<div class="xtend"><a id="pl.1.1"></a><var>1.1</var>CONFERENCE COMMITTEE REPORT ON S.F. No. 1<br />
         		
         <div class="xtend_ce"><a id="pl.1.2"></a><var>1.2</var>A bill for an act<br />
            		
         </div><a id="pl.1.3"></a><var>1.3</var>relating to health care coverage; providing a temporary program to help pay for <br />
         		<a id="pl.1.4"></a><var>1.4</var>health insurance premiums; modifying requirements for health maintenance <br />
         		<a id="pl.1.5"></a><var>1.5</var>organizations; modifying provisions governing health insurance; requiring reports;
         <br />
         		<a id="pl.1.6"></a><var>1.6</var>establishing a state reinsurance program through the Minnesota Comprehensive <br />
         		<a id="pl.1.7"></a><var>1.7</var>Health Association; authorizing agricultural cooperative health plans; appropriating
         <br />
         		<a id="pl.1.8"></a><var>1.8</var>money;amending Minnesota Statutes 2016, sections 60A.08, subdivision 15; <br />
         		<a id="pl.1.9"></a><var>1.9</var>60A.235, subdivision 3; 60A.236; 62D.02, subdivision 4; 62D.03, subdivision 1; <br />
         		<a id="pl.1.10"></a><var>1.10</var>62D.05, subdivision 1; 62D.06, subdivision 1; 62D.19; 62E.02, subdivision 3; <br />
         		<a id="pl.1.11"></a><var>1.11</var>62L.12, subdivision 2; proposing coding for new law in Minnesota Statutes, <br />
         		<a id="pl.1.12"></a><var>1.12</var>chapters 62E; 62H; repealing Minnesota Statutes 2016, section 62D.12, subdivision
         <br />
         		<a id="pl.1.13"></a><var>1.13</var>9; Laws 2007, chapter 147, article 12, section 14, as amended.<br />
         		<a id="pl.1.14"></a><var>1.14</var>January 25, 2017<br />
         		<a id="pl.1.15"></a><var>1.15</var>The Honorable Michelle L. Fischbach<br />
         		<a id="pl.1.16"></a><var>1.16</var>President of the Senate<br />
         		<a id="pl.1.17"></a><var>1.17</var>The Honorable Kurt L. Daudt<br />
         		<a id="pl.1.18"></a><var>1.18</var>Speaker of the House of Representatives<br />
         		<a id="pl.1.19"></a><var>1.19</var>We, the undersigned conferees for S.F. No. 1 report that we have agreed upon the items <br />
         		<a id="pl.1.20"></a><var>1.20</var>in dispute and recommend as follows:<br />
         		<a id="pl.1.21"></a><var>1.21</var>That the House recede from its amendments and that S.F. No. 1 be further amended as <br />
         		<a id="pl.1.22"></a><var>1.22</var>follows:<br />
         		<a id="pl.1.23"></a><var>1.23</var>Delete everything after the enacting clause and insert:<br />
         		<br />
         		<a id="bill.1.0.0"></a><div class="xtend_ce"><a id="pl.1.24"></a><var>1.24</var>"<b>ARTICLE 1</b><br />
            		
         </div>
         <div class="xtend_ce"><a id="pl.1.25"></a><var>1.25</var><b>PREMIUM SUBSIDY PROGRAM</b><br />
            		
         </div><br />
         		<a id="bill.1.1.0"></a><a id="pl.1.26"></a><var>1.26</var>&#160;&#160;&#160;&#160;Section 1. <b>DEFINITIONS.</b><br />
         		<a id="pl.1.27"></a><var>1.27</var>&#160;&#160;&#160;&#160;Subdivision 1. <b>Scope.</b> For purposes of sections 1 to 6, the following terms have the <br />
         		<a id="pl.1.28"></a><var>1.28</var>meanings given.<br />
         		<a id="pl.2.1"></a><var>2.1</var>&#160;&#160;&#160;&#160;Subd. 2. <b>Commissioner.</b> "Commissioner" means the commissioner of Minnesota <br />
         		<a id="pl.2.2"></a><var>2.2</var>Management and Budget.<br />
         		<a id="pl.2.3"></a><var>2.3</var>&#160;&#160;&#160;&#160;Subd. 3. <b>Eligible individual.</b> "Eligible individual" means a Minnesota resident who:<br />
         		<a id="pl.2.4"></a><var>2.4</var>(1) is not receiving a premium tax credit under Code of Federal Regulations, title
         26, <br />
         		<a id="pl.2.5"></a><var>2.5</var>section 1.36B-2, as of the date their coverage is effectuated;<br />
         		<a id="pl.2.6"></a><var>2.6</var>(2) is not enrolled in public program coverage under Minnesota Statutes, section <br />
         		<a id="pl.2.7"></a><var>2.7</var>256B.055, or 256L.04; and<br />
         		<a id="pl.2.8"></a><var>2.8</var>(3) purchased an individual health plan from a health carrier in the individual market.<br />
         		<a id="pl.2.9"></a><var>2.9</var>&#160;&#160;&#160;&#160;Subd. 4. <b>Gross premium.</b> "Gross premium" means the amount billed for a health plan <br />
         		<a id="pl.2.10"></a><var>2.10</var>purchased by an eligible individual prior to a premium subsidy in a calendar year.<br />
         		<a id="pl.2.11"></a><var>2.11</var>&#160;&#160;&#160;&#160;Subd. 5. <b>Health carrier.</b> "Health carrier" has the meaning given in Minnesota Statutes, <br />
         		<a id="pl.2.12"></a><var>2.12</var>section 62A.011, subdivision 2.<br />
         		<a id="pl.2.13"></a><var>2.13</var>&#160;&#160;&#160;&#160;Subd. 6. <b>Individual health plan.</b> "Individual health plan" has the meaning given in <br />
         		<a id="pl.2.14"></a><var>2.14</var>Minnesota Statutes, section 62A.011, subdivision 4.<br />
         		<a id="pl.2.15"></a><var>2.15</var>&#160;&#160;&#160;&#160;Subd. 7. <b>Individual market.</b> "Individual market" has the meaning given in Minnesota <br />
         		<a id="pl.2.16"></a><var>2.16</var>Statutes, section 62A.011, subdivision 5.<br />
         		<a id="pl.2.17"></a><var>2.17</var>&#160;&#160;&#160;&#160;Subd. 8. <b>Net premium.</b> "Net premium" means the gross premium less the premium <br />
         		<a id="pl.2.18"></a><var>2.18</var>subsidy.<br />
         		<a id="pl.2.19"></a><var>2.19</var>&#160;&#160;&#160;&#160;Subd. 9. <b>Premium subsidy.</b> "Premium subsidy":<br />
         		<a id="pl.2.20"></a><var>2.20</var>(1) is a payment made on behalf of eligible individuals for the promotion of general
         <br />
         		<a id="pl.2.21"></a><var>2.21</var>welfare, and is not compensation for any services;<br />
         		<a id="pl.2.22"></a><var>2.22</var>(2) is equal to 25 percent of the monthly gross premium otherwise paid by or on behalf
         <br />
         		<a id="pl.2.23"></a><var>2.23</var>of the eligible individual for coverage purchased in the individual market, that covers
         the <br />
         		<a id="pl.2.24"></a><var>2.24</var>eligible individual and the eligible individual's spouse and dependents, or the percentage
         <br />
         		<a id="pl.2.25"></a><var>2.25</var>established by the commissioner under section 2, subdivision 3, paragraph (c); and<br />
         		<a id="pl.2.26"></a><var>2.26</var>(3) is excluded from any calculation used to determine eligibility within any of the
         <br />
         		<a id="pl.2.27"></a><var>2.27</var>Department of Human Services programs.<br />
         		<br />
         		<a id="bill.1.2.0"></a><a id="pl.3.1"></a><var>3.1</var>&#160;&#160;&#160;&#160;Sec. 2. <b>PAYMENT TO HEALTH CARRIERS ON BEHALF OF ELIGIBLE </b><br />
         		<a id="pl.3.2"></a><var>3.2</var><b>INDIVIDUALS.</b><br />
         		<a id="pl.3.3"></a><var>3.3</var>&#160;&#160;&#160;&#160;Subdivision 1. <b>Program established.</b> The commissioner of Minnesota Management <br />
         		<a id="pl.3.4"></a><var>3.4</var>and Budget, in consultation with the commissioner of commerce and the commissioner
         of <br />
         		<a id="pl.3.5"></a><var>3.5</var>human services, shall establish and administer the premium subsidy program authorized
         by <br />
         		<a id="pl.3.6"></a><var>3.6</var>this act, to help eligible individuals pay for coverage in the individual market in
         2017.<br />
         		<a id="pl.3.7"></a><var>3.7</var>&#160;&#160;&#160;&#160;Subd. 2. <b>Premium subsidy provided.</b> As soon as practicable, but no later than April <br />
         		<a id="pl.3.8"></a><var>3.8</var>30, 2017, health carriers shall begin paying a premium subsidy to each eligible individual
         <br />
         		<a id="pl.3.9"></a><var>3.9</var>who purchases a health plan in the individual market, for all the months for which
         the net <br />
         		<a id="pl.3.10"></a><var>3.10</var>premium is paid. An eligible individual shall pay the net premium amount to the health
         <br />
         		<a id="pl.3.11"></a><var>3.11</var>carrier.<br />
         		<a id="pl.3.12"></a><var>3.12</var>&#160;&#160;&#160;&#160;Subd. 3. <b>Payments to health carriers.</b> (a) The commissioner shall make payments to <br />
         		<a id="pl.3.13"></a><var>3.13</var>health carriers on behalf of eligible individuals effectuating coverage for calendar
         year 2017, <br />
         		<a id="pl.3.14"></a><var>3.14</var>for the months in that year for which the individual has paid the net premium amount
         to the <br />
         		<a id="pl.3.15"></a><var>3.15</var>health carrier. Payments to health carriers shall be based on the premium subsidy
         available <br />
         		<a id="pl.3.16"></a><var>3.16</var>to eligible individuals in the individual market, regardless of the cost of coverage
         purchased. <br />
         		<a id="pl.3.17"></a><var>3.17</var>The commissioner shall not withhold payments because a health carrier cannot prove
         an <br />
         		<a id="pl.3.18"></a><var>3.18</var>enrollee is an eligible individual.<br />
         		<a id="pl.3.19"></a><var>3.19</var>(b) Health carriers seeking reimbursement from the commissioner must submit an invoice
         <br />
         		<a id="pl.3.20"></a><var>3.20</var>and supporting information to the commissioner, using a form developed by the <br />
         		<a id="pl.3.21"></a><var>3.21</var>commissioner, in order to be eligible for payment. The commissioner shall finalize
         the form <br />
         		<a id="pl.3.22"></a><var>3.22</var>by March 1, 2017.<br />
         		<a id="pl.3.23"></a><var>3.23</var>(c) Total state payments to health carriers must be made within the limits of the
         available <br />
         		<a id="pl.3.24"></a><var>3.24</var>appropriation. The commissioner shall reimburse health carriers at the full requested
         amount <br />
         		<a id="pl.3.25"></a><var>3.25</var>up to the level of the appropriation. The commissioner, by July 15, 2017, shall determine
         <br />
         		<a id="pl.3.26"></a><var>3.26</var>whether the available appropriation will be sufficient to provide premium subsidies
         equal <br />
         		<a id="pl.3.27"></a><var>3.27</var>to 25 percent of the gross premium for the period September 1, 2017, through December
         <br />
         		<a id="pl.3.28"></a><var>3.28</var>31, 2017. If the commissioner determines that the available appropriation is not sufficient,
         <br />
         		<a id="pl.3.29"></a><var>3.29</var>the commissioner shall reduce the premium subsidy percentage, beginning September
         1, <br />
         		<a id="pl.3.30"></a><var>3.30</var>2017, through the remainder of the calendar year, by an amount sufficient to ensure
         that the <br />
         		<a id="pl.3.31"></a><var>3.31</var>total amount of premium subsidies provided for the calendar year does not exceed the
         <br />
         		<a id="pl.3.32"></a><var>3.32</var>available appropriation. The commissioner shall notify health carriers of any reduced
         <br />
         		<a id="pl.3.33"></a><var>3.33</var>premium subsidy percentage within five days of making a determination. Health carriers
         <br />
         		<a id="pl.4.1"></a><var>4.1</var>shall provide enrollees with at least 30 days' notice of any reduction in the premium
         subsidy <br />
         		<a id="pl.4.2"></a><var>4.2</var>percentage.<br />
         		<a id="pl.4.3"></a><var>4.3</var>(d) The commissioner shall consider health carriers as vendors under Minnesota Statutes,
         <br />
         		<a id="pl.4.4"></a><var>4.4</var>section 16A.124, subdivision 3, and each monthly invoice shall represent the completed
         <br />
         		<a id="pl.4.5"></a><var>4.5</var>delivery of the service.<br />
         		<a id="pl.4.6"></a><var>4.6</var>&#160;&#160;&#160;&#160;Subd. 4. <b>Data practices.</b> (a) The definitions in Minnesota Statutes, section 13.02, apply <br />
         		<a id="pl.4.7"></a><var>4.7</var>to this subdivision.<br />
         		<a id="pl.4.8"></a><var>4.8</var>(b) Government data on an enrollee or health carrier under this section are private
         data <br />
         		<a id="pl.4.9"></a><var>4.9</var>on individuals or nonpublic data, except that the total reimbursement requested by
         a health <br />
         		<a id="pl.4.10"></a><var>4.10</var>carrier and the total state payment to the health carrier are public data.<br />
         		<a id="pl.4.11"></a><var>4.11</var>(c) Notwithstanding Minnesota Statutes, section 138.17, government data on an enrollee
         <br />
         		<a id="pl.4.12"></a><var>4.12</var>or health carrier under this section must be destroyed by June 30, 2018, or upon completion
         <br />
         		<a id="pl.4.13"></a><var>4.13</var>by the legislative auditor of the audits required by section 3, whichever is later.<br />
         		<br />
         		<a id="bill.1.3.0"></a><a id="pl.4.14"></a><var>4.14</var>&#160;&#160;&#160;&#160;Sec. 3. <b>AUDITS.</b><br />
         		<a id="pl.4.15"></a><var>4.15</var>(a) The legislative auditor shall conduct audits of the health carriers' supporting
         data, as <br />
         		<a id="pl.4.16"></a><var>4.16</var>prescribed by the commissioner, to determine whether payments align with criteria
         <br />
         		<a id="pl.4.17"></a><var>4.17</var>established in sections 1 and 2. The commissioner of human services shall provide
         data as <br />
         		<a id="pl.4.18"></a><var>4.18</var>necessary to the legislative auditor to complete the audit. The commissioner shall
         withhold <br />
         		<a id="pl.4.19"></a><var>4.19</var>or charge back payments to the health carriers to the extent they do not align with
         the criteria <br />
         		<a id="pl.4.20"></a><var>4.20</var>established in sections 1 and 2, as determined by the audit.<br />
         		<a id="pl.4.21"></a><var>4.21</var>(b) The legislative auditor shall audit the extent to which health carriers provided
         premium <br />
         		<a id="pl.4.22"></a><var>4.22</var>subsidies to persons meeting the residency and other eligibility requirements specified
         in <br />
         		<a id="pl.4.23"></a><var>4.23</var>section 1, subdivision 3. The legislative auditor shall report to the commissioner
         the amount <br />
         		<a id="pl.4.24"></a><var>4.24</var>of premium subsidies provided by each health carrier to persons not eligible for a
         premium <br />
         		<a id="pl.4.25"></a><var>4.25</var>subsidy. The commissioner, in consultation with the commissioners of commerce and
         health, <br />
         		<a id="pl.4.26"></a><var>4.26</var>shall develop and implement a process to recover from health carriers the amount of
         premium <br />
         		<a id="pl.4.27"></a><var>4.27</var>subsidies received for enrollees determined to be ineligible for premium subsidies
         by the <br />
         		<a id="pl.4.28"></a><var>4.28</var>legislative auditor. The legislative auditor, when conducting the required audit,
         and the <br />
         		<a id="pl.4.29"></a><var>4.29</var>commissioner, when determining the amount of premium subsidy to be recovered, may
         <br />
         		<a id="pl.4.30"></a><var>4.30</var>take into account the extent to which a health carrier makes use of the Minnesota
         eligibility <br />
         		<a id="pl.4.31"></a><var>4.31</var>system, as defined in Minnesota Statutes, section 62V.055, subdivision 1.<br />
         		<br />
         		<a id="bill.1.4.0"></a><a id="pl.5.1"></a><var>5.1</var>&#160;&#160;&#160;&#160;Sec. 4. <b>APPLICABILITY OF GROSS PREMIUM.</b><br />
         		<a id="pl.5.2"></a><var>5.2</var>Notwithstanding premium subsidies provided under section 2, the premium base for <br />
         		<a id="pl.5.3"></a><var>5.3</var>calculating the amount of any applicable premium taxes under Minnesota Statutes, chapter
         <br />
         		<a id="pl.5.4"></a><var>5.4</var>297I, shall be the gross premium for health plans purchased by eligible individuals
         in the <br />
         		<a id="pl.5.5"></a><var>5.5</var>individual market.<br />
         		<br />
         		<a id="bill.1.5.0"></a><a id="pl.5.6"></a><var>5.6</var>&#160;&#160;&#160;&#160;Sec. 5. <b>SUNSET.</b><br />
         		<a id="pl.5.7"></a><var>5.7</var>This article sunsets June 30, 2018.<br />
         		<br />
         		<a id="bill.1.6.0"></a><a id="pl.5.8"></a><var>5.8</var>&#160;&#160;&#160;&#160;Sec. 6. <b>TRANSFER.</b><br />
         		<a id="pl.5.9"></a><var>5.9</var>$326,945,000 in fiscal year 2017 is transferred from the budget reserve account in
         <br />
         		<a id="pl.5.10"></a><var>5.10</var>Minnesota Statutes, section 16A.152, subdivision 1a, to the general fund.<br />
         		<br />
         		<a id="bill.1.7.0"></a><a id="pl.5.11"></a><var>5.11</var>&#160;&#160;&#160;&#160;Sec. 7. <b>APPROPRIATIONS.</b><br />
         		<a id="pl.5.12"></a><var>5.12</var>(a) $311,788,000 in fiscal year 2017 is appropriated from the general fund to the
         <br />
         		<a id="pl.5.13"></a><var>5.13</var>commissioner of management and budget for premium assistance under section 2. This
         <br />
         		<a id="pl.5.14"></a><var>5.14</var>appropriation is onetime and is available through June 30, 2018.<br />
         		<a id="pl.5.15"></a><var>5.15</var>(b) $157,000 in fiscal year 2017 is appropriated from the general fund to the legislative
         <br />
         		<a id="pl.5.16"></a><var>5.16</var>auditor for purposes of section 3. This appropriation is onetime.<br />
         		<a id="pl.5.17"></a><var>5.17</var>(c) Any unexpended amount from the appropriation in paragraph (a) after June 30, 2018,
         <br />
         		<a id="pl.5.18"></a><var>5.18</var>shall be transferred on July 1, 2018, from the general fund to the budget reserve
         account <br />
         		<a id="pl.5.19"></a><var>5.19</var>under Minnesota Statutes, section 16A.152, subdivision 1a.<br />
         		<br />
         		<a id="bill.1.8.0"></a><a id="pl.5.20"></a><var>5.20</var>&#160;&#160;&#160;&#160;Sec. 8. <b>EFFECTIVE DATE.</b><br />
         		<a id="pl.5.21"></a><var>5.21</var>Sections 1 to 7 are effective the day following final enactment.<br />
         		<br />
         		<a id="bill.2.0.0"></a><div class="xtend_ce"><a id="pl.5.22"></a><var>5.22</var><b>ARTICLE 2</b><br />
            		
         </div>
         <div class="xtend_ce"><a id="pl.5.23"></a><var>5.23</var><b>INSURANCE MARKET REFORMS</b><br />
            		
         </div><br />
         		<a id="bill.2.1.0"></a><a id="pl.5.24"></a><var>5.24</var>&#160;&#160;&#160;&#160;Section 1. Minnesota Statutes 2016, section 60A.08, subdivision 15, is amended to read:<br />
         		<a id="pl.5.25"></a><var>5.25</var>&#160;&#160;&#160;&#160;Subd. 15. <b>Classification of insurance filings data.</b> (a) All forms, rates, and related <br />
         		<a id="pl.5.26"></a><var>5.26</var>information filed with the commissioner under section 
         <statute_ref>61A.02</statute_ref> shall be nonpublic data until <br />
         		<a id="pl.5.27"></a><var>5.27</var>the filing becomes effective.<br />
         		<a id="pl.6.1"></a><var>6.1</var>&#160;&#160;&#160;&#160;(b) All forms, rates, and related information filed with the commissioner under section
         <br />
         		
         <statute_ref><a id="pl.6.2"></a><var>6.2</var>62A.02
         </statute_ref> shall be nonpublic data until the filing becomes effective.<br />
         		<a id="pl.6.3"></a><var>6.3</var>&#160;&#160;&#160;&#160;(c) All forms, rates, and related information filed with the commissioner under section
         <br />
         		
         <statute_ref><a id="pl.6.4"></a><var>6.4</var>62C.14, subdivision 10
         </statute_ref>, shall be nonpublic data until the filing becomes effective.<br />
         		<a id="pl.6.5"></a><var>6.5</var>&#160;&#160;&#160;&#160;(d) All forms, rates, and related information filed with the commissioner under section
         <br />
         		
         <statute_ref><a id="pl.6.6"></a><var>6.6</var>70A.06
         </statute_ref> shall be nonpublic data until the filing becomes effective.<br />
         		<a id="pl.6.7"></a><var>6.7</var>&#160;&#160;&#160;&#160;(e) All forms, rates, and related information filed with the commissioner under section
         <br />
         		
         <statute_ref><a id="pl.6.8"></a><var>6.8</var>79.56
         </statute_ref> shall be nonpublic data until the filing becomes effective.<br />
         		<a id="pl.6.9"></a><var>6.9</var>&#160;&#160;&#160;&#160;(f) Notwithstanding paragraphs (b) and (c), for all rate increases subject to review
         under <br />
         		<a id="pl.6.10"></a><var>6.10</var>section 2794 of the Public Health Services Act and any amendments to, or regulations,
         or <br />
         		<a id="pl.6.11"></a><var>6.11</var>guidance issued under the act that are filed with the commissioner on or after September
         1, <br />
         		<a id="pl.6.12"></a><var>6.12</var>2011, the commissioner:<br />
         		<a id="pl.6.13"></a><var>6.13</var>&#160;&#160;&#160;&#160;(1) may acknowledge receipt of the information;<br />
         		<a id="pl.6.14"></a><var>6.14</var>&#160;&#160;&#160;&#160;(2) may acknowledge that the corresponding rate filing is pending review;<br />
         		<a id="pl.6.15"></a><var>6.15</var>&#160;&#160;&#160;&#160;(3) must provide public access from the Department of Commerce's Web site to parts
         I <br />
         		<a id="pl.6.16"></a><var>6.16</var>and II of the Preliminary Justifications of the rate increases subject to review;
         and<br />
         		<a id="pl.6.17"></a><var>6.17</var>&#160;&#160;&#160;&#160;(4) must provide notice to the public on the Department of Commerce's Web site of
         the <br />
         		<a id="pl.6.18"></a><var>6.18</var>review of the proposed rate, which must include a statement that the public has 30
         calendar <br />
         		<a id="pl.6.19"></a><var>6.19</var>days to submit written comments to the commissioner on the rate filing subject to
         review.<br />
         		<a id="pl.6.20"></a><var>6.20</var>&#160;&#160;&#160;&#160;(g) Notwithstanding paragraphs (b) and (c), for all proposed premium rates filed with
         <br />
         		<a id="pl.6.21"></a><var>6.21</var>the commissioner for individual health plans, as defined in section 62A.011, subdivision
         4, <br />
         		<a id="pl.6.22"></a><var>6.22</var>and small group health plans, as defined in section 62K.03, subdivision 12, the commissioner
         <br />
         		<a id="pl.6.23"></a><var>6.23</var>must provide public access on the Department of Commerce's Web site to compiled data
         <br />
         		<a id="pl.6.24"></a><var>6.24</var>of the proposed changes to rates, separated by health plan and geographic rating area,
         within <br />
         		<a id="pl.6.25"></a><var>6.25</var>ten business days after the deadline by which health carriers, as defined in section
         62A.011, <br />
         		<a id="pl.6.26"></a><var>6.26</var>subdivision 2, must submit proposed rates to the commissioner for approval.<br />
         		<a id="pl.6.27"></a><var>6.27</var><b>EFFECTIVE DATE.</b>This section is effective 30 days following final enactment.<br />
         		<br />
         		<a id="bill.2.2.0"></a><a id="pl.6.28"></a><var>6.28</var>&#160;&#160;&#160;&#160;Sec. 2. Minnesota Statutes 2016, section 60A.235, subdivision 3, is amended to read:<br />
         		<a id="pl.6.29"></a><var>6.29</var>&#160;&#160;&#160;&#160;Subd. 3. <b>Health plan policies issued as stop loss coverage.</b> (a) An insurance company <br />
         		<a id="pl.6.30"></a><var>6.30</var>or health carrier issuing or renewing an insurance policy or other evidence of coverage,
         that <br />
         		<a id="pl.6.31"></a><var>6.31</var>provides coverage to an employer for health care expenses incurred under an <br />
         		<a id="pl.6.32"></a><var>6.32</var>employer-sponsored plan provided to the employer's employees, retired employees, or
         their <br />
         		<a id="pl.7.1"></a><var>7.1</var>dependents, shall issue the policy or evidence of coverage as a health plan if the
         policy or <br />
         		<a id="pl.7.2"></a><var>7.2</var>evidence of coverage:<br />
         		<a id="pl.7.3"></a><var>7.3</var>(1) has a specific attachment point for claims incurred per individual that is lower
         than <br />
         		<a id="pl.7.4"></a><var>7.4</var>$20,000; or<br />
         		<a id="pl.7.5"></a><var>7.5</var>(2) has an aggregate attachment point, for groups of 50 or fewer, that is lower than
         the <br />
         		<a id="pl.7.6"></a><var>7.6</var>greater of:<br />
         		<a id="pl.7.7"></a><var>7.7</var>(i) $4,000 times the number of group members;<br />
         		<a id="pl.7.8"></a><var>7.8</var>(ii) 120 percent of expected claims; or<br />
         		<a id="pl.7.9"></a><var>7.9</var>(iii) $20,000; or<br />
         		<a id="pl.7.10"></a><var>7.10</var>(3) (2) has an aggregate attachment point for groups of 51 or more that is lower than <br />
         		<a id="pl.7.11"></a><var>7.11</var>110 percent of expected claims.<br />
         		<a id="pl.7.12"></a><var>7.12</var>(b) An insurer shall determine the number of persons in a group, for the purposes
         of this <br />
         		<a id="pl.7.13"></a><var>7.13</var>section, on a consistent basis, at least annually. Where the insurance policy or evidence
         of <br />
         		<a id="pl.7.14"></a><var>7.14</var>coverage applies to a contract period of more than one year, the dollar amounts set
         forth in <br />
         		<a id="pl.7.15"></a><var>7.15</var>paragraph (a), clauses clause (1) and (2), must be multiplied by the length of the contract <br />
         		<a id="pl.7.16"></a><var>7.16</var>period expressed in years.<br />
         		<a id="pl.7.17"></a><var>7.17</var>(c) The commissioner may adjust the constant dollar amounts provided in paragraph
         <br />
         		<a id="pl.7.18"></a><var>7.18</var>(a), clauses (1), (2), and (3), on January 1 of any year, based upon changes in the
         medical <br />
         		<a id="pl.7.19"></a><var>7.19</var>component of the Consumer Price Index (CPI). Adjustments must be in increments of
         $100 <br />
         		<a id="pl.7.20"></a><var>7.20</var>and must not be made unless at least that amount of adjustment is required. The commissioner
         <br />
         		<a id="pl.7.21"></a><var>7.21</var>shall publish any change in these dollar amounts at least six months before their
         effective <br />
         		<a id="pl.7.22"></a><var>7.22</var>date.<br />
         		<a id="pl.7.23"></a><var>7.23</var>(d) (c) A policy or evidence of coverage issued by an insurance company or health carrier
         <br />
         		<a id="pl.7.24"></a><var>7.24</var>that provides direct coverage of health care expenses of an individual including a
         policy or <br />
         		<a id="pl.7.25"></a><var>7.25</var>evidence of coverage administered on a group basis is a health plan regardless of
         whether <br />
         		<a id="pl.7.26"></a><var>7.26</var>the policy or evidence of coverage is denominated as stop loss coverage.<br />
         		<a id="pl.7.27"></a><var>7.27</var><b>EFFECTIVE DATE.</b>This section is effective June 1, 2017, and applies to policies or <br />
         		<a id="pl.7.28"></a><var>7.28</var>evidence of coverage offered, issued, or renewed to an employer on or after that date.<br />
         		<br />
         		<a id="bill.2.3.0"></a><a id="pl.7.29"></a><var>7.29</var>&#160;&#160;&#160;&#160;Sec. 3. Minnesota Statutes 2016, section 60A.236, is amended to read:<br />
         		<a id="pl.7.30"></a><var>7.30</var><b>60A.236 STOP LOSS REGULATION; SMALL EMPLOYER COVERAGE.</b><br />
         		<a id="pl.8.1"></a><var>8.1</var>A contract providing stop loss coverage, issued or renewed to a small employer, as
         <br />
         		<a id="pl.8.2"></a><var>8.2</var>defined in section 
         <statute_ref>62L.02, subdivision 26</statute_ref>, or to a plan sponsored by a small employer, must <br />
         		<a id="pl.8.3"></a><var>8.3</var>include a claim settlement period no less favorable to the small employer or plan
         than <br />
         		<a id="pl.8.4"></a><var>8.4</var>coverage of all the following:<br />
         		<a id="pl.8.5"></a><var>8.5</var>(1) claims incurred during the contract period regardless of when the claims are; and<br />
         		<a id="pl.8.6"></a><var>8.6</var>(2) paid by the plan during the contract period or within three months after expiration <br />
         		<a id="pl.8.7"></a><var>8.7</var>of the contract period.<br />
         		<a id="pl.8.8"></a><var>8.8</var><b>EFFECTIVE DATE.</b>This section is effective June 1, 2017, and applies to policies or <br />
         		<a id="pl.8.9"></a><var>8.9</var>evidence of coverage offered, issued, or renewed to an employer on or after that date.<br />
         		<br />
         		<a id="bill.2.4.0"></a><a id="pl.8.10"></a><var>8.10</var>&#160;&#160;&#160;&#160;Sec. 4. Minnesota Statutes 2016, section 62D.02, subdivision 4, is amended to read:<br />
         		<a id="pl.8.11"></a><var>8.11</var>&#160;&#160;&#160;&#160;Subd. 4. <b>Health maintenance organization.</b> (a) "Health maintenance organization" <br />
         		<a id="pl.8.12"></a><var>8.12</var>means a nonprofit foreign or domestic corporation organized under chapter 317A, or a local <br />
         		<a id="pl.8.13"></a><var>8.13</var>governmental unit as defined in subdivision 11, controlled and operated as provided
         in <br />
         		<a id="pl.8.14"></a><var>8.14</var>sections 
         <statute_ref>62D.01</statute_ref> to 
         <statute_ref>62D.30</statute_ref>, which provides, either directly or through arrangements with <br />
         		<a id="pl.8.15"></a><var>8.15</var>providers or other persons, comprehensive health maintenance services, or arranges
         for the <br />
         		<a id="pl.8.16"></a><var>8.16</var>provision of these services, to enrollees on the basis of a fixed prepaid sum without
         regard <br />
         		<a id="pl.8.17"></a><var>8.17</var>to the frequency or extent of services furnished to any particular enrollee.<br />
         		<a id="pl.8.18"></a><var>8.18</var>(b) [Expired]<br />
         		<a id="pl.8.19"></a><var>8.19</var><b>EFFECTIVE DATE.</b>This section is effective the day following final enactment.<br />
         		<br />
         		<a id="bill.2.5.0"></a><a id="pl.8.20"></a><var>8.20</var>&#160;&#160;&#160;&#160;Sec. 5. Minnesota Statutes 2016, section 62D.03, subdivision 1, is amended to read:<br />
         		<a id="pl.8.21"></a><var>8.21</var>&#160;&#160;&#160;&#160;Subdivision 1. <b>Certificate of authority required.</b> Notwithstanding any law of this state <br />
         		<a id="pl.8.22"></a><var>8.22</var>to the contrary, any nonprofit foreign or domestic corporation organized to do so or a local <br />
         		<a id="pl.8.23"></a><var>8.23</var>governmental unit may apply to the commissioner of health for a certificate of authority
         to <br />
         		<a id="pl.8.24"></a><var>8.24</var>establish and operate a health maintenance organization in compliance with sections
         
         <statute_ref>62D.01</statute_ref> <br />
         		<a id="pl.8.25"></a><var>8.25</var>to 
         <statute_ref>62D.30</statute_ref>. No person shall establish or operate a health maintenance organization in this <br />
         		<a id="pl.8.26"></a><var>8.26</var>state, nor sell or offer to sell, or solicit offers to purchase or receive advance
         or periodic <br />
         		<a id="pl.8.27"></a><var>8.27</var>consideration in conjunction with a health maintenance organization or health maintenance
         <br />
         		<a id="pl.8.28"></a><var>8.28</var>contract unless the organization has a certificate of authority under sections 
         <statute_ref>62D.01</statute_ref> to <br />
         		
         <statute_ref><a id="pl.8.29"></a><var>8.29</var>62D.30
         </statute_ref>.<br />
         		<a id="pl.8.30"></a><var>8.30</var><b>EFFECTIVE DATE.</b>This section is effective the day following final enactment.<br />
         		<br />
         		<a id="bill.2.6.0"></a><a id="pl.9.1"></a><var>9.1</var>&#160;&#160;&#160;&#160;Sec. 6. Minnesota Statutes 2016, section 62D.05, subdivision 1, is amended to read:<br />
         		<a id="pl.9.2"></a><var>9.2</var>&#160;&#160;&#160;&#160;Subdivision 1. <b>Authority granted.</b> Any nonprofit corporation or local governmental <br />
         		<a id="pl.9.3"></a><var>9.3</var>unit may, upon obtaining a certificate of authority as required in sections 
         <statute_ref>62D.01</statute_ref> to 
         <statute_ref>62D.30</statute_ref>, <br />
         		<a id="pl.9.4"></a><var>9.4</var>operate as a health maintenance organization.<br />
         		<a id="pl.9.5"></a><var>9.5</var><b>EFFECTIVE DATE.</b>This section is effective the day following final enactment.<br />
         		<br />
         		<a id="bill.2.7.0"></a><a id="pl.9.6"></a><var>9.6</var>&#160;&#160;&#160;&#160;Sec. 7. Minnesota Statutes 2016, section 62D.06, subdivision 1, is amended to read:<br />
         		<a id="pl.9.7"></a><var>9.7</var>&#160;&#160;&#160;&#160;Subdivision 1. <b>Governing body composition; enrollee advisory body.</b> The governing <br />
         		<a id="pl.9.8"></a><var>9.8</var>body of any health maintenance organization which is a nonprofit corporation may include <br />
         		<a id="pl.9.9"></a><var>9.9</var>enrollees, providers, or other individuals; provided, however, that after a health
         maintenance <br />
         		<a id="pl.9.10"></a><var>9.10</var>organization which is a nonprofit corporation has been authorized under sections 
         <statute_ref>62D.01</statute_ref> <br />
         		<a id="pl.9.11"></a><var>9.11</var>to 
         <statute_ref>62D.30</statute_ref> for one year, at least 40 percent of the governing body shall be composed of <br />
         		<a id="pl.9.12"></a><var>9.12</var>enrollees and members elected by the enrollees and members from among the enrollees
         and <br />
         		<a id="pl.9.13"></a><var>9.13</var>members. For purposes of this section, "member" means a consumer who receives health
         <br />
         		<a id="pl.9.14"></a><var>9.14</var>care services through a self-insured contract that is administered by the health maintenance
         <br />
         		<a id="pl.9.15"></a><var>9.15</var>organization or its related third-party administrator. The number of members elected
         to the <br />
         		<a id="pl.9.16"></a><var>9.16</var>governing body shall not exceed the number of enrollees elected to the governing body.
         An <br />
         		<a id="pl.9.17"></a><var>9.17</var>enrollee or member elected to the governing board may not be a person:<br />
         		<a id="pl.9.18"></a><var>9.18</var>(1) whose occupation involves, or before retirement involved, the administration of
         <br />
         		<a id="pl.9.19"></a><var>9.19</var>health activities or the provision of health services;<br />
         		<a id="pl.9.20"></a><var>9.20</var>(2) who is or was employed by a health care facility as a licensed health professional;
         <br />
         		<a id="pl.9.21"></a><var>9.21</var>or<br />
         		<a id="pl.9.22"></a><var>9.22</var>(3) who has or had a direct substantial financial or managerial interest in the rendering
         <br />
         		<a id="pl.9.23"></a><var>9.23</var>of a health service, other than the payment of a reasonable expense reimbursement
         or <br />
         		<a id="pl.9.24"></a><var>9.24</var>compensation as a member of the board of a health maintenance organization.<br />
         		<a id="pl.9.25"></a><var>9.25</var>After a health maintenance organization which is a local governmental unit has been
         <br />
         		<a id="pl.9.26"></a><var>9.26</var>authorized under sections 
         <statute_ref>62D.01</statute_ref> to 
         <statute_ref>62D.30</statute_ref> for one year, an enrollee advisory body shall <br />
         		<a id="pl.9.27"></a><var>9.27</var>be established. The enrollees who make up this advisory body shall be elected by the
         enrollees <br />
         		<a id="pl.9.28"></a><var>9.28</var>from among the enrollees.<br />
         		<a id="pl.9.29"></a><var>9.29</var><b>EFFECTIVE DATE.</b>This section is effective the day following final enactment.<br />
         		<br />
         		<a id="bill.2.8.0"></a><a id="pl.9.30"></a><var>9.30</var>&#160;&#160;&#160;&#160;Sec. 8. Minnesota Statutes 2016, section 62D.19, is amended to read:<br />
         		<a id="pl.9.31"></a><var>9.31</var><b>62D.19 UNREASONABLE EXPENSES.</b><br />
         		<a id="pl.10.1"></a><var>10.1</var>No health maintenance organization shall incur or pay for any expense of any nature
         <br />
         		<a id="pl.10.2"></a><var>10.2</var>which is unreasonably high in relation to the value of the service or goods provided.
         The <br />
         		<a id="pl.10.3"></a><var>10.3</var>commissioner of health shall implement and enforce this section by rules adopted under
         <br />
         		<a id="pl.10.4"></a><var>10.4</var>this section.<br />
         		<a id="pl.10.5"></a><var>10.5</var>In an effort to achieve the stated purposes of sections 
         <statute_ref>62D.01</statute_ref> to 
         <statute_ref>62D.30</statute_ref>; in order to <br />
         		<a id="pl.10.6"></a><var>10.6</var>safeguard the underlying nonprofit status of health maintenance organizations; and to ensure <br />
         		<a id="pl.10.7"></a><var>10.7</var>that the payment of health maintenance organization money to major participating entities
         <br />
         		<a id="pl.10.8"></a><var>10.8</var>results in a corresponding benefit to the health maintenance organization and its
         enrollees, <br />
         		<a id="pl.10.9"></a><var>10.9</var>when determining whether an organization has incurred an unreasonable expense in relation
         <br />
         		<a id="pl.10.10"></a><var>10.10</var>to a major participating entity, due consideration shall be given to, in addition
         to any other <br />
         		<a id="pl.10.11"></a><var>10.11</var>appropriate factors, whether the officers and trustees of the health maintenance organization
         <br />
         		<a id="pl.10.12"></a><var>10.12</var>have acted with good faith and in the best interests of the health maintenance organization
         <br />
         		<a id="pl.10.13"></a><var>10.13</var>in entering into, and performing under, a contract under which the health maintenance
         <br />
         		<a id="pl.10.14"></a><var>10.14</var>organization has incurred an expense. The commissioner has standing to sue, on behalf
         of <br />
         		<a id="pl.10.15"></a><var>10.15</var>a health maintenance organization, officers or trustees of the health maintenance
         organization <br />
         		<a id="pl.10.16"></a><var>10.16</var>who have breached their fiduciary duty in entering into and performing such contracts.<br />
         		<a id="pl.10.17"></a><var>10.17</var><b>EFFECTIVE DATE.</b>This section is effective the day following final enactment.<br />
         		<br />
         		<a id="bill.2.9.0"></a><a id="pl.10.18"></a><var>10.18</var>&#160;&#160;&#160;&#160;Sec. 9. Minnesota Statutes 2016, section 62E.02, subdivision 3, is amended to read:<br />
         		<a id="pl.10.19"></a><var>10.19</var>&#160;&#160;&#160;&#160;Subd. 3. <b>Health maintenance organization.</b> "Health maintenance organization" means <br />
         		<a id="pl.10.20"></a><var>10.20</var>a nonprofit corporation licensed and operated as provided in chapter 62D.<br />
         		<a id="pl.10.21"></a><var>10.21</var><b>EFFECTIVE DATE.</b>This section is effective the day following final enactment.<br />
         		<br />
         		<a id="bill.2.10.0"></a><a id="pl.10.22"></a><var>10.22</var>&#160;&#160;&#160;&#160;Sec. 10. <b>[62H.18] AGRICULTURAL COOPERATIVE HEALTH PLAN.</b><br />
         		<a id="pl.10.23"></a><var>10.23</var>&#160;&#160;&#160;&#160;Subdivision 1. <b>Definitions.</b> (a) The definitions in this subdivision apply to this section.<br />
         		<a id="pl.10.24"></a><var>10.24</var>(b) "Agricultural cooperative" means a cooperative organized under chapter 308A or
         <br />
         		<a id="pl.10.25"></a><var>10.25</var>308B that meets the requirements of subdivision 2.<br />
         		<a id="pl.10.26"></a><var>10.26</var>(c) "Broker" means an insurance agent engaged in brokerage business according to <br />
         		<a id="pl.10.27"></a><var>10.27</var>section 60K.49.<br />
         		<a id="pl.10.28"></a><var>10.28</var>(d) "Employee Retirement Income Security Act" means the Employee Retirement Income
         <br />
         		<a id="pl.10.29"></a><var>10.29</var>Security Act of 1974, United States Code, title 29, sections 1001, et seq.<br />
         		<a id="pl.10.30"></a><var>10.30</var>(e) "Enrollee" means a natural person covered by a joint self-insurance plan operating
         <br />
         		<a id="pl.10.31"></a><var>10.31</var>under this section.<br />
         		<a id="pl.11.1"></a><var>11.1</var>(f) "Insurance agent" has the meaning given to insurance agent in section 60A.02,
         <br />
         		<a id="pl.11.2"></a><var>11.2</var>subdivision 7.<br />
         		<a id="pl.11.3"></a><var>11.3</var>(g) "Joint self-insurance plan" or "plan" means a plan or any other arrangement established
         <br />
         		<a id="pl.11.4"></a><var>11.4</var>for the benefit of two or more entities authorized to transact business in the state,
         in order <br />
         		<a id="pl.11.5"></a><var>11.5</var>to jointly self-insure through a single employee welfare benefit plan funded through
         a trust, <br />
         		<a id="pl.11.6"></a><var>11.6</var>to provide health, dental, or other benefits as permitted under the Employee Retirement
         <br />
         		<a id="pl.11.7"></a><var>11.7</var>Income Security Act.<br />
         		<a id="pl.11.8"></a><var>11.8</var>(h) "Service plan administrator" means a vendor of risk management services licensed
         <br />
         		<a id="pl.11.9"></a><var>11.9</var>under section 60A.23.<br />
         		<a id="pl.11.10"></a><var>11.10</var>(i) "Trust" means a trust established to accept and hold assets of the joint self-insurance
         <br />
         		<a id="pl.11.11"></a><var>11.11</var>plan in trust and use and disperse funds in accordance with the terms of the written
         trust <br />
         		<a id="pl.11.12"></a><var>11.12</var>document and joint self-insurance plan for the sole purposes of providing benefits
         and <br />
         		<a id="pl.11.13"></a><var>11.13</var>defraying reasonable administrative costs of providing the benefits.<br />
         		<a id="pl.11.14"></a><var>11.14</var>&#160;&#160;&#160;&#160;Subd. 2. <b>Exemption.</b> A joint self-insurance plan, its service plan administrator, stop loss <br />
         		<a id="pl.11.15"></a><var>11.15</var>carrier, and any broker assisting the agricultural cooperative are exempt from sections
         <br />
         		<a id="pl.11.16"></a><var>11.16</var>62H.01 to 62H.17, and are governed by the requirements of this section, if the joint
         <br />
         		<a id="pl.11.17"></a><var>11.17</var>self-insurance plan is administrated through a trust established by an agricultural
         cooperative <br />
         		<a id="pl.11.18"></a><var>11.18</var>that:<br />
         		<a id="pl.11.19"></a><var>11.19</var>(1) has members who (i) actively work in production agriculture in Minnesota and file
         <br />
         		<a id="pl.11.20"></a><var>11.20</var>either Form 1065 or Schedule F with the member's income tax return; or (ii) provide
         direct <br />
         		<a id="pl.11.21"></a><var>11.21</var>services to production agriculture in Minnesota;<br />
         		<a id="pl.11.22"></a><var>11.22</var>(2) specifies criteria for membership in the agricultural cooperative in their articles
         of <br />
         		<a id="pl.11.23"></a><var>11.23</var>organization or bylaws, however criteria cannot be based on health status factors
         of the <br />
         		<a id="pl.11.24"></a><var>11.24</var>individuals to be covered through the joint self-insurance plan; and<br />
         		<a id="pl.11.25"></a><var>11.25</var>(3) grants at least 51 percent of the aggregate voting power on matters for which
         all <br />
         		<a id="pl.11.26"></a><var>11.26</var>members may vote to members who satisfy clause (1) and any additional criteria in
         the <br />
         		<a id="pl.11.27"></a><var>11.27</var>agricultural cooperative's articles of organization and bylaws.<br />
         		<a id="pl.11.28"></a><var>11.28</var>&#160;&#160;&#160;&#160;Subd. 3. <b>Plan requirements.</b> A joint self-insurance plan operating under this section <br />
         		<a id="pl.11.29"></a><var>11.29</var>must:<br />
         		<a id="pl.11.30"></a><var>11.30</var>(1) offer health coverage to members of the agricultural cooperative that establishes
         the <br />
         		<a id="pl.11.31"></a><var>11.31</var>plan and their dependents, to employees of members of the agricultural cooperative
         that <br />
         		<a id="pl.11.32"></a><var>11.32</var>establishes the plan and their dependents, or to employees of the agricultural cooperative
         <br />
         		<a id="pl.11.33"></a><var>11.33</var>that establishes the plan and their dependents. Health coverage may be offered only
         to those <br />
         		<a id="pl.12.1"></a><var>12.1</var>individuals who meet certain criteria described in the joint self-insurance plan governing
         <br />
         		<a id="pl.12.2"></a><var>12.2</var>documents, however the criteria cannot be based on health status factors of the individuals
         <br />
         		<a id="pl.12.3"></a><var>12.3</var>to be covered through the joint self-insurance plan;<br />
         		<a id="pl.12.4"></a><var>12.4</var>(2) include stop-loss coverage with an individual attachment point not lower than
         $20,000 <br />
         		<a id="pl.12.5"></a><var>12.5</var>and an aggregate attachment point not lower than 110 percent of expected claims, issued
         <br />
         		<a id="pl.12.6"></a><var>12.6</var>by an insurance company licensed in Minnesota;<br />
         		<a id="pl.12.7"></a><var>12.7</var>(3) establish a reserve fund, certified by an actuary to be sufficient to cover unpaid
         claim <br />
         		<a id="pl.12.8"></a><var>12.8</var>liability for incurred but not reported liabilities in the event of plan termination.
         Certification <br />
         		<a id="pl.12.9"></a><var>12.9</var>from the actuary must include all maximum funding requirements for plan fixed cost
         <br />
         		<a id="pl.12.10"></a><var>12.10</var>requirements and current claims liability requirements, and must include a calculation
         of <br />
         		<a id="pl.12.11"></a><var>12.11</var>the reserve levels needed to fund all incurred but not reported liabilities in the
         event of <br />
         		<a id="pl.12.12"></a><var>12.12</var>member or plan termination. These reserve funds must be held in a trust;<br />
         		<a id="pl.12.13"></a><var>12.13</var>(4) be governed by a board elected by agricultural cooperative members that participate
         <br />
         		<a id="pl.12.14"></a><var>12.14</var>in the plan;<br />
         		<a id="pl.12.15"></a><var>12.15</var>(5) contract for services with a service plan administrator; and<br />
         		<a id="pl.12.16"></a><var>12.16</var>(6) satisfy the requirements of the Employee Retirement Income Security Act that apply
         <br />
         		<a id="pl.12.17"></a><var>12.17</var>to employee welfare benefit plans.<br />
         		<a id="pl.12.18"></a><var>12.18</var>&#160;&#160;&#160;&#160;Subd. 4. <b>Submission of documents to commissioner of commerce.</b> A joint <br />
         		<a id="pl.12.19"></a><var>12.19</var>self-insurance plan operating under this section must submit to the commissioner of
         <br />
         		<a id="pl.12.20"></a><var>12.20</var>commerce copies of all filings and reports that are submitted to the United States
         Department <br />
         		<a id="pl.12.21"></a><var>12.21</var>of Labor according to the Employee Retirement Income Security Act. Members participating
         <br />
         		<a id="pl.12.22"></a><var>12.22</var>in the joint self-insurance plan may designate an agricultural cooperative that establishes
         <br />
         		<a id="pl.12.23"></a><var>12.23</var>the plan as the entity responsible for satisfying the reporting requirements of the
         Employee <br />
         		<a id="pl.12.24"></a><var>12.24</var>Retirement Income Security Act and for providing copies of these filings and reports
         to the <br />
         		<a id="pl.12.25"></a><var>12.25</var>commissioner of commerce.<br />
         		<a id="pl.12.26"></a><var>12.26</var>&#160;&#160;&#160;&#160;Subd. 5. <b>Participation; termination of participation.</b> If a member chooses to participate <br />
         		<a id="pl.12.27"></a><var>12.27</var>in a joint self-insurance plan under this section, the member must participate in
         the plan for <br />
         		<a id="pl.12.28"></a><var>12.28</var>at least three consecutive years. If a member terminates participation in the plan
         before the <br />
         		<a id="pl.12.29"></a><var>12.29</var>end of the three-year period, a financial penalty may be assessed under the plan,
         not to <br />
         		<a id="pl.12.30"></a><var>12.30</var>exceed the amount contributed by the member to the plan reserves.<br />
         		<a id="pl.12.31"></a><var>12.31</var>&#160;&#160;&#160;&#160;Subd. 6. <b>Single risk pool.</b> The enrollees of a joint self-insurance plan operating under <br />
         		<a id="pl.12.32"></a><var>12.32</var>this section shall be members of a single risk pool. The plan shall provide benefits
         as a <br />
         		<a id="pl.13.1"></a><var>13.1</var>single, self-insured plan with the size of the plan based on the total enrollees in
         the risk <br />
         		<a id="pl.13.2"></a><var>13.2</var>pool.<br />
         		<a id="pl.13.3"></a><var>13.3</var>&#160;&#160;&#160;&#160;Subd. 7. <b>Promotion, marketing, sale of coverage.</b> (a) Coverage in a joint self-insurance <br />
         		<a id="pl.13.4"></a><var>13.4</var>plan operating under this section may be promoted, marketed, and sold by insurance
         agents <br />
         		<a id="pl.13.5"></a><var>13.5</var>and brokers to members of the agricultural cooperative sponsoring the plan and their
         <br />
         		<a id="pl.13.6"></a><var>13.6</var>dependents, employees of members of the agricultural cooperative sponsoring the plan
         and <br />
         		<a id="pl.13.7"></a><var>13.7</var>their dependents, and employees of the agricultural cooperative sponsoring the plan
         and <br />
         		<a id="pl.13.8"></a><var>13.8</var>their dependents.<br />
         		<a id="pl.13.9"></a><var>13.9</var>(b) Coverage in a joint self-insurance plan operating under this section may be promoted
         <br />
         		<a id="pl.13.10"></a><var>13.10</var>and marketed by a cooperative organized under chapter 308A or 308B to persons who
         may <br />
         		<a id="pl.13.11"></a><var>13.11</var>be eligible to participate in the joint self-insurance plan.<br />
         		<a id="pl.13.12"></a><var>13.12</var>&#160;&#160;&#160;&#160;Subd. 8. <b>Taxation.</b> Joint self-insurance plans are exempt from the taxation imposed <br />
         		<a id="pl.13.13"></a><var>13.13</var>under section 297I.05, subdivision 12.<br />
         		<a id="pl.13.14"></a><var>13.14</var>&#160;&#160;&#160;&#160;Subd. 9. <b>Compliance with other laws.</b> A joint self-insurance plan operating under this <br />
         		<a id="pl.13.15"></a><var>13.15</var>section:<br />
         		<a id="pl.13.16"></a><var>13.16</var>(1) is exempt from providing the mandated health benefits in chapters 62A and 62Q,
         if <br />
         		<a id="pl.13.17"></a><var>13.17</var>the plan otherwise provides the benefits required under the Employee Retirement Income
         <br />
         		<a id="pl.13.18"></a><var>13.18</var>Security Act;<br />
         		<a id="pl.13.19"></a><var>13.19</var>(2) is exempt from the continuation requirements in sections 62A.146, 62A.16, 62A.17,
         <br />
         		<a id="pl.13.20"></a><var>13.20</var>62A.20, and 62A.21, if the plan complies with the continuation requirements under
         the <br />
         		<a id="pl.13.21"></a><var>13.21</var>Employee Retirement Income Security Act; and<br />
         		<a id="pl.13.22"></a><var>13.22</var>(3) must comply with all requirements of the Affordable Care Act, as defined in section
         <br />
         		<a id="pl.13.23"></a><var>13.23</var>62A.011, subdivision 1a, to the extent that they apply to such plans.<br />
         		<a id="pl.13.24"></a><var>13.24</var><b>EFFECTIVE DATE.</b>This section is effective the day following final enactment.<br />
         		<br />
         		<a id="bill.2.11.0"></a><a id="pl.13.25"></a><var>13.25</var>&#160;&#160;&#160;&#160;Sec. 11. Minnesota Statutes 2016, section 62K.10, is amended by adding a subdivision to <br />
         		<a id="pl.13.26"></a><var>13.26</var>read:<br />
         		<a id="pl.13.27"></a><var>13.27</var>&#160;&#160;&#160;&#160;Subd. 5a. <b>Appeal of waiver of network adequacy requirements.</b> (a) If a health carrier <br />
         		<a id="pl.13.28"></a><var>13.28</var>receives a waiver under subdivision 5 applicable to a health plan's provider network,
         a <br />
         		<a id="pl.13.29"></a><var>13.29</var>provider who is in the service area served by the health plan and who is aggrieved
         by the <br />
         		<a id="pl.13.30"></a><var>13.30</var>issuance of the waiver may appeal the commissioner's decision using the contested
         case <br />
         		<a id="pl.13.31"></a><var>13.31</var>procedures in sections 14.57 to 14.62. A contested case proceeding must be initiated
         within <br />
         		<a id="pl.13.32"></a><var>13.32</var>60 days after the date on which the commissioner grants a waiver, except that a proceeding
         <br />
         		<a id="pl.14.1"></a><var>14.1</var>regarding a waiver in effect as of January 1, 2017, must be initiated within 60 days
         after <br />
         		<a id="pl.14.2"></a><var>14.2</var>the effective date of this subdivision. The commissioner must provide timely notice
         of an <br />
         		<a id="pl.14.3"></a><var>14.3</var>appeal under this subdivision to the health carrier that received the waiver that
         is subject to <br />
         		<a id="pl.14.4"></a><var>14.4</var>the appeal. After considering the appeal, the administrative law judge must either
         uphold <br />
         		<a id="pl.14.5"></a><var>14.5</var>or nullify the waiver of network adequacy requirements. The prevailing party in the
         contested <br />
         		<a id="pl.14.6"></a><var>14.6</var>case proceeding may seek an award of expenses and fees from the nonprevailing party
         by <br />
         		<a id="pl.14.7"></a><var>14.7</var>applying to the administrative law judge using the procedure in section 15.472, paragraph
         <br />
         		<a id="pl.14.8"></a><var>14.8</var>(b). The administrative law judge shall award fees and expenses to the prevailing
         party if <br />
         		<a id="pl.14.9"></a><var>14.9</var>the administrative law judge finds that the position of the nonprevailing party was
         not <br />
         		<a id="pl.14.10"></a><var>14.10</var>substantially justified. For purposes of this paragraph, "substantially justified"
         has the <br />
         		<a id="pl.14.11"></a><var>14.11</var>meaning given in section 15.471, subdivision 8.<br />
         		<a id="pl.14.12"></a><var>14.12</var>(b) The decision of the administrative law judge constitutes the final decision regarding
         <br />
         		<a id="pl.14.13"></a><var>14.13</var>the waiver. A party aggrieved by the administrative law judge's decision may seek
         judicial <br />
         		<a id="pl.14.14"></a><var>14.14</var>review of the decision as provided in chapter 14. If the waiver is nullified and no
         judicial <br />
         		<a id="pl.14.15"></a><var>14.15</var>review is sought, the health carrier must comply with the network adequacy requirements
         <br />
         		<a id="pl.14.16"></a><var>14.16</var>in subdivisions 2, 3, and 4, within 30 days after the deadline for seeking judicial
         review in <br />
         		<a id="pl.14.17"></a><var>14.17</var>section 14.63.<br />
         		<a id="pl.14.18"></a><var>14.18</var>(c) This subdivision expires December 31, 2018.<br />
         		<a id="pl.14.19"></a><var>14.19</var><b>EFFECTIVE DATE.</b>This section is effective the day following final enactment, and <br />
         		<a id="pl.14.20"></a><var>14.20</var>applies to network adequacy waivers in effect on or after January 1, 2017.<br />
         		<br />
         		<a id="bill.2.12.0"></a><a id="pl.14.21"></a><var>14.21</var>&#160;&#160;&#160;&#160;Sec. 12. Minnesota Statutes 2016, section 62L.12, subdivision 2, is amended to read:<br />
         		<a id="pl.14.22"></a><var>14.22</var>&#160;&#160;&#160;&#160;Subd. 2. <b>Exceptions.</b> (a) A health carrier may renew individual conversion policies to <br />
         		<a id="pl.14.23"></a><var>14.23</var>eligible employees otherwise eligible for conversion coverage under section 
         <statute_ref>62D.104</statute_ref> as a <br />
         		<a id="pl.14.24"></a><var>14.24</var>result of leaving a health maintenance organization's service area.<br />
         		<a id="pl.14.25"></a><var>14.25</var>(b) A health carrier may renew individual conversion policies to eligible employees
         <br />
         		<a id="pl.14.26"></a><var>14.26</var>otherwise eligible for conversion coverage as a result of the expiration of any continuation
         <br />
         		<a id="pl.14.27"></a><var>14.27</var>of group coverage required under sections 
         <statute_ref>62A.146</statute_ref>, 
         <statute_ref>62A.17</statute_ref>, 
         <statute_ref>62A.21</statute_ref>, 
         <statute_ref>62C.142</statute_ref>, 
         <statute_ref>62D.101</statute_ref>, <br />
         		<a id="pl.14.28"></a><var>14.28</var>and 
         <statute_ref>62D.105</statute_ref>.<br />
         		<a id="pl.14.29"></a><var>14.29</var>(c) A health carrier may renew conversion policies to eligible employees.<br />
         		<a id="pl.14.30"></a><var>14.30</var>(d) A health carrier may sell, issue, or renew individual continuation policies to
         eligible <br />
         		<a id="pl.14.31"></a><var>14.31</var>employees as required.<br />
         		<a id="pl.14.32"></a><var>14.32</var>(e) A health carrier may sell, issue, or renew individual health plans if the coverage
         is <br />
         		<a id="pl.14.33"></a><var>14.33</var>appropriate due to an unexpired preexisting condition limitation or exclusion applicable
         to <br />
         		<a id="pl.15.1"></a><var>15.1</var>the person under the employer's group health plan or due to the person's need for
         health <br />
         		<a id="pl.15.2"></a><var>15.2</var>care services not covered under the employer's group health plan.<br />
         		<a id="pl.15.3"></a><var>15.3</var>(f) A health carrier may sell, issue, or renew an individual health plan, if the individual
         <br />
         		<a id="pl.15.4"></a><var>15.4</var>has elected to buy the individual health plan not as part of a general plan to substitute
         <br />
         		<a id="pl.15.5"></a><var>15.5</var>individual health plans for a group health plan nor as a result of any violation of
         subdivision <br />
         		<a id="pl.15.6"></a><var>15.6</var>3 or 4.<br />
         		<a id="pl.15.7"></a><var>15.7</var>(g) A health carrier may sell, issue, or renew an individual health plan if coverage
         <br />
         		<a id="pl.15.8"></a><var>15.8</var>provided by the employer is determined to be unaffordable under the provisions of
         the <br />
         		<a id="pl.15.9"></a><var>15.9</var>Affordable Care Act as defined in section 
         <statute_ref>62A.011, subdivision 1a</statute_ref>.<br />
         		<a id="pl.15.10"></a><var>15.10</var>(h) Nothing in this subdivision relieves a health carrier of any obligation to provide
         <br />
         		<a id="pl.15.11"></a><var>15.11</var>continuation or conversion coverage otherwise required under federal or state law.<br />
         		<a id="pl.15.12"></a><var>15.12</var>(i) Nothing in this chapter restricts the offer, sale, issuance, or renewal of coverage
         issued <br />
         		<a id="pl.15.13"></a><var>15.13</var>as a supplement to Medicare under sections 
         <statute_ref>62A.3099</statute_ref> to 
         <statute_ref>62A.44</statute_ref>, or policies or contracts <br />
         		<a id="pl.15.14"></a><var>15.14</var>that supplement Medicare issued by health maintenance organizations, or those contracts
         <br />
         		<a id="pl.15.15"></a><var>15.15</var>governed by sections 1833, 1851 to 1859, 1860D, or 1876 of the federal Social Security
         <br />
         		<a id="pl.15.16"></a><var>15.16</var>Act, United States Code, title 42, section 1395 et seq., as amended.<br />
         		<a id="pl.15.17"></a><var>15.17</var>(j) Nothing in this chapter restricts the offer, sale, issuance, or renewal of individual
         <br />
         		<a id="pl.15.18"></a><var>15.18</var>health plans necessary to comply with a court order.<br />
         		<a id="pl.15.19"></a><var>15.19</var>(k) A health carrier may offer, issue, sell, or renew an individual health plan to
         persons <br />
         		<a id="pl.15.20"></a><var>15.20</var>eligible for an employer group health plan, if the individual health plan is a high
         deductible <br />
         		<a id="pl.15.21"></a><var>15.21</var>health plan for use in connection with an existing health savings account, in compliance
         <br />
         		<a id="pl.15.22"></a><var>15.22</var>with the Internal Revenue Code, section 223. In that situation, the same or a different
         health <br />
         		<a id="pl.15.23"></a><var>15.23</var>carrier may offer, issue, sell, or renew a group health plan to cover the other eligible
         <br />
         		<a id="pl.15.24"></a><var>15.24</var>employees in the group.<br />
         		<a id="pl.15.25"></a><var>15.25</var>(l) A health carrier may offer, sell, issue, or renew an individual health plan to
         one or <br />
         		<a id="pl.15.26"></a><var>15.26</var>more employees of a small employer if the individual health plan is marketed directly
         to <br />
         		<a id="pl.15.27"></a><var>15.27</var>all employees of the small employer and the small employer does not contribute directly
         or <br />
         		<a id="pl.15.28"></a><var>15.28</var>indirectly to the premiums or facilitate the administration of the individual health
         plan. The <br />
         		<a id="pl.15.29"></a><var>15.29</var>requirement to market an individual health plan to all employees does not require
         the health <br />
         		<a id="pl.15.30"></a><var>15.30</var>carrier to offer or issue an individual health plan to any employee. For purposes
         of this <br />
         		<a id="pl.15.31"></a><var>15.31</var>paragraph, an employer is not contributing to the premiums or facilitating the administration
         <br />
         		<a id="pl.15.32"></a><var>15.32</var>of the individual health plan if the employer does not contribute to the premium and
         merely <br />
         		<a id="pl.15.33"></a><var>15.33</var>collects the premiums from an employee's wages or salary through payroll deductions
         and <br />
         		<a id="pl.15.34"></a><var>15.34</var>submits payment for the premiums of one or more employees in a lump sum to the health
         <br />
         		<a id="pl.16.1"></a><var>16.1</var>carrier. Except for coverage under section 
         <statute_ref>62A.65</statute_ref>, subdivision 5, paragraph (b), at the <br />
         		<a id="pl.16.2"></a><var>16.2</var>request of an employee, the health carrier may bill the employer for the premiums
         payable <br />
         		<a id="pl.16.3"></a><var>16.3</var>by the employee, provided that the employer is not liable for payment except from
         payroll <br />
         		<a id="pl.16.4"></a><var>16.4</var>deductions for that purpose. If an employer is submitting payments under this paragraph,
         <br />
         		<a id="pl.16.5"></a><var>16.5</var>the health carrier shall provide a cancellation notice directly to the primary insured
         at least <br />
         		<a id="pl.16.6"></a><var>16.6</var>ten days prior to termination of coverage for nonpayment of premium. Individual coverage
         <br />
         		<a id="pl.16.7"></a><var>16.7</var>under this paragraph may be offered only if the small employer has not provided coverage
         <br />
         		<a id="pl.16.8"></a><var>16.8</var>under section 
         <statute_ref>62L.03</statute_ref> to the employees within the past 12 months.<br />
         		<a id="pl.16.9"></a><var>16.9</var>(m) A health carrier may offer, sell, issue, or renew an individual health plan to
         one or <br />
         		<a id="pl.16.10"></a><var>16.10</var>more employees of a small employer if the small employer, eligible employee, and individual
         <br />
         		<a id="pl.16.11"></a><var>16.11</var>health plan are in compliance with the 21st Century Cures Act, Public Law 114-255,
         section <br />
         		<a id="pl.16.12"></a><var>16.12</var>18001.<br />
         		<a id="pl.16.13"></a><var>16.13</var><b>EFFECTIVE DATE.</b>This section is effective the day following final enactment.<br />
         		<br />
         		<a id="bill.2.13.0"></a><a id="pl.16.14"></a><var>16.14</var>&#160;&#160;&#160;&#160;Sec. 13. <b>[62Q.556] UNAUTHORIZED PROVIDER SERVICES.</b><br />
         		<a id="pl.16.15"></a><var>16.15</var>&#160;&#160;&#160;&#160;Subdivision 1. <b>Unauthorized provider services.</b> (a) Except as provided in paragraph <br />
         		<a id="pl.16.16"></a><var>16.16</var>(c), unauthorized provider services occur when an enrollee receives services:<br />
         		<a id="pl.16.17"></a><var>16.17</var>(1) from a nonparticipating provider at a participating hospital or ambulatory surgical
         <br />
         		<a id="pl.16.18"></a><var>16.18</var>center, when the services are rendered:<br />
         		<a id="pl.16.19"></a><var>16.19</var>(i) due to the unavailability of a participating provider;<br />
         		<a id="pl.16.20"></a><var>16.20</var>(ii) by a nonparticipating provider without the enrollee's knowledge; or<br />
         		<a id="pl.16.21"></a><var>16.21</var>(iii) due to the need for unforeseen services arising at the time the services are
         being <br />
         		<a id="pl.16.22"></a><var>16.22</var>rendered; or<br />
         		<a id="pl.16.23"></a><var>16.23</var>(2) from a participating provider that sends a specimen taken from the enrollee in
         the <br />
         		<a id="pl.16.24"></a><var>16.24</var>participating provider's practice setting to a nonparticipating laboratory, pathologist,
         or other <br />
         		<a id="pl.16.25"></a><var>16.25</var>medical testing facility.<br />
         		<a id="pl.16.26"></a><var>16.26</var>(b) Unauthorized provider services do not include emergency services as defined in
         <br />
         		<a id="pl.16.27"></a><var>16.27</var>section 62Q.55, subdivision 3.<br />
         		<a id="pl.16.28"></a><var>16.28</var>(c) The services described in paragraph (a), clause (2), are not unauthorized provider
         <br />
         		<a id="pl.16.29"></a><var>16.29</var>services if the enrollee gives advance written consent to the provider acknowledging
         that <br />
         		<a id="pl.16.30"></a><var>16.30</var>the use of a provider, or the services to be rendered, may result in costs not covered
         by the <br />
         		<a id="pl.16.31"></a><var>16.31</var>health plan.<br />
         		<a id="pl.17.1"></a><var>17.1</var>&#160;&#160;&#160;&#160;Subd. 2. <b>Prohibition.</b> (a) An enrollee's financial responsibility for the unauthorized <br />
         		<a id="pl.17.2"></a><var>17.2</var>provider services shall be the same cost-sharing requirements, including co-payments,
         <br />
         		<a id="pl.17.3"></a><var>17.3</var>deductibles, coinsurance, coverage restrictions, and coverage limitations, as those
         applicable <br />
         		<a id="pl.17.4"></a><var>17.4</var>to services received by the enrollee from a participating provider. A health plan
         company <br />
         		<a id="pl.17.5"></a><var>17.5</var>must apply any enrollee cost sharing requirements, including co-payments, deductibles,
         and <br />
         		<a id="pl.17.6"></a><var>17.6</var>coinsurance, for unauthorized provider services to the enrollee's annual out-of-pocket
         limit <br />
         		<a id="pl.17.7"></a><var>17.7</var>to the same extent payments to a participating provider would be applied.<br />
         		<a id="pl.17.8"></a><var>17.8</var>(b) A health plan company must attempt to negotiate the reimbursement, less any <br />
         		<a id="pl.17.9"></a><var>17.9</var>applicable enrollee cost sharing under paragraph (a), for the unauthorized provider
         services <br />
         		<a id="pl.17.10"></a><var>17.10</var>with the nonparticipating provider. If a health plan company's and nonparticipating
         provider's <br />
         		<a id="pl.17.11"></a><var>17.11</var>attempts to negotiate reimbursement for the health care services do not result in
         a resolution, <br />
         		<a id="pl.17.12"></a><var>17.12</var>the health plan company or provider may elect to refer the matter for binding arbitration,
         <br />
         		<a id="pl.17.13"></a><var>17.13</var>chosen in accordance with paragraph (c). A nondisclosure agreement must be executed
         by <br />
         		<a id="pl.17.14"></a><var>17.14</var>both parties prior to engaging an arbitrator in accordance with this section. The
         cost of <br />
         		<a id="pl.17.15"></a><var>17.15</var>arbitration must be shared equally between the parties.<br />
         		<a id="pl.17.16"></a><var>17.16</var>(c) The commissioner of health, in consultation with the commissioner of the Bureau
         <br />
         		<a id="pl.17.17"></a><var>17.17</var>of Mediation Services, must develop a list of professionals qualified in arbitration,
         for the <br />
         		<a id="pl.17.18"></a><var>17.18</var>purpose of resolving disputes between a health plan company and nonparticipating provider
         <br />
         		<a id="pl.17.19"></a><var>17.19</var>arising from the payment for unauthorized provider services. The commissioner of health
         <br />
         		<a id="pl.17.20"></a><var>17.20</var>shall publish the list on the department of health's Web Site, and update the list
         as appropriate.<br />
         		<a id="pl.17.21"></a><var>17.21</var>(d) The arbitrator must consider relevant information, including the health plan company's
         <br />
         		<a id="pl.17.22"></a><var>17.22</var>payments to other nonparticipating providers for the same services, the circumstances
         and <br />
         		<a id="pl.17.23"></a><var>17.23</var>complexity of the particular case, and the usual and customary rate for the service
         based on <br />
         		<a id="pl.17.24"></a><var>17.24</var>information available in a database in a national, independent, not-for-profit corporation,
         <br />
         		<a id="pl.17.25"></a><var>17.25</var>and similar fees received by the provider for the same services from other health
         plans in <br />
         		<a id="pl.17.26"></a><var>17.26</var>which the provider is nonparticipating, in reaching a decision.<br />
         		<a id="pl.17.27"></a><var>17.27</var><b>EFFECTIVE DATE.</b>This section is effective 90 days following final enactment and <br />
         		<a id="pl.17.28"></a><var>17.28</var>applies to provider services provided on or after that date.<br />
         		<br />
         		<a id="bill.2.14.0"></a><a id="pl.17.29"></a><var>17.29</var>&#160;&#160;&#160;&#160;Sec. 14. Minnesota Statutes 2016, section 297I.05, subdivision 12, is amended to read:<br />
         		<a id="pl.17.30"></a><var>17.30</var>&#160;&#160;&#160;&#160;Subd. 12. <b>Other entities.</b> (a) A tax is imposed equal to two percent of:<br />
         		<a id="pl.17.31"></a><var>17.31</var>&#160;&#160;&#160;&#160;(1) gross premiums less return premiums written for risks resident or located in Minnesota
         <br />
         		<a id="pl.17.32"></a><var>17.32</var>by a risk retention group;<br />
         		<a id="pl.18.1"></a><var>18.1</var>&#160;&#160;&#160;&#160;(2) gross premiums less return premiums received by an attorney in fact acting in
         <br />
         		<a id="pl.18.2"></a><var>18.2</var>accordance with chapter 71A;<br />
         		<a id="pl.18.3"></a><var>18.3</var>&#160;&#160;&#160;&#160;(3) gross premiums less return premiums received pursuant to assigned risk policies
         and <br />
         		<a id="pl.18.4"></a><var>18.4</var>contracts of coverage under chapter 79; and<br />
         		<a id="pl.18.5"></a><var>18.5</var>&#160;&#160;&#160;&#160;(4) the direct funded premium received by the reinsurance association under section
         <br />
         		
         <statute_ref><a id="pl.18.6"></a><var>18.6</var>79.34
         </statute_ref> from self-insurers approved under section 
         <statute_ref>176.181</statute_ref> and political subdivisions that <br />
         		<a id="pl.18.7"></a><var>18.7</var>self-insure.<br />
         		<a id="pl.18.8"></a><var>18.8</var>&#160;&#160;&#160;&#160;(b) A tax is imposed on a joint self-insurance plan operating under chapter 60F. The
         rate <br />
         		<a id="pl.18.9"></a><var>18.9</var>of tax is equal to two percent of the total amount of claims paid during the fund
         year, with <br />
         		<a id="pl.18.10"></a><var>18.10</var>no deduction for claims wholly or partially reimbursed through stop-loss insurance.<br />
         		<a id="pl.18.11"></a><var>18.11</var>&#160;&#160;&#160;&#160;(c) A tax is imposed on a joint self-insurance plan operating under chapter 62H, except <br />
         		<a id="pl.18.12"></a><var>18.12</var>as provided in section 62H.18, subdivision 8. The rate of tax is equal to two percent of the <br />
         		<a id="pl.18.13"></a><var>18.13</var>total amount of claims paid during the fund's fiscal year, with no deduction for claims
         wholly <br />
         		<a id="pl.18.14"></a><var>18.14</var>or partially reimbursed through stop-loss insurance.<br />
         		<a id="pl.18.15"></a><var>18.15</var>&#160;&#160;&#160;&#160;(d) A tax is imposed equal to the tax imposed under section 
         <statute_ref>297I.05, subdivision 5</statute_ref>, on <br />
         		<a id="pl.18.16"></a><var>18.16</var>the gross premiums less return premiums on all coverages received by an accountable
         <br />
         		<a id="pl.18.17"></a><var>18.17</var>provider network or agents of an accountable provider network in Minnesota, in cash
         or <br />
         		<a id="pl.18.18"></a><var>18.18</var>otherwise, during the year.<br />
         		<a id="pl.18.19"></a><var>18.19</var><b>EFFECTIVE DATE.</b>This section is effective the day following final enactment.<br />
         		<br />
         		<a id="bill.2.15.0"></a><a id="pl.18.20"></a><var>18.20</var>&#160;&#160;&#160;&#160;Sec. 15. <b>TRANSITION OF CARE COVERAGE FOR CALENDAR YEAR 2017; </b><br />
         		<a id="pl.18.21"></a><var>18.21</var><b>INVOLUNTARY TERMINATION OF COVERAGE.</b><br />
         		<a id="pl.18.22"></a><var>18.22</var>&#160;&#160;&#160;&#160;Subdivision 1. <b>Definitions.</b> (a) For purposes of this section, the following terms have <br />
         		<a id="pl.18.23"></a><var>18.23</var>the meanings given.<br />
         		<a id="pl.18.24"></a><var>18.24</var>(b) "Enrollee" has the meaning given in Minnesota Statutes, section 62Q.01, subdivision
         <br />
         		<a id="pl.18.25"></a><var>18.25</var>2b.<br />
         		<a id="pl.18.26"></a><var>18.26</var>(c) "Health plan" has the meaning given in Minnesota Statutes, section 62Q.01, <br />
         		<a id="pl.18.27"></a><var>18.27</var>subdivision 3.<br />
         		<a id="pl.18.28"></a><var>18.28</var>(d) "Health plan company" has the meaning given in Minnesota Statutes, section 62Q.01,
         <br />
         		<a id="pl.18.29"></a><var>18.29</var>subdivision 4.<br />
         		<a id="pl.18.30"></a><var>18.30</var>(e) "Individual market" has the meaning given in Minnesota Statutes, section 62A.011,
         <br />
         		<a id="pl.18.31"></a><var>18.31</var>subdivision 5.<br />
         		<a id="pl.19.1"></a><var>19.1</var>(f) "Involuntary termination of coverage" means the termination of a health plan due
         to <br />
         		<a id="pl.19.2"></a><var>19.2</var>a health plan company's refusal to renew the health plan in the individual market
         because <br />
         		<a id="pl.19.3"></a><var>19.3</var>the health plan company elects to cease offering individual market health plans in
         all or <br />
         		<a id="pl.19.4"></a><var>19.4</var>some geographic rating areas of the state.<br />
         		<a id="pl.19.5"></a><var>19.5</var>&#160;&#160;&#160;&#160;Subd. 2. <b>Application.</b> This section applies to an enrollee who is subject to a change in <br />
         		<a id="pl.19.6"></a><var>19.6</var>health plans in the individual market due to an involuntary termination of coverage
         from a <br />
         		<a id="pl.19.7"></a><var>19.7</var>health plan in the individual market after October 31, 2016, and before January 1,
         2017, <br />
         		<a id="pl.19.8"></a><var>19.8</var>and who enrolls in a new health plan in the individual market for all or a portion
         of calendar <br />
         		<a id="pl.19.9"></a><var>19.9</var>year 2017 that goes into effect after December 31, 2016, and before March 2, 2017.<br />
         		<a id="pl.19.10"></a><var>19.10</var>&#160;&#160;&#160;&#160;Subd. 3. <b>Change in health plans; transition of care coverage.</b> (a) If an enrollee satisfies <br />
         		<a id="pl.19.11"></a><var>19.11</var>the criteria in subdivision 2, the enrollee's new health plan company must provide,
         upon <br />
         		<a id="pl.19.12"></a><var>19.12</var>request of the enrollee or the enrollee's health care provider, authorization to receive
         services <br />
         		<a id="pl.19.13"></a><var>19.13</var>that are otherwise covered under the terms of the enrollee's calendar year 2017 health
         plan <br />
         		<a id="pl.19.14"></a><var>19.14</var>from a provider who provided care on an in-network basis to the enrollee during calendar
         <br />
         		<a id="pl.19.15"></a><var>19.15</var>year 2016 but who is out of network in the enrollee's calendar year 2017 health plan:<br />
         		<a id="pl.19.16"></a><var>19.16</var>(1) for up to 120 days if the enrollee has, within 45 days before an involuntary termination
         <br />
         		<a id="pl.19.17"></a><var>19.17</var>of coverage, received a diagnosis of, or is engaged in a current course of treatment
         for, one <br />
         		<a id="pl.19.18"></a><var>19.18</var>or more of the following conditions:<br />
         		<a id="pl.19.19"></a><var>19.19</var>(i) an acute condition;<br />
         		<a id="pl.19.20"></a><var>19.20</var>(ii) a life-threatening mental or physical illness;<br />
         		<a id="pl.19.21"></a><var>19.21</var>(iii) pregnancy beyond the first trimester of pregnancy;<br />
         		<a id="pl.19.22"></a><var>19.22</var>(iv) a physical or mental disability defined as an inability to engage in one or more
         major <br />
         		<a id="pl.19.23"></a><var>19.23</var>life activities, provided the disability has lasted or can be expected to last for
         at least one <br />
         		<a id="pl.19.24"></a><var>19.24</var>year or can be expected to result in death; or<br />
         		<a id="pl.19.25"></a><var>19.25</var>(v) a disabling or chronic condition that is in an acute phase; or<br />
         		<a id="pl.19.26"></a><var>19.26</var>(2) for the rest of the enrollee's life if a physician certifies that the enrollee
         has an expected <br />
         		<a id="pl.19.27"></a><var>19.27</var>lifetime of 180 days or less.<br />
         		<a id="pl.19.28"></a><var>19.28</var>(b) For all requests for authorization under this subdivision, the health plan company
         <br />
         		<a id="pl.19.29"></a><var>19.29</var>must grant the request for authorization unless the enrollee does not meet the criteria
         in <br />
         		<a id="pl.19.30"></a><var>19.30</var>paragraph (a) or subdivision 2.<br />
         		<a id="pl.19.31"></a><var>19.31</var>&#160;&#160;&#160;&#160;Subd. 4. <b>Limitations.</b> (a) Subdivision 3 applies only if the enrollee's health care provider <br />
         		<a id="pl.19.32"></a><var>19.32</var>agrees to:<br />
         		<a id="pl.20.1"></a><var>20.1</var>(1) accept as payment in full the lesser of:<br />
         		<a id="pl.20.2"></a><var>20.2</var>(i) the health plan company's reimbursement rate for in-network providers for the
         same <br />
         		<a id="pl.20.3"></a><var>20.3</var>or similar service; or<br />
         		<a id="pl.20.4"></a><var>20.4</var>(ii) the provider's regular fee for that service;<br />
         		<a id="pl.20.5"></a><var>20.5</var>(2) request authorization for services in the form and manner specified by the enrollee's
         <br />
         		<a id="pl.20.6"></a><var>20.6</var>new health plan company; and<br />
         		<a id="pl.20.7"></a><var>20.7</var>(3) provide the enrollee's new health plan company with all necessary medical information
         <br />
         		<a id="pl.20.8"></a><var>20.8</var>related to the care provided to the enrollee.<br />
         		<a id="pl.20.9"></a><var>20.9</var>(b) Nothing in this section requires a health plan company to provide coverage for
         a <br />
         		<a id="pl.20.10"></a><var>20.10</var>health care service or treatment that is not covered under the enrollee's health plan.<br />
         		<a id="pl.20.11"></a><var>20.11</var>&#160;&#160;&#160;&#160;Subd. 5. <b>Request for authorization.</b> The enrollee's health plan company may require <br />
         		<a id="pl.20.12"></a><var>20.12</var>medical records and other supporting documentation to be submitted with a request
         for <br />
         		<a id="pl.20.13"></a><var>20.13</var>authorization under subdivision 3 to the extent that the records and other documentation
         <br />
         		<a id="pl.20.14"></a><var>20.14</var>are relevant to a determination regarding the existence of a condition under subdivision
         3, <br />
         		<a id="pl.20.15"></a><var>20.15</var>paragraph (a). If authorization is denied, the health plan company must explain the
         criteria <br />
         		<a id="pl.20.16"></a><var>20.16</var>used to make its decision on the request for authorization and must explain the enrollee's
         <br />
         		<a id="pl.20.17"></a><var>20.17</var>right to appeal the decision. If an enrollee chooses to appeal a denial, the enrollee
         must <br />
         		<a id="pl.20.18"></a><var>20.18</var>appeal the denial within five business days of the date on which the enrollee receives
         the <br />
         		<a id="pl.20.19"></a><var>20.19</var>denial. If authorization is granted, the health plan company must provide the enrollee,
         within <br />
         		<a id="pl.20.20"></a><var>20.20</var>five business days of granting the authorization, with an explanation of how transition
         of <br />
         		<a id="pl.20.21"></a><var>20.21</var>care will be provided.<br />
         		<a id="pl.20.22"></a><var>20.22</var>&#160;&#160;&#160;&#160;Subd. 6. <b>Reimbursement.</b> (a) The commissioner of management and budget must <br />
         		<a id="pl.20.23"></a><var>20.23</var>reimburse the enrollee's new health plan company for the cost of claims that the health
         plan <br />
         		<a id="pl.20.24"></a><var>20.24</var>company certifies as eligible for reimbursement under this subdivision.  The cost
         eligible <br />
         		<a id="pl.20.25"></a><var>20.25</var>for reimbursement under this subdivision is the difference between the in-network
         level of <br />
         		<a id="pl.20.26"></a><var>20.26</var>benefits under the enrollee's health plan and the out-of-network level of benefits
         under the <br />
         		<a id="pl.20.27"></a><var>20.27</var>enrollee's health plan. The health plan company must seek reimbursement for the cost
         of <br />
         		<a id="pl.20.28"></a><var>20.28</var>claims from the commissioner in a form and manner mutually agreed upon by the <br />
         		<a id="pl.20.29"></a><var>20.29</var>commissioner and the affected health plan companies. Total state reimbursements to
         health <br />
         		<a id="pl.20.30"></a><var>20.30</var>plan companies under this subdivision are subject to the limits of the available appropriation
         <br />
         		<a id="pl.20.31"></a><var>20.31</var>and the commissioner may prorate equally across all claims paid as necessary. In the
         event <br />
         		<a id="pl.20.32"></a><var>20.32</var>that funding for reimbursements to health plan companies is not sufficient to fully
         reimburse <br />
         		<a id="pl.20.33"></a><var>20.33</var>health plan companies for the costs of claims for reimbursement for services authorized
         <br />
         		<a id="pl.21.1"></a><var>21.1</var>under this section, health plan companies must continue to cover services authorized
         under <br />
         		<a id="pl.21.2"></a><var>21.2</var>this section.<br />
         		<a id="pl.21.3"></a><var>21.3</var>(b) For any service provided under this section, the enrollee shall not owe the provider
         <br />
         		<a id="pl.21.4"></a><var>21.4</var>more than the cost-sharing amount the enrollee would be required to pay if the services
         <br />
         		<a id="pl.21.5"></a><var>21.5</var>were performed by an in-network provider under the enrollee's new health plan.<br />
         		<a id="pl.21.6"></a><var>21.6</var><b>EFFECTIVE DATE.</b>This section is effective for health plans issued after December <br />
         		<a id="pl.21.7"></a><var>21.7</var>31, 2016, and before March 2, 2017, and that are in effect for all or a portion of
         calendar <br />
         		<a id="pl.21.8"></a><var>21.8</var>year 2017. This section expires June 30, 2018.<br />
         		<br />
         		<a id="bill.2.16.0"></a><a id="pl.21.9"></a><var>21.9</var>&#160;&#160;&#160;&#160;Sec. 16. <b>COSTS RELATED TO IMPLEMENTATION OF THIS ACT.</b><br />
         		<a id="pl.21.10"></a><var>21.10</var>A state agency that incurs administrative costs to implement any provision in this
         act <br />
         		<a id="pl.21.11"></a><var>21.11</var>and does not receive an appropriation for administrative costs in this act, must implement
         <br />
         		<a id="pl.21.12"></a><var>21.12</var>the act within the limits of existing appropriations.<br />
         		<a id="pl.21.13"></a><var>21.13</var><b>EFFECTIVE DATE.</b>This section is effective the day following final enactment.<br />
         		<br />
         		<a id="bill.2.17.0"></a><a id="pl.21.14"></a><var>21.14</var>&#160;&#160;&#160;&#160;Sec. 17. <b>INSURANCE MARKET OPTIONS.</b><br />
         		<a id="pl.21.15"></a><var>21.15</var>The commissioner of commerce shall report by March 1, 2017, to the standing committees
         <br />
         		<a id="pl.21.16"></a><var>21.16</var>of the legislature having jurisdiction over insurance and health on the past and future
         use <br />
         		<a id="pl.21.17"></a><var>21.17</var>of Minnesota Statutes 2005, section 62L.056, and Minnesota Statutes, section 62Q.188,
         <br />
         		<a id="pl.21.18"></a><var>21.18</var>including:<br />
         		<a id="pl.21.19"></a><var>21.19</var>(1) rate and form filings received, approved, or withdrawn;<br />
         		<a id="pl.21.20"></a><var>21.20</var>(2) barriers to current utilization, including federal and state laws; and<br />
         		<a id="pl.21.21"></a><var>21.21</var>(3) recommendations for allowing or increasing the offering of health plans compliant
         <br />
         		<a id="pl.21.22"></a><var>21.22</var>with Minnesota Statutes, section 62Q.188.<br />
         		<a id="pl.21.23"></a><var>21.23</var><b>EFFECTIVE DATE.</b>This section is effective the day following final enactment.<br />
         		<br />
         		<a id="bill.2.18.0"></a><a id="pl.21.24"></a><var>21.24</var>&#160;&#160;&#160;&#160;Sec. 18. <b>APPROPRIATION.</b><br />
         		<a id="pl.21.25"></a><var>21.25</var>$15,000,000 in fiscal year 2017 is appropriated from the general fund to the commissioner
         <br />
         		<a id="pl.21.26"></a><var>21.26</var>of management and budget to reimburse health plan companies for costs of claims eligible
         <br />
         		<a id="pl.21.27"></a><var>21.27</var>for reimbursement for coverage of transition of care services. Of this amount, $272,400
         is <br />
         		<a id="pl.21.28"></a><var>21.28</var>available to the commissioner for purposes of administering reimbursement for coverage
         <br />
         		<a id="pl.21.29"></a><var>21.29</var>of transition of care services and administering the premium subsidy program in article
         1. <br />
         		<a id="pl.21.30"></a><var>21.30</var>This is a onetime appropriation and is available until June 30, 2018. Any funds remaining
         <br />
         		<a id="pl.22.1"></a><var>22.1</var>from this appropriation after June 30, 2018, shall be transferred on July 1, 2018,
         from the <br />
         		<a id="pl.22.2"></a><var>22.2</var>general fund to the budget reserve account in Minnesota Statutes, section 16A.152,
         <br />
         		<a id="pl.22.3"></a><var>22.3</var>subdivision 1a.<br />
         		<a id="pl.22.4"></a><var>22.4</var><b>EFFECTIVE DATE.</b>This section is effective the day following final enactment.<br />
         		<br />
         		<a id="bill.2.19.0"></a><a id="pl.22.5"></a><var>22.5</var>&#160;&#160;&#160;&#160;Sec. 19. <b> REPEALER.</b><br />
         		<a id="pl.22.6"></a><var>22.6</var>(a) Minnesota Statutes 2016, section 62D.12, subdivision 9, is repealed effective the <br />
         		<a id="pl.22.7"></a><var>22.7</var>day following final enactment.<br />
         		<a id="pl.22.8"></a><var>22.8</var>(b) Laws 2007, chapter 147, article 12, section 14, as amended by Laws 2010, chapter
         <br />
         		<a id="pl.22.9"></a><var>22.9</var>344, section 4, Laws 2010, chapter 384, section 99, Laws 2013, chapter 135, article
         1, <br />
         		<a id="pl.22.10"></a><var>22.10</var>section 9; Laws 2010, chapter 384, section 99; and Laws 2013, chapter 135, article
         1, section <br />
         		<a id="pl.22.11"></a><var>22.11</var>9, are repealed effective the day following final enactment."<br />
         		<a id="pl.22.12"></a><var>22.12</var>Delete the title and insert:<br />
         		
         <div class="xtend_ce"><a id="pl.22.13"></a><var>22.13</var>"A bill for an act<br />
            		
         </div><a id="pl.22.14"></a><var>22.14</var>relating to health care coverage; providing a temporary program to help pay for <br />
         		<a id="pl.22.15"></a><var>22.15</var>health insurance premiums; requiring audits by the legislative auditor; modifying
         <br />
         		<a id="pl.22.16"></a><var>22.16</var>requirements for health maintenance organizations; modifying provisions governing
         <br />
         		<a id="pl.22.17"></a><var>22.17</var>health insurance; authorizing agricultural cooperative health plans; modifying a <br />
         		<a id="pl.22.18"></a><var>22.18</var>tax provision; authorizing transition of care coverage for 2017; requiring reports;
         <br />
         		<a id="pl.22.19"></a><var>22.19</var>transferring funds; appropriating money;amending Minnesota Statutes 2016, <br />
         		<a id="pl.22.20"></a><var>22.20</var>sections 60A.08, subdivision 15; 60A.235, subdivision 3; 60A.236; 62D.02, <br />
         		<a id="pl.22.21"></a><var>22.21</var>subdivision 4; 62D.03, subdivision 1; 62D.05, subdivision 1; 62D.06, subdivision <br />
         		<a id="pl.22.22"></a><var>22.22</var>1; 62D.19; 62E.02, subdivision 3; 62K.10, by adding a subdivision; 62L.12, <br />
         		<a id="pl.22.23"></a><var>22.23</var>subdivision 2; 297I.05, subdivision 12; proposing coding for new law in Minnesota
         <br />
         		<a id="pl.22.24"></a><var>22.24</var>Statutes, chapters 62H; 62Q; repealing Minnesota Statutes 2016, section 62D.12, <br />
         		<a id="pl.22.25"></a><var>22.25</var>subdivision 9; Laws 2007, chapter 147, article 12, section 14, as amended; Laws <br />
         		<a id="pl.22.26"></a><var>22.26</var>2010, chapter 384, section 99; Laws 2013, chapter 135, article 1, section 9."<br />
         		
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            <col width="252px"></col>
            <tr>
               <td><a id="pl.23.1"></a><var>23.1</var><br />
                  		
               </td>
               <td colspan="3">We request the adoption of this report and repassage of the bill.<br />
                  		
               </td>
            </tr>
            <tr>
               <td><a id="pl.23.2"></a><var>23.2</var><br />
                  		
               </td>
               <td>Senate Conferees:<br />
                  		<span width="2em"></span></td>
               <td></td>
               <td></td>
            </tr>
            <tr>
               <td><a id="pl.23.3"></a><var>23.3</var><br />
                  		
               </td>
               <td><span>
                     							.....
                     						</span><br />
                  		
               </td>
               <td></td>
               <td><span>
                     							.....
                     						</span><br />
                  		
               </td>
            </tr>
            <tr>
               <td><a id="pl.23.4"></a><var>23.4</var><br />
                  		
               </td>
               <td>Michelle R. Benson<br />
                  		
               </td>
               <td></td>
               <td>Jim Abeler<br />
                  		
               </td>
            </tr>
            <tr>
               <td><a id="pl.23.5"></a><var>23.5</var><br />
                  		
               </td>
               <td><span>
                     							.....
                     						</span><br />
                  		
               </td>
               <td></td>
               <td><span>
                     							.....
                     						</span><br />
                  		
               </td>
            </tr>
            <tr>
               <td><a id="pl.23.6"></a><var>23.6</var><br />
                  		
               </td>
               <td>Gary H. Dahms<br />
                  		
               </td>
               <td></td>
               <td>Scott M. Jensen<br />
                  		
               </td>
            </tr>
            <tr>
               <td><a id="pl.23.7"></a><var>23.7</var><br />
                  		
               </td>
               <td><span>
                     							.....
                     						</span><br />
                  		
               </td>
               <td></td>
               <td></td>
            </tr>
            <tr>
               <td><a id="pl.23.8"></a><var>23.8</var><br />
                  		
               </td>
               <td>Melisa Franzen<br />
                  		
               </td>
               <td></td>
               <td></td>
            </tr>
            <tr>
               <td><a id="pl.23.9"></a><var>23.9</var><br />
                  		
               </td>
               <td>House Conferees:<br />
                  		<span width="2em"></span></td>
               <td></td>
               <td></td>
            </tr>
            <tr>
               <td><a id="pl.23.10"></a><var>23.10</var><br />
                  		
               </td>
               <td><span>
                     							.....
                     						</span><br />
                  		
               </td>
               <td></td>
               <td><span>
                     							.....
                     						</span><br />
                  		
               </td>
            </tr>
            <tr>
               <td><a id="pl.23.11"></a><var>23.11</var><br />
                  		
               </td>
               <td>Joe Hoppe<br />
                  		
               </td>
               <td></td>
               <td>Greg Davids<br />
                  		
               </td>
            </tr>
            <tr>
               <td><a id="pl.23.12"></a><var>23.12</var><br />
                  		
               </td>
               <td><span>
                     							.....
                     						</span><br />
                  		
               </td>
               <td></td>
               <td><span>
                     							.....
                     						</span><br />
                  		
               </td>
            </tr>
            <tr>
               <td><a id="pl.23.13"></a><var>23.13</var><br />
                  		
               </td>
               <td>Matt Dean<br />
                  		
               </td>
               <td></td>
               <td>Dan Fabian<br />
                  		
               </td>
            </tr>
            <tr>
               <td><a id="pl.23.14"></a><var>23.14</var><br />
                  		
               </td>
               <td><span>
                     							.....
                     						</span><br />
                  		
               </td>
               <td></td>
               <td></td>
            </tr>
            <tr>
               <td><a id="pl.23.15"></a><var>23.15</var><br />
                  		
               </td>
               <td>Laurie Halverson<br />
                  		
               </td>
               <td></td>
               <td></td>
            </tr>
         </table>
      </div>