Bill Text: MN HF222 | 2011-2012 | 87th Legislature | Introduced
NOTE: There are more recent revisions of this legislation. Read Latest Draft
Bill Title: Health plans guaranteed issue in the individual market required; Minnesota Comprehensive Health Association reinsurance of ceded risk on certain health plans required, and additional enrollment ended.
Spectrum: Partisan Bill (Republican 7-0)
Status: (Introduced - Dead) 2012-01-24 - Author added Banaian [HF222 Detail]
Download: Minnesota-2011-HF222-Introduced.html
Bill Title: Health plans guaranteed issue in the individual market required; Minnesota Comprehensive Health Association reinsurance of ceded risk on certain health plans required, and additional enrollment ended.
Spectrum: Partisan Bill (Republican 7-0)
Status: (Introduced - Dead) 2012-01-24 - Author added Banaian [HF222 Detail]
Download: Minnesota-2011-HF222-Introduced.html
1.2relating to health insurance; requiring guaranteed issue in the individual
1.3market; requiring MCHA to reinsure ceded risk on certain health plans; ending
1.4additional enrollment in MCHA; amending Minnesota Statutes 2010, sections
1.562A.65, subdivision 2, by adding a subdivision; 62E.10, subdivision 7; 62E.11,
1.6subdivision 1; 62E.14, subdivision 1; repealing Minnesota Statutes 2010, section
1.762A.65, subdivision 6.
1.8BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
1.9 Section 1. Minnesota Statutes 2010, section 62A.65, subdivision 2, is amended to read:
1.10 Subd. 2. Guaranteed issue and renewal. No individual health plan may be offered,
1.11sold, issued, or renewed to a Minnesota resident unlessthe health plan provides that the
1.12plan is on a guaranteed issue basis. The health plan must be guaranteed renewable at a
1.13premium rate that does not take into account the claims experience or any change in the
1.14health status of any covered person that occurred after the initial issuance of the health
1.15plan to the person. The premium rate upon renewal must also otherwise comply with this
1.16section. A health carrier must not refuse to renew an individual health plan, except for
1.17nonpayment of premiums, fraud, or misrepresentation.
1.18 Sec. 2. Minnesota Statutes 2010, section 62A.65, is amended by adding a subdivision
1.19to read:
1.20 Subd. 2a. Ceding risk to MCHA. A health carrier may cede risk to the Minnesota
1.21Comprehensive Health Association with respect to any individual health plan issued by
1.22the carrier under section 62E.10, subdivision 7.
1.23 Sec. 3. Minnesota Statutes 2010, section 62E.10, subdivision 7, is amended to read:
2.1 Subd. 7. General powers. The association may:
2.2(a) Exercise the powers granted to insurers under the laws of this state;
2.3(b) Sue or be sued;
2.4(c) Enter into contracts with insurers, similar associations in other states or with
2.5other persons for the performance of administrative functions including the functions
2.6provided for in clauses (e) and (f);
2.7(d) Establish administrative and accounting procedures for the operation of the
2.8association; and
2.9(e) Provide for the reinsuring of risks incurred as a result of issuing the coverages
2.10required bysections
62E.04 and
62E.16Each member
2.11which elects to reinsure its required risks shall determine the categories of coverage it
2.12elects to reinsure in the association. The categories of coverage are:
2.13(1) individual qualified plans, excluding group conversions;
2.14(2) group conversions;
2.15(3) group qualified plans with fewer than 50 employees or members; and
2.16(4) major medical coverage.
2.17A separate election may be made for each category of coverage. If a member elects
2.18to reinsure the risks of a category of coverage, it must reinsure the risk of the coverage
2.19of every life covered under every policy issued in that category. A member electing to
2.20reinsure risks ofa category of coverage health coverage issued shall enter into a contract
2.21with the association establishing a reinsurance plan for the risks. This contract may
2.22include provision forthe rules for ceding of risk, reinsurance thresholds, reinsurance
2.23premiums, and pooling of members' risks reinsured through the associationand. It may
2.24provide for assessment of each member reinsuring risks for losses and operating and
2.25administrative expenses incurred, or estimated to be incurred in the operation of the
2.26reinsurance plan. This reinsurance plan shall be approved by the commissioner before it is
2.27effective. Members electing to administer the risks which are reinsured in the association
2.28shall comply with the benefit determination guidelines, claim processing standards, and
2.29accounting procedures established by the association. The fee charged by the association
2.30for the reinsurance of risks shall not be less than 110 percent of the total anticipated
2.31expenses incurred by the association for the reinsurance; and.
2.32(f) Provide for the administration by the association of policies which are reinsured
2.33pursuant to clause (e). Each member electing to reinsure one or more categories of
2.34coverage in the association may elect to have the association administer the categories of
2.35coverage on the member's behalf. If a member elects to have the association administer
2.36the categories of coverage, it must do so for every life covered under every policy issued
3.1in that category. The fee for the administration shall not be less than 110 percent of the
3.2total anticipated expenses incurred by the association for the administration.
3.3 Sec. 4. Minnesota Statutes 2010, section 62E.11, subdivision 1, is amended to read:
3.4 Subdivision 1. Enrollment. Upon certification as an eligible person in the manner
3.5provided by section62E.14 , an eligible person may enroll in the comprehensive health
3.6insurance plan by payment of the state plan premium to the writing carrier. Effective
3.7January 1, 2012, no further enrollment may be accepted into the comprehensive health
3.8insurance plan.
3.9 Sec. 5. Minnesota Statutes 2010, section 62E.14, subdivision 1, is amended to read:
3.10 Subdivision 1. Application, contents. Subject to section 62E.11, subdivision 1, the
3.11comprehensive health insurance plan shall be open for enrollment by eligible persons.
3.12An eligible person shall enroll by submission of an application to the writing carrier. The
3.13application must provide the following:
3.14(a) name, address, age, list of residences for the immediately preceding six months
3.15and length of time at current residence of the applicant;
3.16(b) name, address, and age of spouse and children if any, if they are to be insured;
3.17(c) evidence of rejection, a requirement of restrictive riders, a rate up, or a
3.18preexisting conditions limitation on a qualified plan, the effect of which is to substantially
3.19reduce coverage from that received by a person considered a standard risk, by at least one
3.20association member within six months of the date of the application, or other eligibility
3.21requirements adopted by rule by the commissioner which are not inconsistent with this
3.22chapter and which evidence that a person is unable to obtain coverage substantially similar
3.23to that which may be obtained by a person who is considered a standard risk;
3.24(d) if the applicant has been terminated from individual health coverage which
3.25does not provide replacement coverage, evidence that no replacement coverage that
3.26meets the requirements of section62D.121 was offered, and evidence of termination of
3.27individual health coverage by an insurer, nonprofit health service plan corporation, or
3.28health maintenance organization, provided that the contract or policy has been terminated
3.29for reasons other than (1) failure to pay the charge for health care coverage; (2) failure to
3.30make co-payments required by the health care plan; (3) enrollee moving out of the area
3.31served; or (4) a materially false statement or misrepresentation by the enrollee in the
3.32application for the terminated contract or policy; and
3.33(e) a designation of the coverage desired.
4.1An eligible person may not purchase more than one policy from the state plan. Upon
4.2ceasing to be a resident of Minnesota a person is no longer eligible to purchase or renew
4.3coverage under the state plan, except as required by state or federal law with respect to
4.4renewal of Medicare supplement coverage.
4.5 Sec. 6. REPEALER.
4.6Minnesota Statutes 2010, section 62A.65, subdivision 6, is repealed.
4.7 Sec. 7. EFFECTIVE DATE.
4.8Sections 1 to 6 are effective January 1, 2012.
1.3market; requiring MCHA to reinsure ceded risk on certain health plans; ending
1.4additional enrollment in MCHA; amending Minnesota Statutes 2010, sections
1.562A.65, subdivision 2, by adding a subdivision; 62E.10, subdivision 7; 62E.11,
1.6subdivision 1; 62E.14, subdivision 1; repealing Minnesota Statutes 2010, section
1.762A.65, subdivision 6.
1.8BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
1.9 Section 1. Minnesota Statutes 2010, section 62A.65, subdivision 2, is amended to read:
1.10 Subd. 2. Guaranteed issue and renewal. No individual health plan may be offered,
1.11sold, issued, or renewed to a Minnesota resident unless
1.12
1.13premium rate that does not take into account the claims experience or any change in the
1.14health status of any covered person that occurred after the initial issuance of the health
1.15plan to the person. The premium rate upon renewal must also otherwise comply with this
1.16section. A health carrier must not refuse to renew an individual health plan, except for
1.17nonpayment of premiums, fraud, or misrepresentation.
1.18 Sec. 2. Minnesota Statutes 2010, section 62A.65, is amended by adding a subdivision
1.19to read:
1.20 Subd. 2a. Ceding risk to MCHA. A health carrier may cede risk to the Minnesota
1.21Comprehensive Health Association with respect to any individual health plan issued by
1.22the carrier under section 62E.10, subdivision 7.
1.23 Sec. 3. Minnesota Statutes 2010, section 62E.10, subdivision 7, is amended to read:
2.1 Subd. 7. General powers. The association may:
2.2(a) Exercise the powers granted to insurers under the laws of this state;
2.3(b) Sue or be sued;
2.4(c) Enter into contracts with insurers, similar associations in other states or with
2.5other persons for the performance of administrative functions including the functions
2.6provided for in clauses (e) and (f);
2.7(d) Establish administrative and accounting procedures for the operation of the
2.8association; and
2.9(e) Provide for the reinsuring of risks incurred as a result of issuing the coverages
2.10required by
2.11
2.12
2.13
2.14
2.15
2.16
2.17
2.18
2.19
2.20reinsure risks of
2.21with the association establishing a reinsurance plan for the risks. This contract may
2.22include provision for
2.23premiums, and pooling of members' risks reinsured through the association
2.24provide for assessment of each member reinsuring risks for losses and operating and
2.25administrative expenses incurred, or estimated to be incurred in the operation of the
2.26reinsurance plan. This reinsurance plan shall be approved by the commissioner before it is
2.27effective. Members electing to administer the risks which are reinsured in the association
2.28shall comply with the benefit determination guidelines, claim processing standards, and
2.29accounting procedures established by the association. The fee charged by the association
2.30for the reinsurance of risks shall not be less than 110 percent of the total anticipated
2.31expenses incurred by the association for the reinsurance
2.32
2.33
2.34
2.35
2.36
3.1
3.2
3.3 Sec. 4. Minnesota Statutes 2010, section 62E.11, subdivision 1, is amended to read:
3.4 Subdivision 1. Enrollment. Upon certification as an eligible person in the manner
3.5provided by section
3.6insurance plan by payment of the state plan premium to the writing carrier. Effective
3.7January 1, 2012, no further enrollment may be accepted into the comprehensive health
3.8insurance plan.
3.9 Sec. 5. Minnesota Statutes 2010, section 62E.14, subdivision 1, is amended to read:
3.10 Subdivision 1. Application, contents. Subject to section 62E.11, subdivision 1, the
3.11comprehensive health insurance plan shall be open for enrollment by eligible persons.
3.12An eligible person shall enroll by submission of an application to the writing carrier. The
3.13application must provide the following:
3.14(a) name, address, age, list of residences for the immediately preceding six months
3.15and length of time at current residence of the applicant;
3.16(b) name, address, and age of spouse and children if any, if they are to be insured;
3.17(c) evidence of rejection, a requirement of restrictive riders, a rate up, or a
3.18preexisting conditions limitation on a qualified plan, the effect of which is to substantially
3.19reduce coverage from that received by a person considered a standard risk, by at least one
3.20association member within six months of the date of the application, or other eligibility
3.21requirements adopted by rule by the commissioner which are not inconsistent with this
3.22chapter and which evidence that a person is unable to obtain coverage substantially similar
3.23to that which may be obtained by a person who is considered a standard risk;
3.24(d) if the applicant has been terminated from individual health coverage which
3.25does not provide replacement coverage, evidence that no replacement coverage that
3.26meets the requirements of section
3.27individual health coverage by an insurer, nonprofit health service plan corporation, or
3.28health maintenance organization, provided that the contract or policy has been terminated
3.29for reasons other than (1) failure to pay the charge for health care coverage; (2) failure to
3.30make co-payments required by the health care plan; (3) enrollee moving out of the area
3.31served; or (4) a materially false statement or misrepresentation by the enrollee in the
3.32application for the terminated contract or policy; and
3.33(e) a designation of the coverage desired.
4.1An eligible person may not purchase more than one policy from the state plan. Upon
4.2ceasing to be a resident of Minnesota a person is no longer eligible to purchase or renew
4.3coverage under the state plan, except as required by state or federal law with respect to
4.4renewal of Medicare supplement coverage.
4.5 Sec. 6. REPEALER.
4.6Minnesota Statutes 2010, section 62A.65, subdivision 6, is repealed.
4.7 Sec. 7. EFFECTIVE DATE.
4.8Sections 1 to 6 are effective January 1, 2012.
