2007 Minnesota Statutes

43A.23 CONTRACTING AUTHORITY.
    Subdivision 1. General. (a) The commissioner is authorized to request proposals or to
negotiate and to enter into contracts with parties which in the judgment of the commissioner are
best qualified to provide service to the benefit plans. Contracts entered into are not subject to the
requirements of sections 16C.16 to 16C.19. The commissioner may negotiate premium rates and
coverage. The commissioner shall consider the cost of the plans, conversion options relating to
the contracts, service capabilities, character, financial position, and reputation of the carriers, and
any other factors which the commissioner deems appropriate. Each benefit contract must be for a
uniform term of at least one year, but may be made automatically renewable from term to term
in the absence of notice of termination by either party. A carrier licensed under chapter 62A is
exempt from the taxes imposed by chapter 297I on premiums paid to it by the state.
    (b) All self-insured hospital and medical service products must comply with coverage
mandates, data reporting, and consumer protection requirements applicable to the licensed carrier
administering the product, had the product been insured, including chapters 62J, 62M, and 62Q.
Any self-insured products that limit coverage to a network of providers or provide different levels
of coverage between network and nonnetwork providers shall comply with section 62D.123 and
geographic access standards for health maintenance organizations adopted by the commissioner
of health in rule under chapter 62D.
    (c) Notwithstanding paragraph (b), a self-insured hospital and medical product offered
under sections 43A.22 to 43A.30 is not required to extend dependent coverage to an eligible
employee's unmarried child under the age of 25 to the full extent required under chapters 62A
and 62L. Dependent coverage must, at a minimum, extend to an eligible employee's unmarried
child who is under the age of 19 or an unmarried child under the age of 25 who is a full-time
student. The definition of "full-time student" for purposes of this paragraph includes any student
who by reason of illness, injury, or physical or mental disability as documented by a physician is
unable to carry what the educational institution considers a full-time course load so long as the
student's course load is at least 60 percent of what otherwise is considered by the institution to be
a full-time course load. Any notice regarding termination of coverage due to attainment of the
limiting age must include information about this definition of "full-time student."
    Subd. 2. Contract to contain statement of benefits. (a) Each contract under sections
43A.22 to 43A.30 shall contain a detailed statement of benefits offered and shall include any
maximums, limitations, exclusions, and other definitions of benefits the commissioner deems
necessary or desirable. Each hospital and medical benefits contract shall provide benefits at least
equal to those required by section 62E.06, subdivision 2.
(b) All summaries of benefits describing the hospital and medical service benefits offered
to state employees must comply with laws and rules for content and clarity applicable to the
licensed carrier administering the product. Referral procedures must be clearly described. The
commissioners of commerce and health, as appropriate, shall review the summaries of benefits,
whether written or electronic, and advise the commissioner of employee relations on any changes
needed to ensure compliance.
    Subd. 3. Contract with insurance carriers. The commissioner of employee relations may
contract with carriers authorized to provide coverage under the state employees group insurance
plan to extend coverage to eligible employees who incur medical expenses due to a personal
injury which results from their state employment which is compensable under chapter 176.
History: 1981 c 210 s 23; 1983 c 290 s 1; 1983 c 301 s 101; 1984 c 544 s 81; 1984 c 642 s
2; 1988 c 667 s 12,13; 1990 c 571 s 28; 1991 c 199 art 2 s 1; 1998 c 386 art 2 s 20; 1999 c 250
art 1 s 73,74; 2000 c 394 art 2 s 1; 2005 c 156 art 3 s 1; 2007 c 35 s 2; 2007 c 147 art 12 s 1