Minnesota Administrative Rules

4685.3200 WAIVER.

Subpart 1.

Application to the commissioner.

The requirements of Minnesota Statutes, section 62D.10 may be waived or the imposition of necessary underwriting restrictions may be authorized upon a written application to the commissioner stating the grounds for the request.

Subp. 2.

Compliance.

The commissioner shall determine whether or not compliance with the requirement for open enrollment would:

A.

contravene the maximum enrollment limitation of 500,000 enrollees imposed by the act;

B.

prevent a health plan from competing effectively with other health plans or with commercial health insurers for the enrollment of new members or for the retention of current members;

C.

result in a health plan incurring unreasonably high expenses in relation to the value of the benefits or services it provides;

D.

jeopardize the availability or adequacy of a health plan's working capital and any required surpluses or reserves; or

E.

endanger the ability of a health plan to meet its current and future obligations to enrollees.

Subp. 3.

Considerations.

In making this determination the commissioner of health shall:

A.

consider information supplied by a health plan in its application for the waiver or underwriting restrictions;

B.

be permitted access to all health plan records pertinent to such application;

C.

consider prevailing practices and standards relating to the financing and delivery of health care service in the community; and

D.

consider any comments submitted by the commissioner of commerce or any interested party.

Statutory Authority:

MS s 62D.10

History:

L 1983 c 289 s 114 subd 1; L 1984 c 655 art 1 s 92

Published Electronically:

October 11, 2007