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Key: (1) language to be deleted (2) new language

  

                         Laws of Minnesota 1990 

                        CHAPTER 404-H.F.No. 1984 
           An act relating to insurance; accident and health; 
          providing for coordination of benefits between group 
          and individual contracts; amending Minnesota Statutes 
          1989 Supplement, section 62A.046. 
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
    Section 1.  Minnesota Statutes 1989 Supplement, section 
62A.046, is amended to read: 
     62A.046 [COORDINATION OF BENEFITS.] 
     (1) No group contract providing coverage for hospital and 
medical treatment or expenses issued or renewed after August 1, 
1984, which is responsible for secondary coverage for services 
provided, may deny coverage or payment of the amount it owes as 
a secondary payor solely on the basis of the failure of another 
group contract, which is responsible for primary coverage, to 
pay for those services.  
     (2) A group contract which provides coverage of a claimant 
as a dependent of a parent who has legal responsibility for the 
dependent's medical care pursuant to a court order under section 
518.171 must make payments directly to the provider of care.  In 
such cases, liability to the insured is satisfied to the extent 
of benefit payments made to the provider.  
     (3) This section applies to an insurer, a vendor of risk 
management services regulated under section 60A.23, a nonprofit 
health service plan corporation regulated under chapter 62C and 
a health maintenance organization regulated under chapter 62D. 
Nothing in this section shall require a secondary payor to pay 
the obligations of the primary payor nor shall it prevent the 
secondary payor from recovering from the primary payor the 
amount of any obligation of the primary payor that the secondary 
payor elects to pay. 
     (4) Payments made by an enrollee or by the commissioner on 
behalf of an enrollee in the children's health plan under 
section 256.936, or a person receiving benefits under chapter 
256B or 256D, for services that are covered by the policy or 
plan of health insurance shall, for purposes of the deductible, 
be treated as if made by the insured. 
    (5) The commissioner of human services shall recover 
payments made by the children's health plan from the responsible 
insurer, for services provided by the children's health plan and 
covered by the policy or plan of health insurance. 
     (6) Insurers, vendors of risk management services, 
nonprofit health service plan corporations, fraternals, and 
health maintenance organizations may coordinate benefits to 
prohibit greater than 100 percent coverage when an insured, 
subscriber, or enrollee is covered by both an individual and a 
group contract providing coverage for hospital and medical 
treatment or expenses.  Benefits coordinated under this 
paragraph must provide for 100 percent coverage of an insured, 
subscriber, or enrollee.  To the extent appropriate, all 
coordination of benefits provisions currently applicable by law 
or rule to insurers, vendors of risk management services, 
nonprofit health service plan corporations, fraternals, and 
health maintenance organizations, shall apply to coordination of 
benefits between individual and group contracts, except that the 
group contract shall always be the primary plan.  This paragraph 
does not apply to specified accident, hospital indemnity, 
specified disease, or other limited benefit insurance policies. 
    Presented to the governor April 3, 1990 
    Signed by the governor April 6, 1990, 10:34 a.m.

Official Publication of the State of Minnesota
Revisor of Statutes