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Minnesota Legislature

Office of the Revisor of Statutes

SF 994

1st Engrossment - 83rd Legislature (2003 - 2004) Posted on 12/15/2009 12:00am

KEY: stricken = removed, old language.
underscored = added, new language.

Current Version - 1st Engrossment

  1.1                          A bill for an act 
  1.2             relating to insurance; permitting the comprehensive 
  1.3             health association to offer policies with higher 
  1.4             annual deductibles; permitting extension of the 
  1.5             writing carrier contract; clarifying the effective 
  1.6             date of coverage and other matters; amending Minnesota 
  1.7             Statutes 2002, sections 62E.08, subdivision 1; 
  1.8             62E.091; 62E.12; 62E.13, subdivision 2, by adding a 
  1.9             subdivision; 62E.14; 62E.18. 
  1.10  BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
  1.11     Section 1.  Minnesota Statutes 2002, section 62E.08, 
  1.12  subdivision 1, is amended to read: 
  1.13     Subdivision 1.  [ESTABLISHMENT.] The association shall 
  1.14  establish the following maximum premiums to be charged for 
  1.15  membership in the comprehensive health insurance plan: 
  1.16     (a) the premium for the number one qualified plan shall 
  1.17  range from a minimum of 101 percent to a maximum of 125 percent 
  1.18  of the weighted average of rates charged by those insurers and 
  1.19  health maintenance organizations with individuals enrolled in: 
  1.20     (1) $1,000 annual deductible individual plans of insurance 
  1.21  in force in Minnesota; 
  1.22     (2) individual health maintenance organization contracts of 
  1.23  coverage with a $1,000 annual deductible which are in force in 
  1.24  Minnesota; and 
  1.25     (3) other plans of coverage similar to plans offered by the 
  1.26  association based on generally accepted actuarial principles; 
  1.27     (b) the premium for the number two qualified plan shall 
  2.1   range from a minimum of 101 percent to a maximum of 125 percent 
  2.2   of the weighted average of rates charged by those insurers and 
  2.3   health maintenance organizations with individuals enrolled in: 
  2.4      (1) $500 annual deductible individual plans of insurance in 
  2.5   force in Minnesota; 
  2.6      (2) individual health maintenance organization contracts of 
  2.7   coverage with a $500 annual deductible which are in force in 
  2.8   Minnesota; and 
  2.9      (3) other plans of coverage similar to plans offered by the 
  2.10  association based on generally accepted actuarial principles; 
  2.11     (c) the premium premiums for the plan plans with a 
  2.12  $2,000, $5,000, or $10,000 annual deductible shall range from a 
  2.13  minimum of 101 percent to a maximum of 125 percent of the 
  2.14  weighted average of rates charged by those insurers and health 
  2.15  maintenance organizations with individuals enrolled in: 
  2.16     (1) $2,000, $5,000, or $10,000 annual deductible individual 
  2.17  plans, respectively, in force in Minnesota; and 
  2.18     (2) individual health maintenance organization contracts of 
  2.19  coverage with a $2,000, $5,000, or $10,000 annual deductible, 
  2.20  respectively, which are in force in Minnesota; or 
  2.21     (3) other plans of coverage similar to plans offered by the 
  2.22  association based on generally accepted actuarial principles; 
  2.23     (d) the premium for each type of Medicare supplement plan 
  2.24  required to be offered by the association pursuant to section 
  2.25  62E.12 shall range from a minimum of 101 percent to a maximum of 
  2.26  125 percent of the weighted average of rates charged by those 
  2.27  insurers and health maintenance organizations with individuals 
  2.28  enrolled in:  
  2.29     (1) Medicare supplement plans in force in Minnesota; 
  2.30     (2) health maintenance organization Medicare supplement 
  2.31  contracts of coverage which are in force in Minnesota; and 
  2.32     (3) other plans of coverage similar to plans offered by the 
  2.33  association based on generally accepted actuarial principles; 
  2.34  and 
  2.35     (e) the charge for health maintenance organization coverage 
  2.36  shall be based on generally accepted actuarial principles. 
  3.1      The list of insurers and health maintenance organizations 
  3.2   whose rates are used to establish the premium for coverage 
  3.3   offered by the association pursuant to paragraphs (a) to (d) 
  3.4   shall be established by the commissioner on the basis of 
  3.5   information which shall be provided to the association by all 
  3.6   insurers and health maintenance organizations annually at the 
  3.7   commissioner's request.  This information shall include the 
  3.8   number of individuals covered by each type of plan or contract 
  3.9   specified in paragraphs (a) to (d) that is sold, issued, and 
  3.10  renewed by the insurers and health maintenance organizations, 
  3.11  including those plans or contracts available only on a renewal 
  3.12  basis.  The information shall also include the rates charged for 
  3.13  each type of plan or contract.  
  3.14     In establishing premiums pursuant to this section, the 
  3.15  association shall utilize generally accepted actuarial 
  3.16  principles, provided that the association shall not discriminate 
  3.17  in charging premiums based upon sex.  In order to compute a 
  3.18  weighted average for each type of plan or contract specified 
  3.19  under paragraphs (a) to (d), the association shall, using the 
  3.20  information collected pursuant to this subdivision, list 
  3.21  insurers and health maintenance organizations in rank order of 
  3.22  the total number of individuals covered by each insurer or 
  3.23  health maintenance organization.  The association shall then 
  3.24  compute a weighted average of the rates charged for coverage by 
  3.25  all the insurers and health maintenance organizations by: 
  3.26     (1) multiplying the numbers of individuals covered by each 
  3.27  insurer or health maintenance organization by the rates charged 
  3.28  for coverage; 
  3.29     (2) separately summing both the number of individuals 
  3.30  covered by all the insurers and health maintenance organizations 
  3.31  and all the products computed under clause (1); and 
  3.32     (3) dividing the total of the products computed under 
  3.33  clause (1) by the total number of individuals covered.  
  3.34     The association may elect to use a sample of information 
  3.35  from the insurers and health maintenance organizations for 
  3.36  purposes of computing a weighted average.  In no case, however, 
  4.1   may a sample used by the association to compute a weighted 
  4.2   average include information from fewer than the two insurers or 
  4.3   health maintenance organizations highest in rank order.  
  4.4      Sec. 2.  Minnesota Statutes 2002, section 62E.091, is 
  4.5   amended to read: 
  4.6      62E.091 [APPROVAL OF STATE PLAN PREMIUMS.] 
  4.7      The association shall submit to the commissioner any 
  4.8   premiums it proposes to become effective for coverage under the 
  4.9   comprehensive health insurance plan, pursuant to section 62E.08, 
  4.10  subdivision 3.  No later than 45 days before the effective date 
  4.11  for premiums specified in section 62E.08, subdivision 3, the 
  4.12  commissioner shall approve, modify, or reject the proposed 
  4.13  premiums on the basis of the following criteria:  
  4.14     (a) whether the association has complied with the 
  4.15  provisions of section 62E.11, subdivision 11; 
  4.16     (b) whether the association has submitted the proposed 
  4.17  premiums in a manner which provides sufficient time for 
  4.18  individuals covered under the comprehensive insurance plan to 
  4.19  receive notice of any premium increase no less than 30 days 
  4.20  prior to the effective date of the increase; 
  4.21     (c) the degree to which the association's computations and 
  4.22  conclusions are consistent with section 62E.08; 
  4.23     (d) the degree to which any sample used to compute a 
  4.24  weighted average by the association pursuant to section 62E.08 
  4.25  reasonably reflects circumstances existing in the private 
  4.26  marketplace for individual coverage; 
  4.27     (e) the degree to which a weighted average computed 
  4.28  pursuant to section 62E.08 that uses information pertaining to 
  4.29  individual coverage available only on a renewal basis reflects 
  4.30  the circumstances existing in the private marketplace for 
  4.31  individual coverage; 
  4.32     (f) a comparison of the proposed increases with increases 
  4.33  in the cost of medical care and increases experienced in the 
  4.34  private marketplace for individual coverage; 
  4.35     (g) the financial consequences to enrollees of the proposed 
  4.36  increase; 
  5.1      (h) the actuarially projected effect of the proposed 
  5.2   increase upon both total enrollment in, and the nature of the 
  5.3   risks assumed by, the comprehensive health insurance plan; 
  5.4      (i) the relative solvency of the contributing members; and 
  5.5      (j) other factors deemed relevant by the commissioner. 
  5.6      In no case, however, may the commissioner approve premiums 
  5.7   for those plans of coverage described in section 62E.08, 
  5.8   subdivision 1, paragraphs (a) to (c) (d), that are lower than 
  5.9   101 percent or greater than 125 percent of the weighted averages 
  5.10  computed by the association pursuant to section 62E.08.  The 
  5.11  commissioner shall support a decision to approve, modify, or 
  5.12  reject any premium proposed by the association with written 
  5.13  findings and conclusions addressing each criterion specified in 
  5.14  this section.  If the commissioner does not approve, modify, or 
  5.15  reject the premiums proposed by the association sooner than 45 
  5.16  days before the effective date for premiums specified in section 
  5.17  62E.08, subdivision 3, the premiums proposed by the association 
  5.18  under this section become effective.  
  5.19     Sec. 3.  Minnesota Statutes 2002, section 62E.12, is 
  5.20  amended to read: 
  5.21     62E.12 [MINIMUM BENEFITS OF COMPREHENSIVE HEALTH INSURANCE 
  5.22  PLAN.] 
  5.23     (a) The association through its comprehensive health 
  5.24  insurance plan shall offer policies which provide the benefits 
  5.25  of a number one qualified plan and a number two qualified plan, 
  5.26  except that the maximum lifetime benefit on these plans shall be 
  5.27  $2,800,000; and an extended basic Medicare supplement plan and a 
  5.28  basic Medicare supplement plan as described in sections 62A.31 
  5.29  to 62A.44.  The association may also offer a plan that is 
  5.30  identical to a number one and number two qualified plan except 
  5.31  that it has a $2,000 annual deductible and a $2,800,000 maximum 
  5.32  lifetime benefit.  The association, subject to the approval of 
  5.33  the commissioner, may also offer plans that are identical to the 
  5.34  number one or number two qualified plan, except that they have 
  5.35  annual deductibles of $5,000 and $10,000, respectively, and that 
  5.36  they have a $2,800,000 maximum lifetime benefit. 
  6.1      (b) The requirement that a policy issued by the association 
  6.2   must be a qualified plan is satisfied if the association 
  6.3   contracts with a preferred provider network and the level of 
  6.4   benefits for services provided within the network satisfies the 
  6.5   requirements of a qualified plan.  If the association uses a 
  6.6   preferred provider network, payments to nonparticipating 
  6.7   providers must meet the minimum requirements of section 72A.20, 
  6.8   subdivision 15.  
  6.9      (c) The association shall offer health maintenance 
  6.10  organization contracts in those areas of the state where a 
  6.11  health maintenance organization has agreed to make the coverage 
  6.12  available and has been selected as a writing carrier.  
  6.13     (d) Notwithstanding the provisions of section 62E.06 and 
  6.14  unless those charges are billed by a provider that is part of 
  6.15  the association's preferred provider network, the state plan 
  6.16  shall exclude coverage of services of a private duty nurse other 
  6.17  than on an inpatient basis and any charges for treatment in a 
  6.18  hospital located outside of the state of Minnesota in which the 
  6.19  covered person is receiving treatment for a mental or nervous 
  6.20  disorder, unless similar treatment for the mental or nervous 
  6.21  disorder is medically necessary, unavailable in Minnesota and 
  6.22  provided upon referral by a licensed Minnesota medical 
  6.23  practitioner. 
  6.24     Sec. 4.  Minnesota Statutes 2002, section 62E.13, 
  6.25  subdivision 2, is amended to read: 
  6.26     Subd. 2.  [SELECTION OF WRITING CARRIER.] The association 
  6.27  may select policies and contracts, or parts thereof, submitted 
  6.28  by a member or members of the association, or by the association 
  6.29  or others, to develop specifications for bids from any entity 
  6.30  which wishes to be selected as a writing carrier to administer 
  6.31  the state plan.  The selection of the writing carrier shall be 
  6.32  based upon criteria established by the board of directors of the 
  6.33  association and approved by the commissioner.  The criteria 
  6.34  shall outline specific qualifications that an entity must 
  6.35  satisfy in order to be selected and, at a minimum, shall include 
  6.36  the entity's proven ability to handle large group accident and 
  7.1   health insurance cases, efficient claim paying capacity, and the 
  7.2   estimate of total charges for administering the plan.  The 
  7.3   association may select separate writing carriers for the two 
  7.4   types of qualified plans and the $2,000, $5,000, and $10,000 
  7.5   deductible plan plans, the qualified medicare supplement plan, 
  7.6   and the health maintenance organization contract. 
  7.7      Sec. 5.  Minnesota Statutes 2002, section 62E.13, is 
  7.8   amended by adding a subdivision to read: 
  7.9      Subd. 3a.  [EXTENSION OF WRITING CARRIER CONTRACT.] Subject 
  7.10  to the approval of the commissioner, and subject to the consent 
  7.11  of the writing carrier, the association may extend the effective 
  7.12  writing carrier contract for a period not to exceed three years, 
  7.13  if the association and the commissioner determine that it would 
  7.14  be in the best interest of the association's enrollees and 
  7.15  contributing members.  This subdivision applies notwithstanding 
  7.16  anything to the contrary in subdivisions 2 and 3. 
  7.17     Sec. 6.  Minnesota Statutes 2002, section 62E.14, is 
  7.18  amended to read: 
  7.19     62E.14 [ENROLLMENT BY AN ELIGIBLE PERSON.] 
  7.20     Subdivision 1.  [CERTIFICATE APPLICATION, CONTENTS.] The 
  7.21  comprehensive health insurance plan shall be open for enrollment 
  7.22  by eligible persons.  An eligible person shall enroll by 
  7.23  submission of a certificate of eligibility an application to the 
  7.24  writing carrier.  The certificate shall application must provide 
  7.25  the following: 
  7.26     (a) name, address, age, list of residences for the 
  7.27  immediately preceding six months and length of time at current 
  7.28  residence of the applicant; 
  7.29     (b) name, address, and age of spouse and children if any, 
  7.30  if they are to be insured; 
  7.31     (c) evidence of rejection, a requirement of restrictive 
  7.32  riders, a rate up, or a preexisting conditions limitation on a 
  7.33  qualified plan, the effect of which is to substantially reduce 
  7.34  coverage from that received by a person considered a standard 
  7.35  risk, by at least one association member within six months of 
  7.36  the date of the certificate application, or other eligibility 
  8.1   requirements adopted by rule by the commissioner which are not 
  8.2   inconsistent with this chapter and which evidence that a person 
  8.3   is unable to obtain coverage substantially similar to that which 
  8.4   may be obtained by a person who is considered a standard risk; 
  8.5      (d) if the applicant has been terminated from individual 
  8.6   health coverage which does not provide replacement coverage, 
  8.7   evidence that no replacement coverage that meets the 
  8.8   requirements of section 62D.121 was offered, and evidence of 
  8.9   termination of individual health coverage by an insurer, 
  8.10  nonprofit health service plan corporation, or health maintenance 
  8.11  organization, provided that the contract or policy has been 
  8.12  terminated for reasons other than (1) failure to pay the charge 
  8.13  for health care coverage; (2) failure to make copayments 
  8.14  required by the health care plan; (3) enrollee moving out of the 
  8.15  area served; or (4) a materially false statement or 
  8.16  misrepresentation by the enrollee in the application for 
  8.17  membership the terminated contract or policy; and 
  8.18     (e) a designation of the coverage desired. 
  8.19     An eligible person may not purchase more than one policy 
  8.20  from the state plan.  Upon ceasing to be a resident of Minnesota 
  8.21  a person is no longer eligible to purchase or renew coverage 
  8.22  under the state plan, except as required by state or federal law 
  8.23  with respect to renewal of Medicare supplement coverage. 
  8.24     Subd. 2.  [WRITING CARRIER'S RESPONSE.] Within 30 days of 
  8.25  receipt of the certificate application described in subdivision 
  8.26  1, the writing carrier shall either reject the application for 
  8.27  failing to comply with the requirements in subdivision 1 or 
  8.28  forward the eligible person a notice of acceptance and billing 
  8.29  information.  If the applicant otherwise complies with the 
  8.30  requirements of sections 62E.01 to 62E.19, insurance shall be 
  8.31  effective immediately upon receipt of the first month's state 
  8.32  plan premium, and shall be retroactive to the date of the 
  8.33  application, if the applicant otherwise complies with the 
  8.34  requirements of sections 62E.01 to 62E.19 the application was 
  8.35  received by the writing carrier, unless a different effective 
  8.36  date is provided in this section. 
  9.1      Subd. 3.  [PREEXISTING CONDITIONS.] No person who obtains 
  9.2   coverage pursuant to this section shall be covered for any 
  9.3   preexisting condition during the first six months of coverage 
  9.4   under the state plan if the person was diagnosed or treated for 
  9.5   that condition during the 90 days immediately preceding the 
  9.6   filing of an application date the application was received by 
  9.7   the writing carrier, except as provided under subdivisions 4, 
  9.8   4a, 4b, 4c, 4d, 5, 6, and 7 and section 62E.18. 
  9.9      Subd. 3a.  [WAIVER OF PREEXISTING CONDITION.] A person may 
  9.10  enroll in the comprehensive health plan with a waiver of the 
  9.11  preexisting condition limitation described in section 62E.14, 
  9.12  subdivision 3, provided that the person meets the following 
  9.13  requirements: 
  9.14     (1) group coverage was provided through a rehabilitation 
  9.15  facility defined in section 268A.01, subdivision 6, and coverage 
  9.16  was terminated; 
  9.17     (2) all other eligibility requirements for enrollment in 
  9.18  the comprehensive health plan are met; and 
  9.19     (3) coverage is applied for within the person submitted an 
  9.20  application that was received by the writing carrier no later 
  9.21  than 90 days of after termination of previous coverage. 
  9.22     Subd. 4.  [WAIVER OF PREEXISTING CONDITIONS FOR MEDICARE 
  9.23  SUPPLEMENT PLAN ENROLLEES.] Notwithstanding the above, any 
  9.24  Minnesota resident holder of a policy or certificate of Medicare 
  9.25  supplement coverages pursuant to sections 62A.315 and 62A.316, 
  9.26  or Medicare supplement plans previously approved by the 
  9.27  commissioner, may enroll in the comprehensive health insurance 
  9.28  plan as described in section 62E.07, with a waiver of the 
  9.29  preexisting condition as described in subdivision 3, without 
  9.30  interruption in coverage, provided, that the policy or 
  9.31  certificate has been terminated by the insurer for reasons other 
  9.32  than nonpayment of premium and, provided further, that the 
  9.33  option to enroll in the plan is exercised within through 
  9.34  submitting an application received by the writing carrier no 
  9.35  later than 90 days of after termination of the existing contract 
  9.36  or certificate. 
 10.1      Coverage in the state plan for purposes of this section 
 10.2   shall be effective on the date of termination upon completion 
 10.3   receipt of the proper application by the writing carrier and 
 10.4   payment of the required premium.  The application must include 
 10.5   evidence of termination of the existing policy or certificate. 
 10.6      Subd. 4a.  [WAIVER OF PREEXISTING CONDITIONS FOR MINNESOTA 
 10.7   RESIDENTS.] A person may enroll in the comprehensive health plan 
 10.8   with a waiver of the preexisting condition limitation described 
 10.9   in subdivision 3, provided that the following requirements are 
 10.10  met: 
 10.11     (1) the person is a Minnesota resident eligible to enroll 
 10.12  in the comprehensive health plan; 
 10.13     (2) the person: 
 10.14     (a) would be eligible for continuation under federal or 
 10.15  state law if continuation coverage were available or were 
 10.16  required to be available; 
 10.17     (b) would be eligible for continuation under clause (a) 
 10.18  except that the person was exercising continuation rights and 
 10.19  the continuation period required under federal or state law has 
 10.20  expired; or 
 10.21     (c) is eligible for continuation of health coverage under 
 10.22  federal or state law; 
 10.23     (3) continuation coverage is not available; and 
 10.24     (4) the person applies person's application for coverage 
 10.25  within is received by the writing carrier no later than 90 days 
 10.26  of after termination of prior coverage from a policy or plan. 
 10.27     Coverage in the comprehensive health plan is effective on 
 10.28  the date of termination of prior coverage.  The availability of 
 10.29  conversion rights does not affect a person's rights under this 
 10.30  subdivision. 
 10.31     Subd. 4b.  [WAIVER OF PREEXISTING CONDITIONS FOR PERSONS 
 10.32  COVERED BY RETIREE PLANS.] A person who was covered by a retiree 
 10.33  health care plan may enroll in the comprehensive health plan 
 10.34  with a waiver of the preexisting condition limitation described 
 10.35  in subdivision 3, provided that the following requirements are 
 10.36  met: 
 11.1      (1) the person is a Minnesota resident eligible to enroll 
 11.2   in the comprehensive health plan; 
 11.3      (2) the person was covered by a retiree health care plan 
 11.4   from an employer and the coverage is no longer available to the 
 11.5   person; and 
 11.6      (3) the person applies person's application for coverage 
 11.7   within is received by the writing carrier no later than 90 days 
 11.8   of after termination of prior coverage. 
 11.9      Coverage in the comprehensive health plan is effective on 
 11.10  the date of termination of prior coverage.  The availability of 
 11.11  conversion rights does not affect a person's rights under this 
 11.12  section. 
 11.13     Subd. 4c.  [WAIVER OF PREEXISTING CONDITIONS FOR PERSONS 
 11.14  WHOSE COVERAGE IS TERMINATED OR WHO EXCEED THE MAXIMUM LIFETIME 
 11.15  BENEFIT.] (a) A Minnesota resident may enroll in the 
 11.16  comprehensive health plan with a waiver of the preexisting 
 11.17  condition limitation described in subdivision 3 if that person 
 11.18  applies persons's application for coverage within is received by 
 11.19  the writing carrier no later than 90 days of after termination 
 11.20  of prior coverage and if the termination is for reasons other 
 11.21  than fraud or nonpayment of premiums.  
 11.22     For purposes of this paragraph, termination of prior 
 11.23  coverage includes exceeding the maximum lifetime benefit of 
 11.24  existing coverage. 
 11.25     Coverage in the comprehensive health plan is effective on 
 11.26  the date of termination of prior coverage.  The availability of 
 11.27  conversion rights does not affect a person's rights under this 
 11.28  paragraph. 
 11.29     This section does not apply to prior coverage provided 
 11.30  under policies designed primarily to provide coverage payable on 
 11.31  a per diem, fixed indemnity, or nonexpense incurred basis, or 
 11.32  policies providing only accident coverage. 
 11.33     (b) An eligible individual, as defined under United States 
 11.34  Code, chapter 42, section 300gg-41(b) may enroll in the 
 11.35  comprehensive health insurance plan with a waiver of the 
 11.36  preexisting condition limitation described in subdivision 3 and 
 12.1   a waiver of the evidence of rejection or similar events 
 12.2   described in subdivision 1, clause (c).  The eligible individual 
 12.3   must apply for enrollment under this paragraph within by 
 12.4   submitting a substantially complete application that is received 
 12.5   by the writing carrier no later than 63 days of after 
 12.6   termination of prior coverage, and coverage under the 
 12.7   comprehensive health insurance plan is effective as of the date 
 12.8   of receipt of the complete application.  The six month 
 12.9   durational residency requirement provided in section 62E.02, 
 12.10  subdivision 13, does not apply with respect to eligibility for 
 12.11  enrollment under this paragraph, but the applicant must be a 
 12.12  Minnesota resident as of the date of that the application was 
 12.13  received by the writing carrier.  A person's eligibility to 
 12.14  enroll under this paragraph does not affect the person's 
 12.15  eligibility to enroll under any other provision. 
 12.16     (c) A qualifying individual, as defined in Internal Revenue 
 12.17  Code of 1986, section 35(e)(2)(B), who is eligible under the 
 12.18  Federal Trade Act of 2002 for the credit for health insurance 
 12.19  costs under the Internal Revenue Code of 1986, section 35, may 
 12.20  enroll in the comprehensive health insurance plan with a waiver 
 12.21  of the preexisting condition limitation described in subdivision 
 12.22  3, and without presenting evidence of rejection or similar 
 12.23  requirements described in subdivision 1, paragraph (c).  The six 
 12.24  month durational residency requirement provided in section 
 12.25  62E.02, subdivision 13, does not apply with respect to 
 12.26  eligibility for enrollment under this paragraph, but the 
 12.27  applicant must be a Minnesota resident as of the date of 
 12.28  application.  A person's eligibility to enroll under this 
 12.29  paragraph does not affect the person's eligibility to enroll 
 12.30  under any other provision.  This paragraph is intended solely to 
 12.31  meet the minimum requirements necessary to qualify the 
 12.32  comprehensive health insurance plan as qualified health coverage 
 12.33  under the Internal Revenue Code of 1986, section 35(e)(2). 
 12.34     Subd. 4d.  [INSURER INSOLVENCY; WAIVER OF PREEXISTING 
 12.35  CONDITIONS.] A Minnesota resident who is otherwise eligible may 
 12.36  enroll in the comprehensive health insurance plan with a waiver 
 13.1   of the preexisting condition limitation described in subdivision 
 13.2   3, if that person applies submits an application for coverage 
 13.3   within that is received by the writing carrier no later than 90 
 13.4   days of after termination of prior coverage due to the 
 13.5   insolvency of the insurer.  
 13.6      Coverage in the comprehensive insurance plan is effective 
 13.7   on the date of termination of prior coverage.  The availability 
 13.8   of conversion rights does not affect a person's rights under 
 13.9   this subdivision. 
 13.10     Subd. 4e.  [WAIVER OF PREEXISTING CONDITIONS; PERSONS 
 13.11  COVERED BY PUBLICLY FUNDED HEALTH PROGRAMS.] A person may enroll 
 13.12  in the comprehensive plan with a waiver of the preexisting 
 13.13  condition limitation in subdivision 3, provided that: 
 13.14     (1) the person was formerly enrolled in the medical 
 13.15  assistance, general assistance medical care, or MinnesotaCare 
 13.16  program; 
 13.17     (2) the person is a Minnesota resident; and 
 13.18     (3) the person applies within submits an application for 
 13.19  coverage that is received by the writing carrier no later than 
 13.20  90 days of after termination from medical assistance, general 
 13.21  assistance medical care, or MinnesotaCare program. 
 13.22     Subd. 5.  [TERMINATED EMPLOYEES.] An employee who is 
 13.23  voluntarily or involuntarily terminated or laid off from 
 13.24  employment and unable to exercise the option to continue 
 13.25  coverage under section 62A.17 may enroll, within by submitting 
 13.26  an application that is received by the writing carrier no later 
 13.27  than 90 days of after termination or layoff, with a waiver of 
 13.28  the preexisting condition limitation set forth in subdivision 3 
 13.29  and a waiver of the evidence of rejection set forth in 
 13.30  subdivision 1, paragraph (c). 
 13.31     Subd. 6.  [TERMINATION OF INDIVIDUAL POLICY OR CONTRACT.] A 
 13.32  Minnesota resident who holds an individual health maintenance 
 13.33  contract, individual nonprofit health service corporation 
 13.34  contract, or an individual insurance policy previously approved 
 13.35  by the commissioners of health or commerce, may enroll in the 
 13.36  comprehensive health insurance plan with a waiver of the 
 14.1   preexisting condition as described in subdivision 3, without 
 14.2   interruption in coverage, provided (1) no replacement coverage 
 14.3   that meets the requirements of section 62D.121 was offered by 
 14.4   the contributing member, and (2) the policy or contract has been 
 14.5   terminated for reasons other than (a) nonpayment of premium; (b) 
 14.6   failure to make copayments required by the health care plan; (c) 
 14.7   moving out of the area served; or (d) a materially false 
 14.8   statement or misrepresentation by the enrollee in the 
 14.9   application for membership the terminated policy or contract; 
 14.10  and, provided further, that the option to enroll in the plan is 
 14.11  exercised within by submitting an application that is received 
 14.12  by the writing carrier no later than 90 days of after 
 14.13  termination of the existing policy or contract. 
 14.14     Coverage allowed under this section is effective when the 
 14.15  contract or policy is terminated and the enrollee has completed 
 14.16  submitted the proper application that is received within the 
 14.17  time period stated in this subdivision and paid the required 
 14.18  premium or fee. 
 14.19     Expenses incurred from the preexisting conditions of 
 14.20  individuals enrolled in the state plan under this subdivision 
 14.21  must be paid by the contributing member canceling coverage as 
 14.22  set forth in section 62E.11, subdivision 10. 
 14.23     The application must include evidence of termination of the 
 14.24  existing policy or certificate as required in subdivision 1. 
 14.25     Subd. 7.  [TERMINATIONS OF CONVERSION POLICIES.] (a) A 
 14.26  Minnesota resident who is covered by a conversion policy or 
 14.27  contract of health coverage may enroll in the comprehensive 
 14.28  health plan with a waiver of the preexisting condition 
 14.29  limitation in subdivision 3 and a waiver of the evidence of 
 14.30  rejection in subdivision 1, paragraph (c), at any time for any 
 14.31  reason by submitting an application that is received by the 
 14.32  writing carrier during the term of coverage. 
 14.33     (b) A Minnesota resident who was covered by a conversion 
 14.34  policy or contract of health coverage may enroll in the 
 14.35  comprehensive health plan with a waiver of the preexisting 
 14.36  condition limitation in subdivision 3 and a waiver of the 
 15.1   evidence of rejection in subdivision 1, paragraph (c), if that 
 15.2   person applies for coverage within by submitting an application 
 15.3   that is received by the writing carrier no later than 90 days 
 15.4   after termination of the conversion policy or contract coverage 
 15.5   regardless of:  (1) the reasons for the termination; or (2) the 
 15.6   party terminating coverage.  
 15.7      (c) Coverage under this subdivision is effective upon 
 15.8   termination of prior coverage if the enrollee has submitted a 
 15.9   completed application that is received within the time period 
 15.10  stated in paragraph (a) or (b), whichever applies, and paid the 
 15.11  required premium or fee. 
 15.12     Sec. 7.  Minnesota Statutes 2002, section 62E.18, is 
 15.13  amended to read: 
 15.14     62E.18 [HEALTH INSURANCE FOR RETIRED EMPLOYEES NOT ELIGIBLE 
 15.15  FOR MEDICARE.] 
 15.16     A Minnesota resident who is age 65 or over and is not 
 15.17  eligible for the health insurance benefits of the federal 
 15.18  Medicare program is entitled to purchase the benefits of a 
 15.19  qualified plan, one or two, or the $2,000, $5,000, or $10,000 
 15.20  annual deductible plan if available, offered by the Minnesota 
 15.21  comprehensive health association without any of the limitations 
 15.22  set forth in section 62E.14, subdivision 1, paragraph (c), and 
 15.23  subdivision 3. 
 15.24     Sec. 8.  [EFFECTIVE DATE.] 
 15.25     Sections 1 to 7 are effective the day following final 
 15.26  enactment and apply to applications received on or after that 
 15.27  date.