HF 4120

as introduced - 85th Legislature (2007 - 2008) Posted on 12/15/2009 12:00am

A bill for an act
relating to insurance; creating the Minnesota comprehensive health plan;
requiring all health carriers and employers to offer the basic health plan;
phasing in the state public health programs into the basic health plan; amending
Minnesota Statutes 2006, sections 62A.65, subdivisions 1, 6; 62L.08, subdivision
1; proposing coding for new law in Minnesota Statutes, chapter 62A.

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

Section 1.

Minnesota Statutes 2006, section 62A.65, subdivision 1, is amended to read:

Subdivision 1.

Applicability.

No health carrier, as defined in section 62A.011, shall
offer, sell, issue, or renew any individual health plan, as defined in section 62A.011, to a
Minnesota resident except in compliance with this section new text begin or section 62A.68 new text end . This section
does not apply to the Comprehensive Health Association established in section 62E.10.

Sec. 2.

Minnesota Statutes 2006, section 62A.65, subdivision 6, is amended to read:

Subd. 6.

Guaranteed issue not required.

Nothing in this section requires a
health carrier to initially issue a health plan to a Minnesota resident, except as otherwise
expressly provided in subdivision 4 or 5 new text begin and section 62A.68 new text end .

Sec. 3.

new text begin [62A.68] MINNESOTA COMPREHENSIVE HEALTH PLAN.
new text end

new text begin Subdivision 1. new text end

new text begin Required offering. new text end

new text begin (a) All health carriers shall offer a health
plan that is designated as the Minnesota comprehensive health plan that satisfies all
requirements of this section. Health carriers may offer additional health plans, in addition
to the comprehensive health plan, to the extent otherwise authorized by law.
new text end

new text begin (b) All employers subject to chapter 268 must offer the comprehensive health plan
to their employees. Employers that are required to offer the comprehensive health plan
shall establish a Section 125 Plan to allow their employees to purchase the comprehensive
health plan for themselves and their dependents with pretax dollars. Nothing in this section
requires employers to purchase group health insurance coverage for their employees. For
purposes of this section, a "Section 125 Plan" means a cafeteria or premium-only plan
under section 125 of the Internal Revenue Code that allows employees to pay for health
insurance premiums with pretax dollars.
new text end

new text begin Subd. 2. new text end

new text begin Covered services. new text end

new text begin The comprehensive health plan must include, at a
minimum, the services provided under a number three qualified plan as described in
section 62E.06. The basic health plan must include all benefits required by law.
new text end

new text begin Subd. 3. new text end

new text begin Coinsurance. new text end

new text begin The comprehensive health plan shall cover, at a minimum,
80 percent of the cost of the covered services in excess of an annual deductible.
new text end

new text begin Subd. 4. new text end

new text begin Maximum deductible. new text end

new text begin The comprehensive health plan shall not include
an annual deductible that exceeds $2,000 per individual and $4,000 per family.
new text end

new text begin Subd. 5. new text end

new text begin Out-of-pocket maximum. new text end

new text begin The total annual out-of-pocket expenses for the
comprehensive health plan shall not exceed $5,000 per individual and $10,000 per family.
new text end

new text begin Subd. 6. new text end

new text begin Lifetime maximum benefit. new text end

new text begin The comprehensive health plan shall not
include a lifetime maximum benefit.
new text end

new text begin Subd. 7. new text end

new text begin Guaranteed issue. new text end

new text begin Notwithstanding section 62L.12, the comprehensive
health plan shall be offered to any individual on a guaranteed issue basis.
new text end

new text begin Subd. 8. new text end

new text begin Premiums. new text end

new text begin (a) Notwithstanding sections 62A.65 and 62L.08, the
comprehensive health plan shall not determine premium rates through a method that is in
any way based upon the gender, the health status, age, occupation, or geographic area of
the individual or eligible employee or dependents.
new text end

new text begin (b) The premiums shall be the same to all enrollees regardless of whether it is
purchased through the individual health plan market or through an employer.
new text end

new text begin Subd. 9. new text end

new text begin MCHA and premium tax. new text end

new text begin The premiums paid to health carriers for the
comprehensive health plan are not subject to the taxes imposed under chapter 297I and to
a Minnesota Comprehensive Health Association assessment under section 62E.11.
new text end

new text begin Subd. 10. new text end

new text begin Risk adjustment. new text end

new text begin The commissioner of commerce shall establish and
administer a risk-adjustment mechanism to spread the risk of high-cost enrollees enrolled
in the comprehensive health plan across all the health carriers.
new text end

new text begin Subd. 11. new text end

new text begin Penalty. new text end

new text begin (a) Beginning January 1, 2010, one percent of the gross annual
premiums of each health carrier required to offer the basic health plan under this section
must be premiums from the basic health plan.
new text end

new text begin (b) If the premium requirement of paragraph (a) is not met by the health carrier, the
health carrier shall be assessed an amount equal to .05 percent of the health carrier's gross
premium minus the amount of premiums that were attributable to the basic health plan.
new text end

new text begin (c) The commissioner of commerce shall calculate any assessments owed and shall
establish a mechanism to collect the assessments. All assessments collected shall be
deposited to the health care access fund.
new text end

Sec. 4.

Minnesota Statutes 2006, section 62L.08, subdivision 1, is amended to read:

Subdivision 1.

Rate restrictions.

Premium rates for all health benefit plans sold or
issued to small employers are subject to the restrictions specified in this section new text begin except
as otherwise expressly authorized under section 62A.68 new text end .

Sec. 5. new text begin STATE HEALTH CARE PROGRAMS.
new text end

new text begin Subdivision 1. new text end

new text begin Consolidation plan. new text end

new text begin The commissioners of human services,
commerce, and health shall prepare a report for implementing the health care reforms
specified in this act. The report must be submitted to the legislature by January 15, 2009.
The report shall include a plan, budget, timeline, and proposed legislation to consolidate
and reform medical assistance, general assistance medical care, and the MinnesotaCare
program. Under the reformed system, the medical assistance program will continue to
provide health coverage for the elderly and disabled. Individuals and families, who are
currently eligible for a state health care program, will receive a voucher to purchase
the Minnesota comprehensive health plan described in Minnesota Statutes, section
62A.68. The amount of the voucher shall be based on income and family size and shall be
determined according to criteria developed by the commissioners. The voucher may be
used for both individual and group policies.
new text end

new text begin Subd. 2. new text end

new text begin Purchasing pool. new text end

new text begin (a) The report shall include the establishment of a public
corporation that will offer the Minnesota comprehensive health plan to individuals and
families that do not have access to employer-subsidized health coverage. The purchasing
pool shall include a risk-adjustment mechanism that will assign high-cost enrollees to a
health carrier in order to spread the risk of these enrollees across the health carriers.
new text end

new text begin (b) The report shall include a transition process for phasing out the Minnesota
Comprehensive Health Association.
new text end

new text begin Subd. 3. new text end

new text begin Federal waivers. new text end

new text begin The commissioner of human services shall seek
authorization from the federal government to implement this act in the form of waivers
or federal legislation. The commissioner shall seek appropriate federal approval to offer
a benefits plan that incorporates premiums and co-payments to the extent allowable
under federal law.
new text end