1999 Minnesota Statutes

     256L.15 Premiums. 

    Subdivision 1.    Premium determination.  Families with 
 children and individuals shall pay a premium determined 
 according to a sliding fee based on a percentage of the family's 
 gross family income.  Pregnant women and children under age two 
 are exempt from the provisions of section 256L.06, subdivision 
 3, paragraph (b), clause (3), requiring disenrollment for 
 failure to pay premiums.  For pregnant women, this exemption 
 continues until the first day of the month following the 60th 
 day postpartum.  Women who remain enrolled during pregnancy or 
 the postpartum period, despite nonpayment of premiums, shall be 
 disenrolled on the first of the month following the 60th day 
 postpartum for the penalty period that otherwise applies under 
 section 256L.06, unless they begin paying premiums. 

    Subd. 1a.    Payment options.  The commissioner may 
 offer the following payment options to an enrollee: 

    (1) payment by check; 

    (2) payment by credit card; 

    (3) payment by recurring automatic checking withdrawal; 

    (4) payment by one-time electronic transfer of funds; 

    (5) payment by wage withholding with the consent of the 
 employer and the employee; or 

    (6) payment by using state tax refund payments. 

    At application or reapplication, a MinnesotaCare applicant 
 or enrollee may authorize the commissioner to use the Revenue 
 Recapture Act in chapter 270A to collect funds from the 
 applicant's or enrollee's state income tax refund for the 
 purposes of meeting all or part of the applicant's or enrollee's 
 MinnesotaCare premium obligation for the forthcoming year.  The 
 applicant or enrollee may authorize the commissioner to apply 
 for the state working family tax credit on behalf of the 
 applicant or enrollee.  The setoff due under this subdivision 
 shall not be subject to the $10 fee under section 270A.07, 
 subdivision 1.  

    Subd. 1b.    Payments nonrefundable.  Only MinnesotaCare 
 premiums paid for future months of coverage for which a health 
 plan capitation fee has not been paid may be refunded. 

    Subd. 2.    Sliding fee scale to determine percentage of 
 gross individual or family income.  (a) The commissioner shall 
 establish a sliding fee scale to determine the percentage of 
 gross individual or family income that households at different 
 income levels must pay to obtain coverage through the 
 MinnesotaCare program.  The sliding fee scale must be based on 
 the enrollee's gross individual or family income.  The sliding 
 fee scale must contain separate tables based on enrollment of 
 one, two, or three or more persons.  The sliding fee scale 
 begins with a premium of 1.5 percent of gross individual or 
 family income for individuals or families with incomes below the 
 limits for the medical assistance program for families and 
 children in effect on January 1, 1999, and proceeds through the 
 following evenly spaced steps:  1.8, 2.3, 3.1, 3.8, 4.8, 5.9, 
 7.4, and 8.8 percent.  These percentages are matched to evenly 
 spaced income steps ranging from the medical assistance income 
 limit for families and children in effect on January 1, 1999, to 
 275 percent of the federal poverty guidelines for the applicable 
 family size, up to a family size of five.  The sliding fee scale 
 for a family of five must be used for families of more than 
 five.  The sliding fee scale and percentages are not subject to 
 the provisions of chapter 14.  If a family or individual reports 
 increased income after enrollment, premiums shall not be 
 adjusted until eligibility renewal. 

    (b) Enrolled individuals and families whose gross annual 
 income increases above 275 percent of the federal poverty 
 guideline shall pay the maximum premium.  The maximum premium is 
 defined as a base charge for one, two, or three or more 
 enrollees so that if all MinnesotaCare cases paid the maximum 
 premium, the total revenue would equal the total cost of 
 MinnesotaCare medical coverage and administration.  In this 
 calculation, administrative costs shall be assumed to equal ten 
 percent of the total.  The costs of medical coverage for 
 pregnant women and children under age two and the enrollees in 
 these groups shall be excluded from the total.  The maximum 
 premium for two enrollees shall be twice the maximum premium for 
 one, and the maximum premium for three or more enrollees shall 
 be three times the maximum premium for one. 

    Subd. 3.    Exceptions to sliding scale.  An annual 
 premium of $48 is required for all children in families with 
 income at or less than 150 percent of federal poverty guidelines.

    HIST: 1995 c 234 art 6 s 20; 1998 c 407 art 5 s 39; 1999 c 245 
 art 4 s 99-101