Minnesota Legislature
HF 3245
1st Engrossment - 86th Legislature (2009 - 2010) Posted on 03/17/2010 12:46pm
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A bill for an act
relating to insurance; creating interstate health insurance choice; regulating
flexible benefits plans; authorizing rulemaking; proposing coding for new law in
Minnesota Statutes, chapter 62L; proposing coding for new law as Minnesota
Statutes, chapter 62V; repealing Minnesota Statutes 2008, section 62L.056.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
ARTICLE 1
INTERSTATE HEALTH INSURANCE COMPETITION
Section 1.
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[62V.01] CITATION AND PURPOSE.
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This chapter may be cited as the "Interstate Health Insurance Competition Act."
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Sec. 2.
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[62V.02] DEFINITIONS.
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new text begin Subdivision 1. new text end
new text begin Application. new text end
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The definitions in this section apply to this chapter.
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new text begin Subd. 2. new text end
new text begin Commissioner. new text end
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"Commissioner" means the commissioner of commerce.
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new text begin Subd. 3. new text end
new text begin Covered person. new text end
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"Covered person" means an individual, whether a
policyholder, subscriber, enrollee, or member of a health plan who is entitled to health
care services provided, arranged for, paid for, or reimbursed pursuant to a health plan.
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new text begin Subd. 4. new text end
new text begin Domestic health insurer. new text end
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"Domestic health insurer" means an insurer
licensed to sell, offer, or provide health plans in Minnesota.
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new text begin Subd. 5. new text end
new text begin Hazardous financial condition. new text end
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"Hazardous financial condition" means
that, based on its present or reasonably anticipated financial condition, an out-of-state
health insurer is unlikely to be able to meet obligations to policyholders with respect to
known claims or to any other obligations in the normal course of business.
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new text begin Subd. 6. new text end
new text begin Health care provider or provider. new text end
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"Health care provider" or "provider"
means any hospital, physician, or other person authorized by statute, licensed, or certified
to furnish health care services.
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new text begin Subd. 7. new text end
new text begin Health care services. new text end
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"Health care services" means the furnishing of
services to any individual for the purpose of preventing, alleviating, curing, or healing
human illness, injury, or physical disability.
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new text begin Subd. 8. new text end
new text begin Health plan. new text end
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"Health plan" means an arrangement for the delivery of
health care, on an individual basis, in which an insurer undertakes to provide, arrange
for, pay for, or reimburse any of the costs of health care services for a covered person
that is in accordance with the laws of any state. Health plan does not include short-term
health coverage, accident only, limited or specified disease, long-term care or individual
conversion policies or contracts, or policies or contracts designed for issuance to persons
eligible for coverage under title XVIII of the federal Social Security Act, known as
Medicare, or any other similar coverage under state or federal governmental plans.
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new text begin Subd. 9. new text end
new text begin Insurer. new text end
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"Insurer" means any entity that is authorized to sell, offer, or
provide a health plan, including an entity providing a plan of health insurance, health
benefits, or health services, an accident and sickness insurance company, a health
maintenance organization, a corporation offering a health plan, a fraternal benefit society,
a community integrated service network, or any other entity that provides health plans
subject to state insurance regulation, or a health carrier described in section 62A.011,
subdivision 2.
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new text begin Subd. 10. new text end
new text begin Out-of-state health plan. new text end
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"Out-of-state health plan" means a health plan
that was filed for use in any other state.
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new text begin Subd. 11. new text end
new text begin Resident. new text end
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"Resident" means an individual whose primary residence is in
Minnesota and who is present in Minnesota for at least six months of the calendar year.
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Sec. 3.
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[62V.03] OUT-OF-STATE HEALTH PLANS TO MINNESOTA
RESIDENTS.
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new text begin Subdivision 1. new text end
new text begin Eligibility. new text end
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(a) Notwithstanding any other law to the contrary, a
health insurer may sell, offer, or issue an out-of-state health plan to residents in Minnesota,
if the following requirements are met:
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(1) the out-of-state health plan must be in compliance with all applicable Minnesota
laws that apply to the type of health plan offered;
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(2) the out-of-state health plan must not be issued, nor any application, rider, or
endorsement be used in connection with the plan, until the form has received prior
approval in Minnesota;
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(3) the offering insurer must have a certificate of authority to do business in
Minnesota pursuant to section 60A.07; and
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(4) the out-of-state health plan shall participate, on a nondiscriminatory basis, in the
Minnesota Life and Health Insurance Guaranty Association created under chapter 61B.
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(b) The provisions of section 62A.02, subdivision 2, shall not apply to plans issued
under this section.
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new text begin Subd. 2. new text end
new text begin Minnesota laws applicable. new text end
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An out-of-state health plan sold, offered, or
provided by a health insurer in Minnesota in accordance with this chapter is subject to laws
applicable to the sale, offering, or provision of accident and sickness insurance or health
plans including, but not limited to, requirements imposed by chapters 62A, 62E, and 62Q.
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new text begin Subd. 3. new text end
new text begin Nature of out-of-state health insurer. new text end
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The out-of-state health insurer
may be a for-profit or nonprofit company.
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Sec. 4.
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[62V.04] CERTIFICATE OF AUTHORITY TO OFFER OUT-OF-STATE
HEALTH PLANS.
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new text begin Subdivision 1. new text end
new text begin Issuance of certificate. new text end
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A health insurer may apply for a certificate
that authorizes the health insurer to offer out-of-state health insurance plans in Minnesota,
using a form prescribed by the commissioner. Upon application, the commissioner shall
issue a certificate to the health insurer unless the commissioner determines that the
out-of-state health insurer:
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(1) will not provide a health plan in compliance with this chapter;
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(2) is in a hazardous financial condition, as determined by an examination by the
commissioner conducted in accordance with the Financial Analysis Handbook of the
National Association of Insurance Commissioners; or
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(3) has not adopted procedures to ensure compliance with all applicable laws
governing the confidentiality of its records with respect to providers and covered persons.
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new text begin Subd. 2. new text end
new text begin Validity. new text end
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A certificate of authority issued pursuant to this section is valid
for three years from the date of issuance by the commissioner.
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new text begin Subd. 3. new text end
new text begin Rulemaking authority. new text end
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The commissioner shall adopt rules that include:
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(1) procedures for an out-of-state health insurer to renew a certificate of authority,
consistent with this chapter; and
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(2) a certificate of authority application and renewal fees, the amount of which must
be no greater than is reasonably necessary to enable the commissioner of commerce
to carry out the provisions of this chapter.
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new text begin Subd. 4. new text end
new text begin Applicability of certain statutory requirements. new text end
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A health insurer
offering health plans pursuant to this chapter shall comply with:
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(1) protections for covered persons from unfair trade practices applicable to accident
and sickness insurance or health plans pursuant to chapter 72A;
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(2) the capital and surplus requirements for licensure specified in chapter 60A, as
determined applicable to out-of-state health insurers by the commissioner;
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(3) applicable requirements of this chapter and sections 297I.05, subdivision 12, and
62E.11, pertaining to taxes and assessments imposed on health insurers selling individual
health insurance policies in Minnesota; and
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(4) applicable requirements of chapter 60A regarding the obtaining of authority to
transact business in Minnesota.
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Sec. 5.
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[62V.06] REVOCATION OF CERTIFICATE OF AUTHORITY;
MARKETING MATERIALS.
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new text begin Subdivision 1. new text end
new text begin Revocation. new text end
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The commissioner may deny, revoke, or suspend, after
notice and opportunity to be heard, a certificate of authority issued to a health insurer
pursuant to this chapter for a violation of this chapter, including any finding by the
commissioner that a health insurer is no longer in compliance with any of the conditions
for issuance of a certificate of authority set forth in section 60A.07, or the administrative
rules adopted pursuant to this chapter. The commissioner shall provide for an appropriate
and timely right of appeal for the out-of-state health insurer whose certificate is denied,
revoked, or suspended.
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new text begin Subd. 2. new text end
new text begin Fair marketing standards. new text end
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The commissioner shall establish fair
marketing standards for marketing materials used by out-of-state health insurers to market
health plans to residents in Minnesota, which standards must be consistent with those
applicable to health plans offered by a domestic health insurer pursuant to chapter 72A.
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new text begin Subd. 3. new text end
new text begin Nondiscrimination. new text end
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The procedures and standards established under
subdivision 2 must be applied on a nondiscriminatory basis so as not to place greater
responsibilities on out-of-state health insurers than the responsibilities placed on domestic
health insurers doing business in Minnesota.
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Sec. 6.
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[62V.07] RULES.
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The commissioner shall adopt rules to effectuate the purposes of this chapter. The
rules must not:
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(1) directly or indirectly require an insurer offering out-of-state health plans to,
directly or indirectly, modify coverage or benefit requirements or restrict underwriting
requirements or premium ratings in any way that conflicts with the insurer's domiciliary
state's laws or regulations, except as necessary to comply with Minnesota law;
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(2) provide for regulatory requirements that are more stringent than those applicable
to carriers providing Minnesota health plans; or
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(3) require any out-of-state health plan issued by the health insurer to be
countersigned by an insurance agent or broker residing in Minnesota.
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ARTICLE 2
FLEXIBLE BENEFITS PLANS
Section 1.
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[62L.0561] FLEXIBLE BENEFITS PLANS.
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new text begin Subdivision 1. new text end
new text begin Definitions. new text end
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For the purposes of this section, the terms used in this
section have the meaning defined in section 62Q.01, except that "health plan" includes
individual and group coverage.
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new text begin Subd. 2. new text end
new text begin Flexible benefits plan. new text end
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Notwithstanding any provision of this chapter,
chapter 363A, or any other law to the contrary, a health plan company may offer, sell,
issue, and renew a health plan that is a flexible benefits plan under this section if the
following requirements are satisfied:
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(1) the health plan must be offered in compliance with the laws of this state, except
as otherwise permitted in this section;
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(2) the health plan must be designed to enable covered persons to better manage
costs and coverage options through the use of co-pays, deductibles, and other cost-sharing
arrangements;
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(3) the health plan may modify or exclude any or all coverages of benefits that
would otherwise be required by law, except for maternity benefits and other benefits
required under federal law;
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(4) each health plan and plan's premiums must be approved by the commissioner
of health or commerce, whichever is appropriate under section 62Q.01, subdivision 2,
but neither commissioner may disapprove a plan on the grounds of a modification or
exclusion permitted under clause (3); and
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(5) prior to sale of the health plan, the purchaser must be given a written list of the
coverages otherwise required by law that are modified or excluded in the health plan.
The list must include a description of each coverage in the list and indicate whether the
coverage is modified or excluded. If coverage is modified, the list must describe the
modification. The list may, but is not required to, also list any or all coverages otherwise
required by law that are included in the health plan and indicate that they are included.
The health plan company must require that a copy of this written list be provided, prior
to the effective date of the health plan, to each enrollee or employee who is eligible for
health coverage under the plan.
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new text begin Subd. 3. new text end
new text begin Employer health plan. new text end
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An employer may provide a health plan permitted
under this section to its employees, the employees' dependents, and other persons eligible
for coverage under the employer's plan, notwithstanding chapter 363A or any other law
to the contrary.
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new text begin EFFECTIVE DATE. new text end
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This section is effective January 1, 2012.
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Sec. 2. new text begin REPEALER.
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Minnesota Statutes 2008, section 62L.056,
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is repealed.
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new text begin EFFECTIVE DATE. new text end
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This section is effective January 1, 2012.
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