Key: (1) language to be deleted (2) new language
Laws of Minnesota 1983
CHAPTER 263--H.F.No. 314
An act relating to insurance; requiring insurance
agents to maintain trust accounts; requiring certain
disclosures in personal sales contacts; requiring
disclosure of certain limitations on medicare
supplement insurance coverage; prohibiting the sale of
more than two medicare supplement insurance policies
to an individual; requiring copies of medicare
supplement and life insurance applications to be
provided to applicants; requiring applications for
medicare supplement insurance to list health and
accident insurance already maintained by applicant;
providing for continuation and conversion of health
and accident coverage for laid off employees;
providing group coverage for handicapped dependents;
allowing a deductible on certain medicare supplement
insurance coverages; providing rulemaking authority;
imposing civil penalties for certain violations;
providing a criminal penalty; amending Minnesota
Statutes 1982, sections 60A.17, subdivisions 1, 1a,
and 6c, and by adding subdivisions; 62A.17; 62A.31;
62A.39; 62A.42; proposing new law coded in Minnesota
Statutes, chapters 61A and 62A.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
Section 1. Minnesota Statutes 1982, section 60A.17,
subdivision 1, is amended to read:
Subdivision 1. [LICENSE.] (a) [REQUIREMENT.] No person
shall act or assume to act as an insurance agent in the
solicitation or procurement of applications for insurance, nor
in the sale of insurance or policies of insurance, nor in any
manner aid as an insurance agent in the negotiation of insurance
by or with an insurer, including resident agents or reciprocal
or interinsurance exchanges and fraternal beneficiary
associations, until that person shall obtain from the
commissioner a license therefor. The license shall specifically
set forth the name of the person so authorized to act as agent
and the class or classes of insurance for which that person is
authorized to solicit or countersign policies. An insurance
agent may qualify for a license in the following classes: (1)
life and health; and (2) property and casualty.
No insurer shall appoint any natural person, partnership,
or corporation to act as an insurance agent on its behalf until
that natural person, partnership, or corporation obtains a
license as an insurance agent.
(b) [PARTNERSHIPS AND CORPORATIONS.] A license issued to a
partnership or corporation shall be solely in the name of the
entity to which it is issued; provided, that each partner,
director, officer, stockholder, or employee of the licensed
entity who is personally engaged in the solicitation or
negotiation of a policy of insurance on behalf of the licensed
entity shall be personally licensed as an insurance agent.
Upon request by the commissioner, each partnership and
corporation licensed as an insurance agent shall provide the
commissioner with a list of the names of each partner, director,
officer, stockholder, and employee who is required to hold a
valid insurance agent's license.
(c) [TRANSITION.] (1) Any agent who is qualified for life
or accident and health as of June 1, 1981 shall be deemed to
have qualified for a life and health license under Laws 1981,
chapter 307 and been appointed by an insurer which has submitted
a written requisition for a license for that agent as of June 1,
1981.
(2) Any agent who is qualified for one or more lines of
insurance, excluding life or accident and health and farm
property liability as of June 1, 1981 shall be deemed to have
qualified for a property and casualty license under Laws 1981,
chapter 307 and been appointed by any insurer which has
submitted a written requisition for a license for that agent as
of June 1, 1981.
(d) [PENALTIES.] (1) A person who acts or assumes to act as
an insurance agent without a valid license issued by the
commissioner is guilty of a gross misdemeanor.
(2) In addition to any other penalty, the commissioner may,
in the manner prescribed by chapter 14, impose a civil penalty,
not to exceed $500 per violation, on a person who acts or
assumes to act as an insurance agent without a valid license
issued by the commissioner.
Sec. 2. Minnesota Statutes 1982, section 60A.17,
subdivision 1a, is amended to read:
Subd. 1a. [LICENSE APPLICATION.] (a) [PROCEDURE.] An
application for a license to act as an insurance agent shall be
made to the commissioner by the person who seeks to be licensed
and shall be accompanied by a money order or cashier's check
payable to the state treasurer for the amount of the examination
fee prescribed by section 60A.14, subdivision 1, paragraph (c),
clause (8). All examination fees shall be nonrefundable. The
applicant shall have six months from the date of payment of the
examination fee to take the exam. The application for license
shall be accompanied by a written appointment from an admitted
insurer authorizing the applicant to act as its agent under one
or both classes of license. The insurer must also submit its
check payable to the state treasurer for the amount of the
appointment fee prescribed by section 60A.14, subdivision 1,
paragraph (c), clause (9) at the time the agent becomes
licensed. The application and appointment shall be on forms
prescribed by the commissioner.
If the applicant is a natural person, no license shall be
issued until that natural person has become qualified.
If the applicant is a partnership or corporation, no
license shall be issued until at least one natural person who is
a partner, director, officer, stockholder, or employee shall be
licensed as an insurance agent.
(b) [RESIDENT AGENT.] The commissioner shall issue a
resident insurance agent's license to a qualified resident of
this state as follows:
(1) A person may qualify as a resident of this state if
that person resides in this state or the principal place of
business of that person is maintained in this state.
Application for a license claiming residency in this state for
licensing purposes, shall constitute an election of residency in
this state. Any license issued upon an application claiming
residency in this state shall be void if the licensee, while
holding a resident license in this state, also holds, or makes
application for, a resident license in, or thereafter claims to
be a resident of, any other state or jurisdiction or if the
licensee ceases to be a resident of this state; provided,
however, if the applicant is a resident of a community or trade
area, the border of which is contiguous with the state line of
this state, the applicant may qualify for a resident license in
this state and at the same time hold a resident license from the
contiguous state;
(2) The commissioner shall subject each applicant who is a
natural person to a written examination as to the applicant's
competence to act as an insurance agent. The examination shall
be held at a reasonable time and place designated by the
commissioner;
(3) The examination shall be approved for use by the
commissioner and shall test the applicant's knowledge of the
lines of insurance, policies, and transactions to be handled
under the class of license applied for, of the duties and
responsibilities of the licensee, and pertinent insurance laws
of this state;
(4) The examination shall be given only after the applicant
has completed a program of studies in a school, which shall
include a school conducted by an admitted insurer, a
correspondence course given by an admitted insurer, or other
course of study. The course of study shall consist of the
equivalent of 45 hours study for each line for which a license
application is made. After January 1, 1982, the program of
studies or study course shall have been approved by the
commissioner in order to qualify under this clause. If the
applicant has been previously licensed for the particular line
of insurance in the state of Minnesota, the requirement of a
program of studies or a study course shall be waived. A
certification of compliance by an admitted insurer shall
accompany the agent's license application. This program of
studies in a school or a study course shall not apply to farm
property perils and farm liability applicants, or to agents
writing such other lines of insurance as the commissioner may
exempt from examination by order;
(5) The applicant must pass the examination with a grade
determined by the commissioner to indicate satisfactory
knowledge and understanding of the class or classes of insurance
for which the applicant seeks qualification. The commissioner
shall inform the applicant as to whether or not the applicant
has passed;
(6) An applicant who has failed to pass an examination may
take subsequent examinations. Examination fees for subsequent
examinations shall not be waived; and
(7) Any applicant for a license covering the same class or
classes of insurance for which the applicant was licensed under
a similar license in this state, other than a temporary license,
within the three years preceding the date of the application
shall be exempt from the requirement of a written examination,
unless the previous license was revoked or suspended by the
commissioner.
(c) [NONRESIDENT AGENT.] The commissioner shall issue a
nonresident insurance agent's license to a qualified person who
is a resident of another state or country as follows:
(1) A person may qualify for a license under this section
as a nonresident only if that person holds a license in another
state, province of Canada, or other foreign country which, in
the opinion of the commissioner, qualifies that person for the
same activity as that for which a license is sought;
(2) The commissioner shall not issue a license to any
nonresident applicant until that person files with the
commissioner a designation of the commissioner and the
commissioner's successors in office as the applicant's true and
lawful attorney upon whom may be served all lawful process in
any action, suit, or proceeding instituted by or on behalf of
any interested person arising out of the applicant's insurance
business in this state. This designation shall constitute an
agreement that this service of process is of the same legal
force and validity as personal service of process in this state
upon that applicant.
Service of process upon any licensee in any action or
proceeding commenced in any court of competent jurisdiction of
this state may be made by serving the commissioner with
appropriate copies of the process along with payment of the fee
pursuant to section 60A.14, subdivision 1, paragraph (c), clause
(4). The commissioner shall forward a copy of the process by
registered or certified mail to the licensee at the last known
address of record or principal place of business of the
licensee; and
(3) A nonresident license shall terminate automatically
when the resident license for that class of license in the
state, province, or foreign country in which the licensee is a
resident is terminated for any reason.
(d) [DENIAL.] (1) If the commissioner finds that an
applicant for a resident or nonresident license has not fully
met the requirements for licensing, the commissioner shall
refuse to issue the license and shall promptly give written
notice to both the applicant and the appointing insurer of the
denial, stating the grounds for the denial. All fees which
accompanied the application and appointment shall be deemed
earned and shall not be refundable.
(2) The commissioner may also deny issuance of a license
for any cause that would subject the license of a licensee to
suspension or revocation. If a license is denied pursuant to
this clause, the provisions of section 60A.17, subdivision 6c,
paragraph (c) apply.
(3) The applicant may make a written demand upon the
commissioner for a hearing within 30 days of the denial of a
license to determine whether the reasons stated for the denial
were lawful. The hearing shall be held pursuant to chapter 14.
(e) [TERM.] All licenses issued pursuant to this section
shall remain in force until voluntarily terminated by the
licensee or until suspended or revoked by the commissioner. A
voluntary termination shall occur when the license is
surrendered to the commissioner with the request that it be
terminated or when the licensee dies, or when the licensee is
dissolved or its existence is terminated. In the case of a
nonresident license, a voluntary termination shall also occur
upon the happening of the event described in paragraph (c),
clause (3).
Every licensed agent shall notify the commissioner within
30 days of any change in address or change in state of residency.
(f) [SUBSEQUENT APPOINTMENTS.] A person who holds a valid
agent's license from this state may solicit applications for
insurance on behalf of an admitted insurer with which the
licensee does not have a valid appointment on file with the
commissioner; provided, that the licensee has permission from
the insurer to solicit insurance on its behalf and, provided
further, that the insurer upon receipt of the application for
insurance submits a written notice of appointment to the
commissioner accompanied by its check payable to the state
treasurer in the amount of the appointment fee prescribed by
section 60A.14, subdivision 1, paragraph (c), clause (9). The
notice of appointment shall be on a form prescribed by the
commissioner.
(g) [AMENDMENT OF LICENSE.] An application to the
commissioner to amend a license to reflect a change of name, or
to include an additional class of license, or for any other
reason, shall be on forms provided by the commissioner and shall
be accompanied by the applicant's surrendered license and a
money order or cashier's check payable to the state treasurer
for the amount of fee specified in section 60A.14, subdivision
1, paragraph (c), clause (7).
An applicant who surrenders an insurance license pursuant
to this clause retains licensed status until an amended license
is received.
(h) [EXCEPTIONS.] The following are exempt from the general
licensing requirements prescribed by this section:
(1) Agents of township mutuals who are exempted pursuant to
subdivision 1b;
(2) Fraternal beneficiary association representatives
exempted pursuant to subdivision 1c;
(3) Any regular salaried officer or employee of a licensed
insurer, without license or other qualification, may act on
behalf of that licensed insurer in the negotiation of insurance
for that insurer; provided that a licensed agent must
participate in the sale of any such insurance;
(4) Employers and their officers or employees, and the
trustees or employees of any trust plan, to the extent that the
employers, officers, employees, or trustees are engaged in the
administration or operation of any program of employee benefits
for the employees of the employers or employees of their
subsidiaries or affiliates involving the use of insurance issued
by a licensed insurance company; provided, that the activities
of the officers, employees and trustees are incidental to
clerical or administrative duties and their compensation does
not vary with the volume of insurance or applications therefor;
(5) Employees of a creditor who enroll debtors for life or
accident and health insurance; provided the employees receive no
commission or fee therefor; and
(6) Clerical or administrative employees of an insurance
agent who take insurance applications or receive premiums in the
office of their employer, if the activities are incidental to
clerical or administrative duties and the employee's
compensation does not vary with the volume of the applications
or premiums.
Sec. 3. Minnesota Statutes 1982, section 60A.17,
subdivision 6c, is amended to read:
Subd. 6c. [REVOCATION OR SUSPENSION OF LICENSE.] (a) The
commissioner may suspend or revoke an insurance agent's license
issued to a natural person or impose a civil penalty appropriate
to the offense, not to exceed $5,000 upon that licensee, or
both, if, after notice and hearing, the commissioner finds as to
that licensee any one or more of the following conditions:
(1) any materially untrue statement in the license
application;
(2) any cause for which issuance of the license could have
been refused had it then existed and been known to the
commissioner at the time of issuance;
(3) violation of, or noncompliance with, any insurance law
or violation of any rule or order of the commissioner or of a
commissioner of insurance of another state or jurisdiction;
(4) obtaining or attempting to obtain any license through
misrepresentation or fraud;
(5) improperly withholding, misappropriating, or converting
to the licensee's own use any moneys belonging to a
policyholder, insurer, beneficiary, or other person, received by
the licensee in the course of the licensee's insurance business;
(6) misrepresentation of the terms of any actual or
proposed insurance contract;
(7) conviction of a felony or of a gross misdemeanor or
misdemeanor involving moral turpitude;
(8) that the licensee has been found guilty of any unfair
trade practice, as defined in chapters 60A to 72A, or of fraud;
(9) that in the conduct of the agent's affairs under the
license, the licensee has used fraudulent, coercive, or
dishonest practices, or the licensee has been shown to be
incompetent, untrustworthy, or financially irresponsible;
(10) that the agent's license has been suspended or revoked
in any other state, province, district, territory, or foreign
country;
(11) that the licensee has forged another's name to an
application for insurance; or
(12) that the licensee has violated subdivision 6b.
(b) The commissioner may suspend or revoke an insurance
agent's license issued to a partnership or corporation or impose
a civil penalty not to exceed $5,000 upon that licensee, or
both, if, after notice and hearing, the commissioner finds as to
that licensee, or as to any partner, director, shareholder,
officer, or employee of that licensee, any one or more of the
conditions set forth in paragraph (a).
(c) A revocation of a license shall prohibit the licensee
from making a new application for a license for at least one
year. Further, the commissioner may, as a condition of
relicensure, require the applicant to file a reasonable bond for
the protection of the citizens of this state, which bond shall
be maintained by the licensee in full force for a period of five
years immediately following issuance of the license, unless the
commissioner at his or her discretion shall after two years
permit the licensee to sooner terminate the maintenance filing
of the bond.
(d) Whenever it appears to the commissioner that any person
has engaged or is about to engage in any act or practice
constituting a violation of chapter 60A or of any rule or order
of the commissioner:
(1) The commissioner may issue and cause to be served upon
the person an order requiring the person to cease and desist
from the violation. The order shall give reasonable notice of
the time and place of hearing and shall state the reasons for
the entry of the order. A hearing shall be held not later than
seven days after the issuance of the order unless the person
requests a delay. After the hearing and within 30 days of
filing of any exceptions to the hearing examiner's report, the
commissioner shall issue an order vacating the cease and desist
order or making it permanent as the facts require. All hearings
shall be conducted in accordance with the provisions of chapter
14. If the person to whom a cease and desist order is issued
fails to appear at the hearing after being duly notified, the
person shall be deemed in default, and the proceeding may be
determined against the person upon consideration of the cease
and desist order, the allegations of which may be deemed to be
true;
(2) The commissioner may bring an action in the district
court in the appropriate county to enjoin the acts or practices
and to enforce compliance with chapter 60A and any rule or order
of the commissioner; and
(3) In any proceeding under chapter 60A relating to
injunction, the request for injunction may be brought on for
hearing and disposition upon an order to show cause returnable
upon not more than eight days notice to the defendant. The case
shall have precedence over other matters on the court calendar
and shall not be continued without the consent of the state of
Minnesota, except upon good cause shown to the court, and then
only for a reasonable length of time as may be necessary in the
opinion of the court to protect the rights of the defendant.
(e) The commissioner may, in the manner prescribed by
chapter 14, impose a civil penalty not to exceed $5,000 upon a
person whose licensed has lapsed, or been suspended, revoked, or
otherwise terminated, for engaging in conduct prohibited by
paragraph (a) before, during, or after the period of his or her
licensure.
Sec. 4. Minnesota Statutes 1982, section 60A.17, is
amended by adding a subdivision to read:
Subd. 17. [PREMIUMS.] All premiums or other monies
received by an agent from an insured or applicant for insurance
must be forthwith deposited directly in a business checking,
savings, or other similar account maintained by the agent or his
agency, unless the moneys are forwarded directly to the
designated insurer.
Sec. 5. Minnesota Statutes 1982, section 60A.17, is
amended by adding a subdivision to read:
Subd. 18. [PERSONAL SOLICITATION OF INSURANCE SALES.] (a)
[DEFINITIONS.] For the purposes of this subdivision, the
following terms have the meanings given them:
(1) "agent" means a person, copartnership, or corporation
required to be licensed pursuant to subdivision 1.
(2) "personal solicitation" means any contact by an agent,
or any person acting on behalf of an agent, made for the purpose
of selling or attempting to sell insurance, when either the
agent or a person acting for the agent contacts the buyer by
telephone or in person, except: an attempted sale in which the
buyer personally knows the identity of the agent, the name of
the general agency, if any, which he or she represents, and the
fact that the agent is an insurance agent; an attempted sale in
which the prospective purchaser of insurance initiated the
contact; or a personal contact which takes place at the agent's
place of business.
(b) [DISCLOSURE REQUIREMENT.] Before a personal
solicitation, the agent or person acting for an agent shall, at
the time of initial personal contact or communication with the
potential buyer, clearly and expressly disclose:
(1) the name of the person making the contact or
communication;
(2) the name of the agent, general agency, or insurer he or
she represents;
(3) the fact that the agent, agency, or insurer is in the
business of selling insurance.
(c) [FALSE REPRESENTATION OF GOVERNMENT AFFILIATION.] No
agent or person acting for an agent shall make any communication
to a potential buyer that indicates or gives the impression that
the agent is acting on behalf of a government agency.
Sec. 6. Minnesota Statutes 1982, section 60A.17, is
amended by adding a subdivision to read:
Subd. 19. [PRIVACY OF CLIENT.] Except as otherwise
provided by law, no insurance agent may disclose nor cause to be
disclosed to any other person the identity of a person insured
through the agent without the consent of the insured.
Sec. 7. [61A.071] [APPLICATIONS.]
No individual life insurance policy, except mass marketed
life insurance as defined in section 72A.13, subdivision 2,
shall be issued or delivered in this state to a person age 65 or
older unless a signed and completed copy of the application for
insurance is left with the applicant at the time application is
made.
Sec. 8. [62A.141] [COVERAGE FOR HANDICAPPED DEPENDENTS.]
No group policy or plan of health and accident insurance
regulated under this chapter, chapter 62C, or chapter 62D, which
provides for dependent coverage may be issued or renewed in this
state after August 1, 1983, unless it covers the handicapped
dependents of the insured, subscriber, or enrollee of the policy
or plan.
Sec. 9. Minnesota Statutes 1982, section 62A.17, is
amended to read:
62A.17 [TERMINATION OF OR LAY OFF FROM EMPLOYMENT.]
Subdivision 1. [CONTINUATION OF COVERAGE.] Every group
insurance policy, group subscriber contract, and health care
plan included within the provisions of section 62A.16, except
policies, contracts, or health care plans covering employees of
an agency of the federal government, shall contain a provision
which permits every eligible employee whose employment who is
terminated or laid off from his employment, if the policy,
contract, or health care plan remains in force for active
employees of the employer, to elect to continue the coverage for
himself and his dependents.
Subd. 2. [RESPONSIBILITY OF EMPLOYEE.] Every eligible
employee electing to continue coverage shall pay his former
employer, on a monthly basis, the cost of the continued
coverage. If the policy, contract, or health care plan is
administered by a trust, every eligible employee electing to
continue coverage shall pay the trust the cost of continued
coverage according to the eligibility rules established by the
trust. The employee shall be eligible to continue the coverage
until he becomes re-employed and eligible for health care
coverage under a group policy, contract, or plan sponsored by
the same or another employer, or for a period of six 12 months
after the termination of or lay off from employment, whichever
is shorter.
Subd. 3. [ELIGIBILITY FOR CONTINUED COVERAGE.] An employee
shall be eligible to make the election for himself and his
dependents provided for in subdivision 1 if:
(a) In the period preceding the termination of or lay off
from his employment, he and his dependents were covered through
his employment by a group insurance policy, subscriber's
contract, or health care plan included within the provisions of
section 62A.16;
(b) The termination of or lay off from employment was for
reasons other than the discontinuance of the business,
bankruptcy, or the employee's disability or retirement.
Subd. 4. [RESPONSIBILITY OF EMPLOYER.] After timely
receipt of the monthly payment from an eligible employee, if the
employer, or the trustee, if the policy, contract, or health
care plan is administered by a trust, fails to make the payment
to the insurer, the nonprofit health service plan corporation,
or the health maintenance organization, with the result that the
employee's coverage is terminated, the employer or the trust
shall become liable for the employee's coverage to the same
extent as the insurer, the nonprofit health service plan
corporation, or the health maintenance organization, would be if
the coverage were still in effect.
Subd. 5. [NOTICE OF OPTIONS.] Upon the termination of or
lay off from employment of an eligible employee, the employer
shall inform the employee within ten days after termination or
lay off of:
(a) his right to elect to continue the coverage;
(b) the amount he must pay monthly to the employer to
retain the coverage;
(c) the manner in which and the office of the employer to
which the payment to the employer must be made; and
(d) the time by which the payments to the employer must be
made to retain coverage.
If the policy, contract, or health care plan is
administered by a trust, the terminating employer is relieved of
the obligation imposed by clauses (a) to (d). The trust shall
inform the employee of the information required by clauses (a)
to (d).
Notice may be in writing and sent by first class mail to
the employee's last known address which the employee has
provided the employer or trust. If the employer or trust fails
to so notify the employee who is properly enrolled in the
program, the employee shall have the option to retain coverage
provided if he makes this election within 60 days of the date
his employment he is terminated or laid off by making the proper
payment to the employer or trust to provide continuous coverage.
A notice in substantially the following form shall be
sufficient. As a terminated or laid off employee, the law
authorizes you to maintain your group medical insurance for a
period of up to six 12 months. To do so you must notify your
former employer within ten days of this notice that you intend
to retain such this coverage and must make a monthly payment of
$.......... to ........... at .......... by the ...............
of each month.
Subd. 6. [CONVERSION TO INDIVIDUAL POLICY.] A group
insurance policy that provides post termination or lay off
coverage as required by this section shall also include a
provision allowing a covered employee or, surviving spouse, or
dependent at the expiration of the post termination or lay off
coverage provided by subdivision 2 to obtain from the insurer
offering the group policy or group subscriber contract, at the
employee's, spouse's, or dependent's option and expense, without
further evidence of insurability and without interruption of
coverage, an individual policy of insurance or an individual
subscriber contract providing at least the minimum benefits of a
qualified plan as prescribed by section 62E.06 and the option of
a number three qualified plan, a number two qualified plan, and
a number one qualified plan as provided by section 62E.06,
subdivisions 1 to 3. A policy providing reduced benefits at a
reduced premium rate may be accepted by the employee, the spouse
, or a dependent in lieu of the optional coverage otherwise
required by this subdivision.
The individual policy shall be renewable at the option of
the individual as long as the individual is not covered under
another qualified plan as defined in section 62E.02, subdivision
4, up to age 65 or to the day before the date of eligibility for
coverage under title XVIII of the Social Security Act, as
amended. Any revisions in the table of rate for the individual
policy shall apply to the covered person's original age at entry
, and shall apply equally to all similar policies issued by the
insurer.
Sec. 10. Minnesota Statutes 1982, section 62A.31, is
amended to read:
Subdivision 1. [POLICY REQUIREMENTS.] No individual or
group policy, certificate, subscriber contract or other evidence
of accident and health insurance issued or delivered in this
state shall be sold or issued to an individual age 65 or older
covered by medicare unless the following requirements are met:
(a) The policy must provide a minimum of the coverage set
out in subdivision 2;
(b) The policy must cover pre-existing conditions during
the first six months of coverage if the insured was not
diagnosed or treated for the particular condition during the 90
days immediately preceding the effective date of coverage;
(c) The policy must contain a provision that the plan will
not be canceled or nonrenewed on the grounds of the
deterioration of health of the insured; and
(d) An outline of coverage as provided in section 62A.39
must be delivered at the time of application and prior to
payment of any premium.
The requirements of sections 62A.31 to 62A.42 62A.44 shall
not apply to disability income protection insurance policies or
group policies of accident and health insurance which do not
purport to supplement medicare issued to any of the following
groups:
(a) A policy issued to an employer or employers or to the
trustee of a fund established by an employer where only
employees or retirees, and dependents of employees or retirees,
are eligible for coverage.
(b) A policy issued to a labor union or similar employee
organization.
(c) A policy issued to an association, a trust or the
trustee of a fund established, created or maintained for the
benefit of members of one or more associations. The association
or associations shall have at the outset a minimum of 100
persons; shall have been organized and maintained in good faith
for purposes other than that of obtaining insurance; shall have
a constitution and by-laws which provide that (1) the
association or associations hold regular meetings not less
frequently than annually to further purposes of the members, (2)
except for credit unions, the association or associations
collect dues or solicit contributions from members, and (3) the
members have voting privileges and representation on the
governing board and committees.
Subd. 2. [GENERAL COVERAGE.] For a policy to meet the
requirements of this section it must contain (1) a designation
specifying whether the policy is a medicare supplement 1+, 1, 2,
or 3, (2) a caption stating that the commissioner has
established four categories of medicare supplement insurance and
minimum standards for each, with medicare supplement 1+ being
the most comprehensive and medicare supplement 3 being the least
comprehensive, and (3) the policy must provide the minimum
coverage prescribed in sections 62A.32 to 62A.35 for the
supplement specified, provided that an annual deductible of not
more than $200 is permissible for those covered charges not paid
by medicare or otherwise included in paragraph (f) of sections
62A.32 and 62A.33.
Sec. 11. Minnesota Statutes 1982, section 62A.39, is
amended to read:
62A.39 [DISCLOSURE.]
No individual medicare supplement plan shall be delivered
or issued in this state and no certificate shall be delivered
pursuant to a group medicare supplement plan delivered or issued
in this state unless an outline containing at least the
following information is delivered to the applicant at the time
the application is made:
(a) A description of the principal benefits and coverage
provided in the policy;
(b) A statement of the exceptions, reductions, and
limitations contained in the policy including the following
language, as applicable, in bold print: "THIS POLICY DOES NOT
COVER ALL MEDICAL EXPENSES BEYOND THOSE COVERED BY MEDICARE.
THIS POLICY DOES NOT COVER ALL SKILLED NURSING HOME CARE
EXPENSES AND DOES NOT COVER CUSTODIAL OR RESIDENTIAL NURSING
CARE. READ YOUR POLICY CAREFULLY TO DETERMINE WHICH NURSING
HOME FACILITIES AND EXPENSES ARE COVERED BY YOUR POLICY.";
(c) A statement of the renewal provisions including any
reservations by the insurer of a right to change premiums;
(d) A statement that the outline of coverage is a summary
of the policy issued or applied for and that the policy should
be consulted to determine governing contractual provisions; and
(e) A statement of the policy's loss ratio as follows:
"This policy provides an anticipated loss ratio of [..%]. This
means that, on the average, policyholders may expect that
[$....] of every $100.00 in premium will be returned as benefits
to policyholders over the life of the contract.".
Sec. 12. Minnesota Statutes 1982, section 62A.42, is
amended to read:
62A.42 [RULEMAKING AUTHORITY.]
To carry out the purposes of sections 62A.31 to 62A.42
62A.44, the commissioner may promulgate rules pursuant to
chapter 14. These rules may:
(a) prescribe additional disclosure requirements for
medicare supplement plans, designed to adequately inform the
prospective insured of the need and extent of coverage offered;
(b) prescribe uniform policy forms in order to give the
insurance purchaser a reasonable opportunity to compare the cost
of insuring with various insurers; and
(c) establish other reasonable standards to further the
purpose of sections 62A.31 to 62A.42 62A.44.
Sec. 13. [62A.43] [LIMITATIONS ON SALES.]
Subdivision 1. [DUPLICATE COVERAGE PROHIBITED.] No agent
shall sell a medicare supplement plan, as defined in section
62A.31, to a person who currently has one plan in effect;
however, an agent may sell a replacement plan in accordance with
section 62A.40, provided that the second plan is not made
effective any sooner than necessary to provide continuous
benefits for preexisting conditions. Every application for
medicare supplement insurance shall require a listing of all
health and accident insurance maintained by the applicant as of
the date the application is taken.
Subd. 2. [REFUNDS.] Notwithstanding the provisions of
section 62A.38, an insurer which issues a medicare supplement
plan to any person who has one plan then in effect, except as
permitted in subdivision 1, shall, at the request of the
insured, either refund the premiums or pay any claims on the
policy, whichever is greater.
Subd. 3. [ACTION BY COMMISSIONER.] If the commissioner
determines after an investigation that an insurer has issued a
medicare supplement plan to a person who already has one plan,
except as permitted in subdivision 1, the commissioner shall
notify the insurer in writing of his or her determination. If
the insurer thereafter fails to take reasonable action to
prevent overselling, the commissioner may, in the manner
prescribed in chapter 14, revoke or suspend the insurer's
authority to sell accident and health insurance in this state or
impose a civil penalty not to exceed $10,000, or both.
Sec. 14. [62A.44] [APPLICATIONS.]
No individual medicare supplement plan shall be issued or
delivered in this state unless a signed and completed copy of
the application for insurance is left with the applicant at the
time application is made.
Approved June 6, 1983
Official Publication of the State of Minnesota
Revisor of Statutes