SF 2684

as introduced - 91st Legislature (2019 - 2020) Posted on 03/27/2019 08:35am

A bill for an act
relating to commerce; allowing for sale of short-term care policies; amending
Minnesota Statutes 2018, section 62A.011, subdivision 3; proposing coding for
new law in Minnesota Statutes, chapter 62A.

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

Section 1.

Minnesota Statutes 2018, section 62A.011, subdivision 3, is amended to read:

Subd. 3.

Health plan.

"Health plan" means a policy or certificate of accident and sickness
insurance as defined in section 62A.01 offered by an insurance company licensed under
chapter 60A; a subscriber contract or certificate offered by a nonprofit health service plan
corporation operating under chapter 62C; a health maintenance contract or certificate offered
by a health maintenance organization operating under chapter 62D; a health benefit certificate
offered by a fraternal benefit society operating under chapter 64B; or health coverage offered
by a joint self-insurance employee health plan operating under chapter 62H. Health plan
means individual and group coverage, unless otherwise specified. Health plan does not
include coverage that is:

(1) limited to disability or income protection coverage;

(2) automobile medical payment coverage;

(3) liability insurance, including general liability insurance and automobile liability
insurance, or coverage issued as a supplement to liability insurance;

(4) designed solely to provide payments on a per diem, fixed indemnity, or
non-expense-incurred basis, including coverage only for a specified disease or illness or
hospital indemnity or other fixed indemnity insurance, if the benefits are provided under a
separate policy, certificate, or contract for insurance; there is no coordination between the
provision of benefits and any exclusion of benefits under any group health plan maintained
by the same plan sponsor; and the benefits are paid with respect to an event without regard
to whether benefits are provided with respect to such an event under any group health plan
maintained by the same plan sponsor;

(5) credit accident and health insurance as defined in section 62B.02;

(6) designed solely to provide hearing, dental, or vision care;

(7) blanket accident and sickness insurance as defined in section 62A.11;

(8) accident-only coverage;

(9) a long-term care policy as defined in section 62A.46 or 62S.01 new text begin or a short-term care
policy as defined in section 62A.58 new text end ;

(10) issued as a supplement to Medicare, as defined in sections 62A.3099 to 62A.44, or
policies, contracts, or certificates that supplement Medicare issued by health maintenance
organizations or those policies, contracts, or certificates governed by section 1833 or 1876,
section 1851, et seq.; or section 1860D-1, et seq., of title XVIII of the federal Social Security
Act, et seq., as amended;

(11) workers' compensation insurance;

(12) issued solely as a companion to a health maintenance contract as described in section
62D.12, subdivision 1a, so long as the health maintenance contract meets the definition of
a health plan;

(13) coverage for on-site medical clinics; or

(14) coverage supplemental to the coverage provided under United States Code, title
10, chapter 55, Civilian Health and Medical Program of the Uniformed Services
(CHAMPUS).

Sec. 2.

new text begin [62A.58] SHORT-TERM CARE POLICY.
new text end

new text begin Subdivision 1. new text end

new text begin Definitions. new text end

new text begin As used in this section, "short-term care policy" means any
individual policy delivered or issued for delivery to any resident of Minnesota that is designed
to provide, within the terms and conditions of the policy, benefits on an expense-incurred,
indemnity, or prepaid basis for necessary care or treatment of an injury, illness, or loss of
functional capacity provided by a certified or licensed health care provider in a setting other
than an acute care hospital for a period not exceeding 300 days. A short-term care policy
must provide benefits for confinement in a nursing home, an insured's own home, or both.
Short-term care policy does not include any policy that is offered primarily to provide
coverage described in section 62A.011, subdivision 3, clauses (1) to (8) or (10) to (14).
new text end

new text begin Subd. 2. new text end

new text begin Filing required. new text end

new text begin (a) A short-term care policy, including any application, rider,
or endorsement used in connection with the policy, must not be delivered or issued for
delivery to any resident in Minnesota until a copy of the form, the classification of risks,
and the premium rates have been filed with the commissioner.
new text end

new text begin (b) The commissioner must disapprove the use of a form at any time if the form does
not conform to the requirements of law, or if the form contains a provision or provisions
that are unfair or deceptive or encourage misrepresentation of the policy. If the commissioner
disapproves a form, the commissioner must (1) provide written notification to the insurer
that filed the form that the commissioner has disapproved the form and specify the reasons
for the disapproval, and (2) order that an insurer must not deliver or issue for delivery to
any person in Minnesota a policy on or containing a disapproved form.
new text end

new text begin Subd. 3. new text end

new text begin Rates. new text end

new text begin A rate filed under the provisions of subdivision 2 is not effective until
the rate has been approved by the commissioner.
new text end

new text begin Subd. 4. new text end

new text begin Disclosure. new text end

new text begin (a) An insurer must not deliver or issue for delivery any short-term
care policy without providing, at the time the purchase or sale of coverage is solicited or
applied for, full and fair written disclosure of the policy's benefits and limitations.
new text end

new text begin (b) At the time an applicant applies for a policy, the applicant must sign an
acknowledgment that the insurer has provided to the applicant the written disclosure required
under this subdivision. If the method of application does not allow for the required signature
at the time the application is submitted, the applicant must sign the acknowledgment no
later than the time the policy is delivered.
new text end

new text begin (c) Except for a short-term care policy for which no applicable premium rate revision
or rate schedule increases can be made, a disclosure under this subdivision must include:
new text end

new text begin (1) a statement in at least 12-point bold-face type that the policy does not provide
long-term care insurance coverage and is not a long-term care insurance policy;
new text end

new text begin (2) a statement that the policy may be subject to rate increases in the future;
new text end

new text begin (3) an explanation of potential future premium rate revisions and the policyholder's
option in the event of a premium rate revision; and
new text end

new text begin (4) the premium rate or rate schedule that applies to the applicant and is effective until
a company, society, corporation, or center files a request with the commissioner to revise
the premium rate or rate schedule.
new text end

new text begin (d) The commissioner must make rules to implement this section. Rules adopted under
this section must include but are not limited to: (1) the permissible loss ratio for a short-term
care policy, if any; (2) the permissible exclusionary periods for coverage under a short-term
care policy, if any; (3) the circumstances under which a short-term care policy is renewable;
and (4) the benefits payable under a short-term care policy in relation to other insurance
coverage that provides benefits to the insured.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2020.
new text end