SF 440

as introduced - 83rd Legislature (2003 - 2004) Posted on 12/15/2009 12:00am

  1.1                          A bill for an act 
  1.2             relating to health maintenance organizations; 
  1.3             modifying enrollee cost sharing; amending Minnesota 
  1.4             Statutes 2002, section 62D.095, subdivisions 3, 4.  
  1.5   BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
  1.6      Section 1.  Minnesota Statutes 2002, section 62D.095, 
  1.7   subdivision 3, is amended to read: 
  1.8      Subd. 3.  [DEDUCTIBLES.] (a) A health maintenance 
  1.9   contract issued by a health maintenance organization that is 
  1.10  assessed less than three percent of the total annual amount 
  1.11  assessed by the Minnesota comprehensive health association may 
  1.12  impose deductibles not to exceed $3,000 $1,000 per person, per 
  1.13  year and $6,000 per family, per year.  For purposes of the 
  1.14  percentage calculation, a health maintenance organization's 
  1.15  assessments include those of its affiliates.  
  1.16     (b) All other health maintenance contracts may impose 
  1.17  deductibles not to exceed $2,250 per person, per year and $4,500 
  1.18  per family, per year.  
  1.19     Sec. 2.  Minnesota Statutes 2002, section 62D.095, 
  1.20  subdivision 4, is amended to read: 
  1.21     Subd. 4.  [ANNUAL OUT-OF-POCKET MAXIMUMS.] (a) A health 
  1.22  maintenance contract issued by a health maintenance organization 
  1.23  that is assessed less than three percent of the total annual 
  1.24  amount assessed by the Minnesota comprehensive health 
  1.25  association must include a limitation not to exceed 
  2.1   $4,500 $3,000 per person and $7,500 $5,000 per family on total 
  2.2   annual out-of-pocket enrollee cost-sharing expenses.  For 
  2.3   purposes of the percentage calculation, a health maintenance 
  2.4   organization's assessments include those of its affiliates.  
  2.5      (b) All other health maintenance contracts must include a 
  2.6   limitation not to exceed $3,000 per person and $6,000 per family 
  2.7   on total annual out-of-pocket enrollee cost-sharing expenses.