relating to expenses incurred for medical treatment or
services of a deleted text begin physician deleted text end new text begin health care provider new text end must also include deleted text begin chiropractic deleted text end treatment and
services of deleted text begin a chiropractor deleted text end new text begin any other licensed, certified, or registered health care provider new text end to
the extent that the deleted text begin chiropractic deleted text end services and treatment are within the scope of deleted text begin chiropractic
licensure deleted text end new text begin the provider's licensure, certification, or registration new text end .

deleted text begin This subdivision is intended to provide equal access to benefits for program members
who choose to obtain treatment for illness or injury from a doctor of chiropractic, as long
as the treatment falls within the chiropractor's scope of practice. This subdivision is not
intended to change or add to the benefits provided for in the program.
deleted text end

Subd. 7.

Premiums.

The proportion of premium paid by the employer and
employee is subject to collective bargaining or personnel policies. If, at the beginning of
the coverage period, no collective bargaining agreement has been finalized, the increased
dollar costs, if any, from the previous year is the sole responsibility of the individual
participant until a collective bargaining agreement states otherwise. Premiums, including
an administration fee, shall be established by the deleted text begin commissioner deleted text end new text begin board new text end . new text begin The board may
decide to rate specific employers separately for premium purposes, if the board determines
that doing so is in the best interests of the program. new text end Each employer shall pay monthly
the amounts due for employee benefits including the amounts under subdivision 8 to the
deleted text begin commissioner deleted text end new text begin board new text end no later than the dates established by the deleted text begin commissioner deleted text end new text begin board new text end . If an
employer fails to make the payments as required, the deleted text begin commissioner may deleted text end new text begin board shall new text end
cancel program benefits and pursue other civil remedies new text begin , as provided in subdivision 5,
paragraph (d) new text end .

Subd. 8.

Continuation of coverage.

(a) A former employee of an employer
participating in the program who is receiving a public pension disability benefit or an
annuity or has met the age and service requirements necessary to receive an annuity under
chapter 353, 353C, 354, 354A, 356, 422A, 423, 423A, or 424, and the former employee's
dependents, are eligible to participate in the program. This participation is at the person's
expense unless a collective bargaining agreement or personnel policy provides otherwise.
Premiums for these participants must be established by the deleted text begin commissioner deleted text end new text begin board new text end .

The deleted text begin commissioner deleted text end new text begin board new text end may provide policy exclusions for preexisting conditions
only when there is a break in coverage between a participant's coverage under the
employment-based group insurance program and the participant's coverage under this
section. An employer shall notify an employee of the option to participate under this
paragraph no later than the effective date of retirement. The retired employee or the
employer of a participating group on behalf of a current or retired employee shall notify
the deleted text begin commissioner deleted text end new text begin board new text end within 30 days of the effective date of retirement of intent to
participate in the program according to the rules established by the deleted text begin commissioner deleted text end new text begin board new text end .

(b) The spouse of a deceased employee or former employee may purchase the
benefits provided at premiums established by the deleted text begin commissioner deleted text end new text begin board new text end if the spouse was
a dependent under the employee's or former employee's coverage under this section at
the time of the death. The spouse remains eligible to participate in the program as long
as the group that included the deceased employee or former employee participates in the
program. Coverage under this clause must be coordinated with relevant insurance benefits
provided through the federally sponsored Medicare program.

(c) The program benefits must continue in the event of strike permitted by section
179A.18, if the exclusive representative chooses to have coverage continue and the
employee pays the total monthly premiums when due.

deleted text begin (d) A participant who discontinues coverage may not reenroll.
deleted text end

new text begin (d) new text end Persons participating under deleted text begin these paragraphs deleted text end new text begin this subdivision new text end shall make
appropriate premium payments in the time and manner established by the deleted text begin commissioner deleted text end new text begin
board new text end .

Subd. 9.

Insurance trust fund.

new text begin (a) new text end The insurance trust fund in the state treasury
consists of deposits of the premiums received from employers participating in the
program and transfers before July 1, 1994, from the excess contributions holding account
established by section 353.65, subdivision 7. All money in the fund is appropriated to the
deleted text begin commissioner deleted text end new text begin board new text end to pay insurance premiums, approved claims, refunds, administrative
costs, and other related service costs. Premiums paid by employers to the fund are exempt
from the taxes imposed by chapter 297I. The deleted text begin commissioner deleted text end new text begin board new text end shall reserve an amount
of money to cover the estimated costs of claims incurred but unpaid. The State Board of
Investment shall invest the money according to section 11A.24. Investment income and
losses attributable to the fund must be credited to the fund.

new text begin (b) If the board determines that the funds in the insurance trust fund are inadequate to
meet the board's obligations, the board may access additional funds as needed in the form
of loans from the health care access fund, not to exceed a total indebtedness of $2,000,000
at any one time. Such loans accrue interest at three percent per annum simple interest and
must be repaid in installments beginning no later than two years after the board first
provides coverage and must be fully repaid no later than five years after that date. The
monthly repayment installments must be reamortized as needed to reflect repayments and
additional loan amounts accessed, so that monthly installments will be sufficient to repay
the existing balance, including accrued interest, at the end of that five-year period. The
$2,000,000 amount is available until the end of that five-year period. Amounts of principal
repaid are available to be accessed for new loans within that period.
new text end

Subd. 10.

Exemption.

The public employee insurance program and, where
applicable, the employers participating in it new text begin , new text end are exempt from chapters 60A, 62A, 62C,
62D, 62E, and 62H, section 471.617, subdivisions 2 and 3, and the bidding requirements
of section 471.6161 new text begin , except:
new text end

new text begin (1) as otherwise provided in subdivision 6, paragraph (a); and
new text end

new text begin (2) that the program is subject to the assessment for the Minnesota Comprehensive
Health Association under section 62E.11, if the type of coverage provided would be
subject to that assessment if provided by a contributing member of that association new text end .

new text begin Subd. 11. new text end

new text begin Reinsurance. new text end

new text begin The board may, on behalf of the program, participate in an
insured or self-insured reinsurance pool.
new text end

new text begin Subd. 12. new text end

new text begin Commissioner of commerce. new text end

new text begin The program's premiums and other
decisions relevant to financial solvency must be submitted to the commissioner of
commerce for prior approval. The premiums and other decisions are deemed approved if
not disapproved within 60 days of their submission to the commissioner.
new text end

Sec. 2.

Minnesota Statutes 2004, section 43A.317, is amended to read:

43A.317 MINNESOTA EMPLOYEES INSURANCE PROGRAM.

Subdivision 1.

Intent.

The legislature finds that the creation of a statewide program
to provide employers with the advantages of a large pool for insurance purchasing would
advance the welfare of the citizens of the state.

Subd. 2.

Definitions.

(a) Scope. For the purposes of this section, the terms defined
have the meaning given them.

(b) deleted text begin Commissioner deleted text end new text begin Board new text end . deleted text begin "Commissioner" means the commissioner of employee
relations. deleted text end new text begin "Board" means the board of directors created under subdivision 4. new text end

(c) Eligible employee. "Eligible employee" means an employee eligible to
participate in the program under the terms described in subdivision 6.

(d) Eligible employer. "Eligible employer" means an employer eligible to
participate in the program under the terms described in subdivision 5.

(e) Eligible individual. "Eligible individual" means a person eligible to participate
in the program under the terms described in subdivision 6.

(f) Employee. "Employee" means an employee of an eligible employer. "Employee"
includes a sole proprietor, partner of a partnership, member of a limited liability company,
or independent contractor.

(g) Employer. "Employer" means a private person, firm, corporation, partnership,
limited liability company, association, or other entity actively engaged in business or
public services. "Employer" includes both for-profit and nonprofit entities.

(h) Program. "Program" means the Minnesota employees insurance program
created by this section.

Subd. 3.

new text begin Entity status and new text end administration.

deleted text begin After consulting with the chairs of the
senate Governmental Operations and Veterans Committee and the house of representatives
Governmental Operations and Veterans Affairs Policy Committee, the commissioner
may determine when the program provided under this section is available. When the
commissioner makes the program available, deleted text end new text begin The board is created and may operate as an
unincorporated association and may incorporate as a Minnesota nonprofit corporation
under chapter 317A. The board shall have all powers available under that chapter, except
to the extent inconsistent with this section. new text end The deleted text begin commissioner deleted text end new text begin board new text end shall, consistent
with the provisions of this section, administer the program and determine its coverage
options, funding and premium arrangements, contractual arrangements, and all other
matters necessary to administer the program. deleted text begin The commissioner's contracting authority
for the program, including authority for competitive bidding and negotiations, is governed
by section 43A.23. deleted text end

Subd. 4.

deleted text begin Advisory committee deleted text end new text begin Board of directors new text end .

deleted text begin After the commissioner
consults as required in subdivision 3 and then determines to make the program available, deleted text end
The deleted text begin commissioner deleted text end new text begin governor new text end shall deleted text begin establish a deleted text end new text begin appoint an initial new text end ten-member deleted text begin advisory
committee deleted text end new text begin board of directors new text end that includes five members who represent eligible employers
deleted text begin and deleted text end deleted text begin five deleted text end new text begin , two new text end members who represent eligible individuals deleted text begin . The committee shall advise
the commissioner on issues related to administration of the program. The committee is
governed by sections 15.014 and 15.059, and continues to exist while the program remains
in operation deleted text end new text begin , and three public members, for initial terms of two years for five directors and
three years for the other five directors. Subsequent board members shall be appointed by
the governor to serve staggered three-year terms new text end .

Subd. 5.

Employer eligibility.

(a) Procedures. All employers are eligible for
coverage through the program subject to the terms of this subdivision. The deleted text begin commissioner deleted text end new text begin
board new text end shall establish procedures for an employer to apply for coverage through the
program.

(b) Term. The initial term of an employer's coverage deleted text begin may deleted text end new text begin must new text end be for deleted text begin up to deleted text end new text begin at least new text end
two years from the effective date of the employer's application. After that, coverage
will be automatically renewed for an additional term new text begin of two years new text end unless the employer
gives notice of withdrawal from the program according to procedures established by
the deleted text begin commissioner deleted text end new text begin board new text end or the deleted text begin commissioner deleted text end new text begin board new text end gives notice to the employer of the
discontinuance of the program. The deleted text begin commissioner deleted text end new text begin board new text end may establish conditions under
which an employer may withdraw from the program prior to the expiration of a term,
including by reason of an increase in health coverage premiums of 50 percent or more
from one insurance year to the next. An employer that withdraws from the program may
not reapply for coverage for deleted text begin a period of time equal to its initial term of coverage deleted text end new text begin two years new text end .

(c) Minnesota work force. An employer is not eligible for coverage through the
program if deleted text begin five deleted text end new text begin 50 new text end percent or more of its eligible employees work primarily outside
Minnesota, except that an employer new text begin that either does or does not meet that requirement
new text end may apply to the program on behalf of only those employees who work primarily in
Minnesota new text begin , and the board may accept or reject the application new text end .

(d) Employee participation; aggregation of groups. An employer is not eligible
for coverage through the program unless its application includes all eligible employees
who work primarily in Minnesota, except employees who waive coverage as permitted by
subdivision 6. Private entities that are eligible to file a combined tax return for purposes
of state tax laws are considered a single employer, except as otherwise approved by the
deleted text begin commissioner deleted text end new text begin board new text end .

(e) Private employer. A private employer is not eligible for coverage unless it has
two or more eligible employees new text begin who live new text end in the state of Minnesota. If an employer has
only two eligible employees and one is the spouse, child, sibling, parent, or grandparent of
the other, the employer must be a Minnesota domiciled employer and have paid Social
Security or self-employment tax on behalf of both eligible employees.

(f) Minimum participation. The commissioner must require as a condition of
employer eligibility that at least 75 percent of its eligible employees who have not waived
coverage participate in the program. The participation level of eligible employees must be
determined at the initial offering of coverage and at the renewal date of coverage. For
purposes of this section, waiver of coverage includes only waivers due to coverage deleted text begin under
another group health benefit plan. deleted text end new text begin eligible for waiver under section 62L.03, subdivision 3,
paragraph (a). An employer may not offer any employee coverage other than that offered
by the board, expect with prior approval of the board. new text end

(g) Employer contribution. The deleted text begin commissioner deleted text end new text begin board new text end must require as a condition
of employer eligibility that the employer contribute at least 50 percent toward the cost
of the premium of the employee and may require that the contribution toward the cost
of coverage is structured in a way that promotes price competition among the coverage
options available through the program.

(h) Enrollment cap. The deleted text begin commissioner deleted text end new text begin board new text end may limit employer enrollment in the
program if necessary to avoid exceeding the program's reserve capacity.

Subd. 6.

Individual eligibility.

(a) Procedures. The deleted text begin commissioner deleted text end new text begin board new text end shall
establish procedures for eligible employees and other eligible individuals to apply for
coverage through the program.

(b) Employees. An employer shall determine when it applies to the program the
criteria its employees must meet to be eligible for coverage under its plan. An employer
may subsequently change the criteria annually or at other times with approval of the
deleted text begin commissioner deleted text end new text begin board new text end . The criteria must provide that new employees become eligible for
coverage after a probationary period of at least 30 days, but no more than 90 days.

(c) Other individuals. An employer may elect to cover under its plan:

(1) the spouse, dependent children, and dependent grandchildren of a covered
employee;

(2) a retiree who is eligible to receive a pension or annuity from the employer and a
covered retiree's spouse, dependent children, and dependent grandchildren;

(3) the surviving spouse, dependent children, and dependent grandchildren of a
deceased employee or retiree, if the spouse, children, or grandchildren were covered
at the time of the death;

(4) a covered employee who becomes disabled, as provided in sections 62A.147
and 62A.148; or

(5) any other categories of individuals for whom group coverage is required by
state or federal law.

An employer shall determine when it applies to the program the criteria individuals
in these categories must meet to be eligible for coverage. An employer may subsequently
change the criteria annually, or at other times with approval of the deleted text begin commissioner deleted text end new text begin board new text end .
The criteria for dependent children and dependent grandchildren may be no more
inclusive than the criteria under section 43A.18, subdivision 2. This paragraph shall
not be interpreted as relieving the program from compliance with any federal and state
continuation of coverage requirements.

(d) Waiver and late entrance. An eligible individual may waive coverage at the
time the employer joins the program or when coverage first becomes available. The
deleted text begin commissioner deleted text end new text begin board new text end may establish a preexisting condition exclusion of not more than 18
months for late entrants as defined in section 62L.02, subdivision 19.

(e) Continuation coverage. The program shall provide all continuation coverage
required by state and federal law.

Subd. 7.

Coverage.

Coverage deleted text begin is available through the program beginning on
July 1, 1993. Until an arrangement is in place to provide coverage deleted text end new text begin may be provided new text end
through a transfer of risk to one or more carriers regulated under chapter 62A, 62C, or
62D deleted text begin , the commissioner shall solicit bids under section 43A.23, from carriers regulated
under chapters 62A, 62C, and 62D, to provide coverage of eligible individuals. The
commissioner shall provide coverage through contracts with carriers, unless the
commissioner receives no reasonable bids from carriers deleted text end new text begin ; through a group self-insured
arrangement under chapter 62H; or through a combination of those methods. The board
may, on behalf of the program, participate in an insured or self-insured reinsurance pool new text end .

(a) Health coverage. Health coverage is available to all employers in the program.
The deleted text begin commissioner deleted text end new text begin board new text end shall attempt to establish health coverage options that have
strong care management features to control costs and promote quality and shall attempt to
make a choice of health coverage options available. Health coverage for a retiree who
is eligible for the federal Medicare program must be administered as though the retiree
is enrolled in Medicare parts A deleted text begin and deleted text end new text begin , new text end B new text begin , and D new text end . deleted text begin To the extent feasible as determined by
the commissioner and in the best interests of the program, the commissioner shall model
coverage after the plan established in section 43A.18, subdivision 2. deleted text end Health coverage
must include at least the benefits required of a carrier regulated under chapter 62A, 62C,
or 62D for comparable coverage. deleted text begin Coverage under this paragraph must not be provided
as part of the health plans available to state employees. deleted text end

(b) new text begin Choice of providers. All benefits provided by the program relating to expenses
incurred for medical treatment or services of a health care provider must also include
treatment and services of any other licensed, certified, or registered health care provider to
the extent that the services and treatment are within the scope of the provider's licensure,
certification, or registration.
new text end

new text begin (c) new text end Optional coverages. In addition to offering health coverage, the deleted text begin commissioner deleted text end new text begin
board new text end may arrange to offer dental new text begin or other health-related new text end coverage through the program.
Employers with health coverage may choose to offer dental new text begin or other health-related
new text end coverage according to the terms established by the deleted text begin commissioner deleted text end new text begin board new text end .

deleted text begin (c) deleted text end new text begin (d) new text end Open enrollment. The program must meet all underwriting requirements of
chapter 62L and must provide periodic open enrollments for eligible individuals for those
coverages where a choice exists.

deleted text begin (d) deleted text end new text begin (e) new text end Technical assistance. The deleted text begin commissioner deleted text end new text begin board new text end may arrange for technical
assistance and referrals for eligible employers in areas such as health promotion and
wellness, employee benefits structure, tax planning, and health care analysis services
as described in section 62J.2930.

Subd. 8.

Premiums.

(a) Payments. Employers enrolled in the program shall pay
premiums according to terms established by the deleted text begin commissioner deleted text end new text begin board new text end . If an employer
fails to make the required payments, the deleted text begin commissioner deleted text end new text begin board new text end may cancel coverage and
pursue other civil remedies.

(b) Rating method. The deleted text begin commissioner deleted text end new text begin board new text end shall determine the premium rates and
rating method for the program. The rating method for eligible small employers must meet
or exceed the requirements of chapter 62L. The rating methods must recover in premiums
all of the ongoing costs for deleted text begin state deleted text end administration and for maintenance of a premium stability
and claim fluctuation reserve. deleted text begin On June 30, 1999, after paying all necessary and reasonable
expenses, the commissioner must apply up to $2,075,000 of any remaining balance in
the Minnesota employees' insurance trust fund to repayment of any amounts drawn or
expended for this program from the health care access fund. deleted text end new text begin The board may decide to rate
specific employers separately for premium purposes, if the board determines that doing
so is in the best interests of the program.
new text end

(c) Taxes and assessments. To the extent that the program operates as a self-insured
group, the premiums paid to the program are not subject to the taxes imposed by chapter
297I, but the program is subject to a Minnesota Comprehensive Health Association
assessment under section 62E.11.

Subd. 9.

deleted text begin Minnesota employees insurance trust fund. deleted text end

deleted text begin (a) deleted text begin Contents. deleted text end The Minnesota
employees insurance trust fund in the state treasury consists of deposits received from
eligible employers and individuals, contractual settlements or rebates relating to the
program, investment income or losses, and direct appropriations.
deleted text end

deleted text begin (b) deleted text begin Appropriation. deleted text end All money in the fund is appropriated to the commissioner to
pay insurance premiums, approved claims, refunds, administrative costs, and other costs
necessary to administer the program.
deleted text end

deleted text begin (c) deleted text end Reserves. new text begin (a) new text end For any coverages for which the program does not contract to
transfer full financial responsibility, the deleted text begin commissioner deleted text end new text begin board new text end shall establish and maintain
reserves:

(1) for claims in process, incomplete and unreported claims, premiums received but
not yet earned, and all other accrued liabilities; and

(2) to ensure premium stability and the timely payment of claims in the event of
adverse claims experience. The reserve for premium stability and claim fluctuations must
be established according to deleted text begin the deleted text end new text begin sound actuarial new text end standards deleted text begin of section 62C.09, subdivision 3,
except that the reserve may exceed the upper limit under this standard until July 1, 1997 deleted text end .

deleted text begin (d) deleted text begin Investments. deleted text end The State Board of Investment shall invest the fund's assets
according to section . Investment income and losses attributable to the fund must
be credited to the fund.
deleted text end

new text begin (b) If the board determines that its reserves are inadequate, the board may access
additional funds as needed in the form of loans from the health care access fund, not to
exceed a total indebtedness of $2,000,000 at any one time. Such loans accrue interest at
three percent per annum simple interest and must be payable in monthly installments
beginning no later than two years after the board first provides coverage and must be fully
repaid no later than five years after that date. The monthly repayment installments must be
reamortized as needed to reflect repayments and additional loan amounts accessed, so that
monthly installments will be sufficient to repay the existing balance, including accrued
interest, at the end of that five-year period. The board may make additional repayments of
principal and interest at any time. The $2,000,000 amount is available until the end of
that five-year period. Amounts of principal repaid are available to be accessed for new
loans within that period.
new text end

Subd. 10.

Program status.

The Minnesota employees insurance program is a state
program to provide the advantages of a large pool to deleted text begin small deleted text end employers for deleted text begin purchasing deleted text end new text begin
providing new text end health coverage, other coverages, and related services from insurance
companies, health maintenance organizations, and other organizations. The program is not
an insurance company. Coverage under this program shall be considered a certificate of
insurance or similar evidence of coverage and is subject to all applicable requirements
of chapters 60A, 62A, 62C, 62E, 62H, 62L, and 72A, and deleted text begin is deleted text end new text begin the coverage, premiums,
and reserves are new text end subject to regulation by the commissioner of commerce to the extent
applicable.

Subd. 12.

Status of agents.

Notwithstanding sections 60K.49 and 72A.07, the
program may use, and pay referral fees, commissions, or other compensation to, agents
licensed as insurance producers under chapter 60K or licensed under section 62C.17,
regardless of whether the agents are appointed to represent the particular health carriers or
community integrated service networks that provide the coverage available through the
program. When acting under this subdivision, an agent is not an agent of the health carrier
or community integrated service network, with respect to that transaction.

Sec. 3. new text begin APPROPRIATIONS.
new text end

new text begin (a) $2,000,000 is appropriated from the health care access fund to the insurance trust
fund for the purpose of the as-needed loans to the Public Employees Insurance Program,
as provided in Minnesota Statutes, section 43A.316, subdivision 9, paragraph (b).
new text end

new text begin (b) $2,000,000 is appropriated from the health care access fund to the commissioner
of commerce for the as-needed loans to the Minnesota Employees Insurance Program, as
provided in Minnesota Statutes, section 43A.317, subdivision 9, paragraph (b).
new text end

Sec. 4. new text begin REVISOR'S INSTRUCTION.
new text end

new text begin The revisor of statutes shall recode:
new text end

new text begin (1) Minnesota Statutes, section 43A.316, as Minnesota Statutes, section 62U.15; and
new text end

new text begin (2) Minnesota Statutes, section 43A.317, as Minnesota Statutes, section 62U.16.
new text end