SF 2959

as introduced - 86th Legislature (2009 - 2010) Posted on 03/02/2010 07:54am

A bill for an act
relating to human services; establishing a MinnesotaCare defined contribution
program; proposing coding for new law in Minnesota Statutes, chapter 256L.

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

Section 1.

new text begin [256L.031] DEFINED CONTRIBUTION PROGRAM.
new text end

new text begin Subdivision 1. new text end

new text begin Defined contributions to enrollees. new text end

new text begin (a) Beginning January 1,
2011, or upon federal approval, whichever is later, the commissioner shall provide each
MinnesotaCare enrollee eligible under section 256L.04 with gross family income that
exceeds 133 percent of the federal poverty guidelines with a monthly defined contribution
to purchase health coverage under a health plan as defined in section 62A.011, subdivision
3.
new text end

new text begin (b) Enrollees eligible under paragraph (a) are exempt from the insurance barriers
specified in section 256L.07, subdivisions 2 and 3, shall not be charged premiums
under section 256L.15, and are exempt from the managed care enrollment requirement
of section 256L.12.
new text end

new text begin (c) Sections 256L.03 and 256L.05, subdivision 3, do not apply to enrollees eligible
under paragraph (a). Covered services, cost-sharing, and the effective date of coverage for
enrollees eligible under paragraph (a) shall be as provided under the terms of the health
plan purchased by the enrollee.
new text end

new text begin Subd. 2. new text end

new text begin Use of defined contribution. new text end

new text begin An enrollee may use the monthly defined
contribution only to pay premiums for coverage under a health plan as defined in section
62A.011, subdivision 3. The defined contribution may be used to pay the enrollee share of
premiums for a health plan that is offered by an employer.
new text end

new text begin Subd. 3. new text end

new text begin Determination of defined contribution amount. new text end

new text begin (a) The commissioner
shall determine the defined contribution sliding scale using the base contribution specified
in paragraph (b) for the specified age ranges. The commissioner shall use a sliding scale
for defined contributions that provides:
new text end

new text begin (1) persons with household incomes greater than 133 percent but not exceeding
134 percent of the federal poverty guidelines with a defined contribution of 150 percent
of the base contribution;
new text end

new text begin (2) persons with household incomes at 175 percent of the federal poverty guidelines
with a defined contribution of 100 percent of the base contribution;
new text end

new text begin (3) persons with household incomes at 275 percent of the federal poverty guidelines
with a defined contribution of 80 percent of the base contribution; and
new text end

new text begin (4) persons with household incomes in evenly spaced increments between the
percentages of the federal poverty guideline specified in clauses (1) to (3) with a base
contribution that is a percentage extrapolated from the defined contribution percentages
specified in clauses (1) to (3).
new text end

new text begin Age new text end	new text begin Monthly Per-Person Base Contribution new text end
new text begin <18 new text end	new text begin 103.29 new text end
new text begin 18-29 new text end	new text begin 122.79 new text end
new text begin 30-31 new text end	new text begin 129.19 new text end
new text begin 32-33 new text end	new text begin 132.38 new text end
new text begin 34-35 new text end	new text begin 134.31 new text end
new text begin 36-37 new text end	new text begin 136.06 new text end
new text begin 38-39 new text end	new text begin 141.02 new text end
new text begin 40-41 new text end	new text begin 151.25 new text end
new text begin 42-43 new text end	new text begin 159.89 new text end
new text begin 44-45 new text end	new text begin 175.08 new text end
new text begin 46-47 new text end	new text begin 191.71 new text end
new text begin 48-49 new text end	new text begin 213.13 new text end
new text begin 50-51 new text end	new text begin 239.51 new text end
new text begin 52-53 new text end	new text begin 266.69 new text end
new text begin 54-55 new text end	new text begin 293.88 new text end
new text begin 56-57 new text end	new text begin 323.77 new text end
new text begin 58-59 new text end	new text begin 341.20 new text end
new text begin 60+ new text end	new text begin 357.19 new text end

new text begin (b) The commissioner shall multiply the defined contribution percentages developed
under paragraph (a) by 1.20 for enrollees who are denied coverage under an individual
health plan by a health plan company, who do not have access to an employer-sponsored
group plan, and who purchase coverage through the Minnesota Comprehensive Health
Association.
new text end

new text begin Subd. 4. new text end

new text begin Administration by commissioner. new text end

new text begin The commissioner shall administer the
defined contributions. The commissioner shall:
new text end

new text begin (1) calculate and process defined contributions for enrollees; and
new text end

new text begin (2) pay premiums to health plan companies, the Minnesota Comprehensive Health
Association, or employers, as applicable, for enrollee health plan coverage, including
any enrollee share of premiums.
new text end

new text begin Subd. 5. new text end

new text begin Assistance to enrollees. new text end

new text begin The commissioner of human services, in
consultation with the commissioner of commerce, shall develop an efficient and
cost-effective method of referring eligible applicants to professional insurance agent
associations. Professional insurance agent associations are authorized to receive an
appropriate per-member per-month override for each MinnesotaCare enrollee. The agent
or broker shall elect a professional association of choice for each MinnesotaCare enrollee.
Agents and brokers serving MinnesotaCare enrollees shall earn the standard commercial
compensation fees for each policy placed, including MinnesotaCare enrollees receiving
coverage through the Minnesota Comprehensive Health Association.
new text end

new text begin Subd. 6. new text end

new text begin MCHA. new text end

new text begin Beginning January 1, 2011, or upon federal approval, whichever is
later, MinnesotaCare enrollees who are denied coverage under an individual health plan by
a health plan company, and who do not have access to an employer-sponsored group plan,
are eligible for coverage through a health plan offered by the Minnesota Comprehensive
Health Association. Any incremental costs to the Minnesota Comprehensive Health
Association related to implementation of this act shall be paid from the health care access
fund.
new text end

new text begin Subd. 7. new text end

new text begin Federal approval. new text end

new text begin The commissioner shall seek all federal waivers and
approvals necessary to implement this section.
new text end

Sec. 2. new text begin MINNESOTACARE COVERAGE FOR LOWER-INCOME
MINNESOTACARE ENROLLEES.
new text end

new text begin The commissioner of human services shall develop and present to the legislature,
by December 15, 2010, a plan to redesign service delivery for MinnesotaCare enrollees
with incomes less than or equal to 133 percent of the federal poverty guidelines. The
plan must be designed to improve continuity and quality of care, reduce unnecessary
emergency room visits, and reduce average per-enrollee costs. In developing the plan,
the commissioner shall consider innovative methods of service delivery, including but
not limited to increasing the use and choice of private sector health plan coverage and
encouraging the use of community health clinics, as defined in the federal Community
Health Care Act of 1964, as health care homes.
new text end