Subdivision 1. Application.
For the purposes of sections
, the terms and
phrases defined in this section have the meanings given them.
Subd. 2. Employer.
"Employer" means any person, partnership, association, trust, estate
or corporation, including the state of Minnesota or any agency, instrumentality or governmental
subdivision thereof, which employs ten or more individuals who are residents of this state.
Subd. 3. Health maintenance organization.
"Health maintenance organization" means a
nonprofit corporation licensed and operated as provided in chapter 62D.
Subd. 4. Qualified plan.
"Qualified plan" means those health benefit plans which have been
certified by the commissioner as providing the minimum benefits required by section
or the actuarial equivalent of those benefits.
Subd. 5. Qualified Medicare supplement plan.
"Qualified Medicare supplement plan"
means those health benefit plans which have been certified by the commissioner as providing the
minimum benefits required by section
Subd. 6. Commissioner.
"Commissioner" means the commissioner of commerce.
Subd. 7. Dependent.
"Dependent" means a spouse or unmarried child under the age of 25, or
a dependent child of any age who is disabled.
Subd. 8. Employee.
"Employee" means any Minnesota resident who has entered into
the employment of or works under contract or service or apprenticeship with any employer.
"Employee" does not include a person who has been employed for less than 30 days by that
person's present employer, nor one who is employed less than 30 hours per week by that person's
present employer, nor an independent contractor.
Subd. 9. Plan of health coverage.
"Plan of health coverage" means any plan or combination
of plans of coverage, including combinations of self insurance, individual accident and health
insurance policies, group accident and health insurance policies, coverage under a nonprofit health
service plan, or coverage under a health maintenance organization subscriber contract.
Subd. 10. Insurer.
"Insurer" means those companies operating pursuant to chapter 62A
or 62C and offering, selling, issuing, or renewing policies or contracts of accident and health
insurance. "Insurer" does not include health maintenance organizations or community integrated
Subd. 11. Accident and health insurance policy or policy.
"Accident and health insurance
policy" or "policy" means insurance or nonprofit health service plan contracts providing benefits
for hospital, surgical and medical care. "Policy" does not include coverage which is (1) limited
to disability or income protection coverage, (2) automobile medical payment coverage, (3)
supplemental to liability insurance, (4) designed solely to provide payments on a per diem, fixed
indemnity or nonexpense incurred basis, (5) credit accident and health insurance issued pursuant
to chapter 62B, (6) designed solely to provide dental or vision care, (7) blanket accident and
sickness insurance as defined in section
, or (8) accident only coverage issued by licensed
and tested insurance agents or solicitors which provides reasonable benefits in relation to the cost
of covered services. The provisions of clause (4) shall not apply to hospital indemnity coverage
which is sold by an insurer to an applicant who is not then currently covered by a qualified plan.
Subd. 12. Health benefits.
"Health benefits" means benefits offered to employees on an
indemnity or prepaid basis which pay the costs of or provide medical, surgical or hospital care.
Subd. 13. Eligible person.
(a) "Eligible person" means an individual who:
(1) is currently and has been a resident of Minnesota for the six months immediately
preceding the date of receipt by the association or its writing carrier of a completed certificate of
(2) meets the enrollment requirements of section
(3) is not otherwise ineligible under this subdivision.
For purposes of eligibility under section
62E.14, subdivision 4c
, paragraph (b), this definition is
modified as provided in that paragraph.
(b) No individual is eligible for coverage under a qualified or a Medicare supplement plan
issued by the association for whom a premium is paid or reimbursed by the medical assistance
program or general assistance medical care program as of the first day of any term for which a
premium amount is paid or reimbursed.
Subd. 14. Minnesota Comprehensive Health Association or association.
Comprehensive Health Association" or "association" means the association created by section
Subd. 15. Medicare.
"Medicare" means part A and part B of the United States Social
Security Act, title XVIII, as amended, United States Code, title 42, sections 1394, et seq.
Subd. 16. Medicare supplement plan.
"Medicare supplement plan" means any plan of
insurance protection which provides benefits for the costs of medical, surgical or hospital care
and which is marketed as providing benefits which complement or supplement the benefits
provided by Medicare.
Subd. 17. State plan premium.
"State plan premium" means the premium determined
pursuant to section
Subd. 18. Writing carrier.
"Writing carrier" means the insurer or insurers, health
maintenance organization or organizations, community integrated service network or networks,
or other entity selected by the association and approved by the commissioner to administer the
comprehensive health insurance plan.
Subd. 19. Fraternal benefit society or fraternal.
"Fraternal benefit society" or "fraternal"
means a corporation, society, order, or voluntary association without capital stock which sells
health and accident insurance in accordance with chapter 64B.
Subd. 20. Comprehensive health insurance plan or state plan.
insurance plan" or "state plan" means policies of insurance and contracts of health maintenance
organization or community integrated service network coverage offered by the association
through the writing carrier.
Subd. 21. Self-insurer.
"Self-insurer" means an employer or an employee welfare benefit
fund or plan which directly or indirectly provides a plan of health coverage to its employees
and administers the plan of health coverage itself or through an insurer, trust or agent except
to the extent of accident and health insurance premium, subscriber contract charges or health
maintenance organization contract charges. "Self-insurer" does not include an employer engaged
in the business of providing health care services to the public which provides health care services
directly to its employees at no charge to them.
Subd. 22. Self-insurance.
"Self-insurance" means a plan of health coverage offered by a
Subd. 23. Contributing member.
"Contributing member" means those companies regulated
under chapter 62A and offering, selling, issuing, or renewing policies or contracts of accident
and health insurance; health maintenance organizations regulated under chapter 62D; nonprofit
health service plan corporations regulated under chapter 62C; community integrated service
networks regulated under chapter 62N; fraternal benefit societies regulated under chapter 64B;
the Minnesota employees insurance program established in section
, effective July 1,
1993; and joint self-insurance plans regulated under chapter 62H. For the purposes of determining
liability of contributing members pursuant to section
payments received from or on
behalf of Minnesota residents for coverage by a health maintenance organization or community
integrated service network shall be considered to be accident and health insurance premiums.
History: 1976 c 296 art 1 s 2; 1977 c 409 s 4-7; 1979 c 272 s 1,2; 1981 c 318 s 13; 1983 c
289 s 114 subd 1; 1984 c 655 art 1 s 92; 1985 c 49 s 41; 1986 c 444; 1987 c 268 art 2 s 17; 1987
c 384 art 2 s 1; art 3 s 47; 1988 c 612 s 27; 1992 c 549 art 3 s 13; 1992 c 564 art 1 s 34,54; 1994
c 625 art 8 s 7-10; art 10 s 50; 1995 c 258 s 40; 1997 c 175 art 1 s 1; 1997 c 225 art 2 s 62; art 6
s 1,2; 1999 c 177 s 44; 1999 c 245 art 10 s 10; 2007 c 147 art 12 s 2