2006 Minnesota Statutes

62L.17 PARTICIPATION IN REINSURANCE ASSOCIATION.
    Subdivision 1. Minimum standards. The board of directors or the interim board shall
establish minimum claim processing and managed care standards which must be met by a health
carrier in order to have its business reinsured by the association.
    Subd. 2. Participation. A health carrier may elect to not participate in the reinsurance
association through transferring risk only after filing an application with the commissioner of
commerce. The commissioner may approve the application after consultation with the board of
directors. In determining whether to approve an application, the commissioner shall consider
whether the health carrier meets the following standards:
(1) demonstration by the health carrier of a substantial and established market presence;
(2) demonstrated experience in the small group market and history of rating and underwriting
small employer groups;
(3) commitment to comply with the requirements of this chapter for small employers in the
state or its service area; and
(4) financial ability to assume and manage the risk of enrolling small employer groups
without the protection of the reinsurance.
Initial application for nonparticipation must be filed with the commissioner no later than
February 1993. The commissioner shall make the determination and notify the carrier no later
than April 15, 1993.
    Subd. 2a. Participation of new small employer health carriers. A health carrier that enters
the small employer market subsequent to February 1993, may elect to not participate in the
reinsurance association by filing an application within 60 days of entry into the small employer
market or May 26, 1995, whichever is later. The commissioner shall make a determination and
notify the health carrier no later than 60 days after receipt of the application. In determining
whether to approve the application, the commissioner shall consider the standards defined in
subdivision 2, except that the commissioner may also consider whether the health carrier has a
guaranteeing organization as permitted under chapter 62N.
    Subd. 3. Length of participation. A health carrier's initial election is for a period of two
years. Subsequent elections of participation are for five-year periods.
    Subd. 4. Appeal. A health carrier whose application for nonparticipation has been rejected
by the commissioner may appeal the decision. The association may also appeal a decision
of the commissioner, if approved by a two-thirds majority of the board. Chapter 14 applies to
all appeals under this subdivision.
    Subd. 5. Annual certification. A health carrier that has received approval to not participate
in the reinsurance association shall annually certify to the commissioner on or before December 1
that it continues to meet the standards described in subdivision 2.
    Subd. 6. Subsequent election. Election to participate in the reinsurance association
must occur on or before December 31 of each year. If after a period of nonparticipation, the
nonparticipating health carrier subsequently elects to participate in the reinsurance association,
the health carrier retains the risk it assumed when not participating in the association.
If a participating health carrier subsequently elects to not participate in the reinsurance
association, the health carrier shall cease reinsuring through the association all of its small
employer business and is liable for any assessment described in section 62L.22 which has
been prorated based on the business covered by the reinsurance mechanism during the year of
the assessment.
    Subd. 7. Election modification. The commissioner, after consultation with the board, may
authorize a health carrier to modify its election to not participate in the association at any time, if
the risk from the carrier's existing small employer business jeopardizes the financial condition of
the health carrier. If the commissioner authorizes a health carrier to participate in the association,
the health carrier shall retain the risk it assumed while not participating in the association. This
election option may not be exercised if the health carrier is in rehabilitation.
History: 1992 c 549 art 2 s 17; 1993 c 247 art 2 s 24,25; 1995 c 234 art 7 s 22; 2005
c 10 art 1 s 15