Minnesota Legislature
HF 3225
as introduced - 89th Legislature (2015 - 2016) Posted on 03/16/2016 11:46am
Bill Text Versions
| Engrossments | ||
|---|---|---|
| Introduction | Posted on 03/16/2016 |
Current Version - as introduced
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A bill for an act
relating to insurance; making the state of Minnesota a single geographic rating
area for purposes of setting premium rates for individual health plans; amending
Minnesota Statutes 2014, section 62A.65, subdivision 3.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
Section 1.
Minnesota Statutes 2014, section 62A.65, subdivision 3, is amended to read:
Subd. 3.
Premium rate restrictions.
No individual health plan may be offered,
sold, issued, or renewed to a Minnesota resident unless the premium rate charged is
determined in accordance with the following requirements:
(a) Premium rates may vary based upon the ages of covered persons in accordance
with the provisions of the Affordable Care Act.
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(b) Premium rates may vary based upon geographic rating area. The commissioner
shall grant approval if the following conditions are met:
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(1) the areas are established in accordance with the Affordable Care Act;
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(2) each geographic region must be composed of no fewer than seven counties that
create a contiguous region; and
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(3) the health carrier provides actuarial justification acceptable to the commissioner
for the proposed geographic variations in premium rates for each area, establishing that the
variations are based upon differences in the cost to the health carrier of providing coverage.
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deleted text begin (c)deleted text end new text begin (b)new text end Premium rates may vary based upon tobacco use, in accordance with the
provisions of the Affordable Care Act.
deleted text begin (d)deleted text end new text begin (c)new text end In developing its premiums for a health plan, a health carrier shall take into
account only deleted text begin the following factors:
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deleted text begin (1)deleted text end actuarially valid differences in rating factors permitted under paragraphs (a)
and deleted text begin (c); anddeleted text end new text begin (b).
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(2) actuarially valid geographic variations if approved by the commissioner as
provided in paragraph (b).
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new text begin
(d) The state of Minnesota shall constitute a single geographic rating area for
purposes of setting premium rates.
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(e) The premium charged with respect to any particular individual health plan shall
not be adjusted more frequently than annually or January 1 of the year following initial
enrollment, except that the premium rates may be changed to reflect:
(1) changes to the family composition of the policyholder;
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(2) changes in geographic rating area of the policyholder, as provided in paragraph
(b);
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deleted text begin (3)deleted text end new text begin (2)new text end changes in age, as provided in paragraph (a);
deleted text begin (4)deleted text end new text begin (3)new text end changes in tobacco use, as provided in paragraph deleted text begin (c)deleted text end new text begin (b)new text end ;
deleted text begin (5)deleted text end new text begin (4)new text end transfer to a new health plan requested by the policyholder; or
deleted text begin (6)deleted text end new text begin (5)new text end other changes required by or otherwise expressly permitted by state or federal
law or regulations.
(f) All premium variations must be justified in initial rate filings and upon request of
the commissioner in rate revision filings. All rate variations are subject to approval by
the commissioner.
(g) The loss ratio must comply with the section 62A.021 requirements for individual
health plans.
(h) The rates must not be approved, unless the commissioner has determined that the
rates are reasonable. In determining reasonableness, the commissioner shall consider the
growth rates applied under section 62J.04, subdivision 1, paragraph (b), to the calendar
year or years that the proposed premium rate would be in effect and actuarially valid
changes in risks associated with the enrollee populations.
(i) A health carrier may, as part of a minimum lifetime loss ratio guarantee filing
under section 62A.02, subdivision 3a, include a rating practices guarantee as provided in
this paragraph. The rating practices guarantee must be in writing and must guarantee that
the policy form will be offered, sold, issued, and renewed only with premium rates and
premium rating practices that comply with subdivisions 2, 3, 4, and 5. The rating practices
guarantee must be accompanied by an actuarial memorandum that demonstrates that the
premium rates and premium rating system used in connection with the policy form will
satisfy the guarantee. The guarantee must guarantee refunds of any excess premiums to
policyholders charged premiums that exceed those permitted under subdivision 2, 3, 4, or
5. A health carrier that complies with this paragraph in connection with a policy form is
exempt from the requirement of prior approval by the commissioner under paragraphs
deleted text begin (b),deleted text end (f)deleted text begin ,deleted text end and (h).
(j) The commissioner may establish regulations to implement the provisions of
this subdivision.
new text begin EFFECTIVE DATE. new text end
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This section is effective for health plans offered, issued,
or renewed on or after January 1, 2017.
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