2004 Minnesota Statutes

     256L.15 Premiums. 

    Subdivision 1.    Premium determination.  (a) Families 
 with children and individuals shall pay a premium determined 
 according to subdivision 2.  

    (b) 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 onetime 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 refund for the purposes of meeting all 
 or part of the applicant's or enrollee's MinnesotaCare premium 
 obligation.  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.  Effective October 1, 2003, the commissioner shall 
 increase each percentage by 0.5 percentage points for enrollees 
 with income greater than 100 percent but not exceeding 200 
 percent of the federal poverty guidelines and shall increase 
 each percentage by 1.0 percentage points for families and 
 children with incomes greater than 200 percent of the federal 
 poverty guidelines.  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)(1) Enrolled families whose gross annual income 
 increases above 275 percent of the federal poverty guideline 
 shall pay the maximum premium.  This clause expires effective 
 February 1, 2004.  

    (2) Effective February 1, 2004, children in families whose 
 gross income is above 275 percent of the federal poverty 
 guidelines shall pay the maximum premium.  

    (3) 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; 2001 c 203 s 16; 1Sp2001 c 9 art 2 s 65; 2002 c 
 220 art 15 s 24,25; 2002 c 379 art 1 s 113; 1Sp2003 c 14 art 12 
 s 83-85