Minnesota Session Laws - 1999, Regular Session

                            CHAPTER 181-S.F.No. 841 
                  An act relating to insurance; providing an alternative 
                  benefit plan for small employers; authorizing a small 
                  employer alternative benefit plan pilot project; 
                  modifying certain health plan company requirements; 
                  amending Minnesota Statutes 1998, sections 62L.02, 
                  subdivision 16; 62L.05, subdivision 5, and by adding a 
                  subdivision; 62Q.095, subdivision 1; and 62Q.51, 
                  subdivision 4; proposing coding for new law in 
                  Minnesota Statutes, chapter 62L. 
        BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
           Section 1.  Minnesota Statutes 1998, section 62L.02, 
        subdivision 16, is amended to read: 
           Subd. 16.  [HEALTH CARRIER.] "Health carrier" means an 
        insurance company licensed under chapter 60A to offer, sell, or 
        issue a policy of accident and sickness insurance as defined in 
        section 62A.01; a health service plan corporation licensed under 
        chapter 62C; a health maintenance organization licensed under 
        chapter 62D; a community integrated service network operating 
        under chapter 62N; an accountable provider network regulated 
        under chapter 62T; a fraternal benefit society operating under 
        chapter 64B; a joint self-insurance employee health plan 
        operating under chapter 62H; a multiple employer welfare 
        arrangement, as defined in United States Code, title 29, section 
        1002(40), as amended.  Any use of this definition in another 
        chapter by reference does not include a community integrated 
        service network, unless otherwise specified.  For the purpose of 
        this chapter, companies that are affiliated companies or that 
        are eligible to file a consolidated tax return must be treated 
        as one health carrier, except that any insurance company or 
        health service plan corporation that is an affiliate of a health 
        maintenance organization located in Minnesota, or any health 
        maintenance organization located in Minnesota that is an 
        affiliate of an insurance company or health service plan 
        corporation, or any health maintenance organization that is an 
        affiliate of another health maintenance organization in 
        Minnesota, may treat the health maintenance organization as a 
        separate health carrier. 
           Sec. 2.  Minnesota Statutes 1998, section 62L.05, is 
        amended by adding a subdivision to read: 
           Subd. 4a.  [ALTERNATIVE BENEFIT PLAN.] In addition to the 
        small employer benefit plans described in subdivisions 1 to 4, a 
        health carrier may offer to a small employer a benefit plan that 
        differs from those plans in the following respects: 
           (1) the plan may include different copayments and 
        deductibles; and 
           (2) the plan may offer coverage on a per diem, fixed 
        indemnity, or nonexpense incurred basis. 
           Sec. 3.  Minnesota Statutes 1998, section 62L.05, 
        subdivision 5, is amended to read: 
           Subd. 5.  [PLAN VARIATIONS.] (a) No health carrier shall 
        offer to a small employer a health benefit plan that differs 
        from the two small employer plans described in subdivisions 1 to 
        4 4a, unless the health benefit plan complies with all 
        provisions of chapters 62A, 62C, 62D, 62E, 62H, 62N, and 64B 
        that otherwise apply to the health carrier, except as expressly 
        permitted by paragraph (b). 
           (b) As an exception to paragraph (a), a health benefit plan 
        is deemed to be a small employer plan and to be in compliance 
        with paragraph (a) if it differs from one of the two small 
        employer plans described in subdivisions 1 to 4 only by 
        providing benefits in addition to those described in subdivision 
        4, provided that the health benefit plan has an actuarial value 
        that exceeds the actuarial value of the benefits described in 
        subdivision 4 by no more than two percent.  "Benefits in 
        addition" means additional units of a benefit listed in 
        subdivision 4 or one or more benefits not listed in subdivision 
        4. 
           Sec. 4.  [62L.055] [SMALL EMPLOYER ALTERNATIVE BENEFIT 
        PLANS; PILOT PROJECT.] 
           (a) Notwithstanding any provision of this chapter or other 
        law to the contrary, the commissioner of commerce shall develop 
        a pilot project by January 1, 2000, to authorize health carriers 
        to offer alternative health benefit plans to small employers if 
        the following requirements are satisfied: 
           (1) the health carrier is assessed less than three percent 
        of the total amount assessed by the Minnesota comprehensive 
        health association; 
           (2) the health plans must be offered in compliance with 
        this chapter, except as otherwise permitted in this section; 
           (3) the health plans to be offered must be designed to 
        enable employers and covered persons to better manage costs and 
        coverage options through the use of copays, deductibles, and 
        other cost-sharing arrangements; 
           (4) the health plans must be issued and administered in 
        compliance with sections 62E.141; 62L.03, subdivision 6; and 
        62L.12, subdivisions 3 and 4, relating to prohibitions against 
        enrolling in the Minnesota comprehensive health association 
        persons eligible for employer group coverage; 
           (5) the health plans must meet a 71 percent loss ratio for 
        small employers with fewer than ten employees, and a 75 percent 
        loss ratio for all other plans; 
           (6) the health plans may alter or eliminate coverages that 
        would otherwise be required by law, other than the requirement 
        that care provided for covered services by osteopaths, 
        optometrists, and chiropractors, or registered nurses meeting 
        the requirements of section 62A.15, subdivision 3a, be 
        reimbursed on a nondiscriminatory basis; and 
           (7) each health plan must be approved by the commissioner 
        of commerce. 
           (b) The definitions in section 62L.02 apply to this section 
        as modified by this section. 
           (c) This section expires August 1, 2003. 
           Sec. 5.  Minnesota Statutes 1998, section 62Q.095, 
        subdivision 1, is amended to read: 
           Subdivision 1.  [PROVIDER ACCEPTANCE REQUIRED.] Each health 
        plan company, with the exception of any health plan company with 
        50,000 or fewer enrollees in its commercial health plan products 
        and health plan companies that are exempt under subdivision 6, 
        shall establish an expanded network of allied independent health 
        providers, in addition to a preferred network.  A health plan 
        company shall accept as a provider in the expanded network any 
        allied independent health provider who:  (1) meets the health 
        plan company's credentialing standards; (2) agrees to the terms 
        of the health plan company's provider contract; and (3) agrees 
        to comply with all managed care protocols of the health plan 
        company.  A preferred network shall be considered an expanded 
        network if all allied independent health providers who meet the 
        requirements of clauses (1), (2), and (3) are accepted into the 
        preferred network.  A community integrated service network may 
        offer to its enrollees an expanded network of allied independent 
        health providers as described under this section.  
           Sec. 6.  Minnesota Statutes 1998, section 62Q.51, 
        subdivision 4, is amended to read: 
           Subd. 4.  [EXEMPTION.] This section does not apply to a 
        health plan company with fewer than 50,000 enrollees in its 
        commercial health plan products. 
           Presented to the governor May 15, 1999 
           Signed by the governor May 19, 1999, 4:12 p.m.