SF 1925

as introduced - 81st Legislature (1999 - 2000) Posted on 12/15/2009 12:00am

  1.1                          A bill for an act 
  1.2             relating to state government; requiring the 
  1.3             commissioner of employee relations to conform to 
  1.4             consumer protection and benefit mandates; requiring 
  1.5             reports; amending Minnesota Statutes 1998, sections 
  1.6             43A.22; 43A.23, subdivisions 1 and 2; and 43A.31, 
  1.7             subdivision 2, and by adding a subdivision. 
  1.8   BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
  1.9      Section 1.  Minnesota Statutes 1998, section 43A.22, is 
  1.10  amended to read: 
  1.11     43A.22 [BENEFITS; INTENT.] 
  1.12     It is the intent of the state to provide eligible employees 
  1.13  and other eligible persons with life insurance and hospital, 
  1.14  medical, and dental benefits coverage through provider 
  1.15  organizations, hereafter referred to as "carriers," authorized 
  1.16  to do business in the state.  
  1.17     The commissioner may self-insure any hospital and medical 
  1.18  plan offered under sections 43A.22 to 43A.31 to promote 
  1.19  reasonably stable and predictable premiums for hospital and 
  1.20  medical benefits paid by the state and its employees and to 
  1.21  promote affordable, ongoing relationships between employees and 
  1.22  dependents and their medical providers.  The commissioner shall 
  1.23  consult with the commissioners of commerce and health and human 
  1.24  services regarding the development and reporting of quality of 
  1.25  care measures. 
  1.26     Sec. 2.  Minnesota Statutes 1998, section 43A.23, 
  2.1   subdivision 1, is amended to read: 
  2.2      Subdivision 1.  [GENERAL.] The commissioner is authorized 
  2.3   to request bids from carriers or to negotiate with carriers and 
  2.4   to enter into contracts with carriers which in the judgment of 
  2.5   the commissioner are best qualified to underwrite and service 
  2.6   the benefit plans.  Contracts entered into with carriers are not 
  2.7   subject to the requirements of sections 16C.16 to 16C.19.  The 
  2.8   commissioner may negotiate premium rates and coverage provisions 
  2.9   with all carriers licensed under chapters 62A, 62C, and 62D.  
  2.10  The commissioner may also negotiate reasonable restrictions to 
  2.11  be applied to all carriers under chapters 62A, 62C, and 62D.  
  2.12  Contracts to underwrite the benefit plans must be bid or 
  2.13  negotiated separately from contracts to service the benefit 
  2.14  plans, which may be awarded only on the basis of competitive 
  2.15  bids.  The commissioner shall consider the cost of the plans, 
  2.16  conversion options relating to the contracts, service 
  2.17  capabilities, character, financial position, and reputation of 
  2.18  the carriers, and any other factors which the commissioner deems 
  2.19  appropriate.  Each benefit contract must be for a uniform term 
  2.20  of at least one year, but may be made automatically renewable 
  2.21  from term to term in the absence of notice of termination by 
  2.22  either party.  The commissioner shall, to the extent feasible, 
  2.23  make hospital and medical benefits available from at least one 
  2.24  carrier licensed to do business pursuant to each of chapters 
  2.25  62A, 62C, and 62D.  The commissioner need not provide health 
  2.26  maintenance organization services to an employee who resides in 
  2.27  an area which is not served by a licensed health maintenance 
  2.28  organization.  The commissioner may refuse to allow a health 
  2.29  maintenance organization to continue as a carrier.  The 
  2.30  commissioner may elect not to offer all three types of carriers 
  2.31  if there are no bids or no acceptable bids by that type of 
  2.32  carrier or if the offering of additional carriers would result 
  2.33  in substantial additional administrative costs.  A carrier 
  2.34  licensed under chapter 62A is exempt from the tax imposed by 
  2.35  section 60A.15 on premiums paid to it by the state. 
  2.36     All self-insured hospital and medical service products must 
  3.1   comply with coverage mandates, data reporting, and consumer 
  3.2   protection requirements applicable to the licensed carrier 
  3.3   administering the product, had the product been insured, 
  3.4   including chapters 62J, 62M, and 62Q.  Any self-insured products 
  3.5   that limit coverage to a network of providers or provide 
  3.6   different levels of coverage between network and non-network 
  3.7   providers shall comply with section 62D.123 and geographic 
  3.8   access standards for health maintenance organizations adopted by 
  3.9   the commissioner of health in rule under chapter 62D. 
  3.10     Sec. 3.  Minnesota Statutes 1998, section 43A.23, 
  3.11  subdivision 2, is amended to read: 
  3.12     Subd. 2.  [CONTRACT TO CONTAIN STATEMENT OF BENEFITS.] Each 
  3.13  contract under sections 43A.22 to 43A.30 shall contain a 
  3.14  detailed statement of benefits offered and shall include any 
  3.15  maximums, limitations, exclusions, and other definitions of 
  3.16  benefits the commissioner deems necessary or desirable.  Each 
  3.17  hospital and medical benefits contract shall provide benefits at 
  3.18  least equal to those required by section 62E.06, subdivision 2.  
  3.19     All summaries of benefits describing the hospital and 
  3.20  medical service benefits offered to state employees must comply 
  3.21  with laws and rules for content and clarity applicable to the 
  3.22  licensed carrier administering the product.  Referral procedures 
  3.23  must be clearly described.  The commissioners of commerce and 
  3.24  health, as appropriate, shall review the summaries of benefits, 
  3.25  whether written or electronic, and advise the commissioner of 
  3.26  employee relations on any changes needed to ensure compliance. 
  3.27     Sec. 4.  Minnesota Statutes 1998, section 43A.31, 
  3.28  subdivision 2, is amended to read: 
  3.29     Subd. 2.  [COMMISSIONER REPORTS.] The commissioner shall 
  3.30  transmit a report each biennium to the legislative commission on 
  3.31  employee relations concerning the operation of sections 43A.22 
  3.32  to 43A.30, including a study of local and statewide market 
  3.33  trends regarding provider concentration, costs, and other 
  3.34  factors as they may relate to the state's health benefits 
  3.35  purchasing strategy.  The commissioner shall consult with the 
  3.36  commissioners of commerce and health in the conduct of this 
  4.1   study.  The commissioner shall also report the number, type, and 
  4.2   disposition of complaints relating to the insurance programs 
  4.3   offered by the commissioner.  
  4.4      Sec. 5.  Minnesota Statutes 1998, section 43A.31, is 
  4.5   amended by adding a subdivision to read: 
  4.6      Subd. 4.  [CUSTOMER ASSISTANCE.] The commissioner shall 
  4.7   employ staff for the purposes of assisting state employees and 
  4.8   their dependents in: 
  4.9      (1) understanding their benefits and coverage levels; 
  4.10     (2) obtaining information and responses to questions 
  4.11  regarding issues of coverage, benefits, and service from 
  4.12  carriers and providers; and 
  4.13     (3) making use of all grievance, appeals, and complaint 
  4.14  resolution processes provided by law or contract.