Bill Text: MN HF1317 | 2011-2012 | 87th Legislature | Introduced
Bill Title: Separate insurance risk pool provided for employers that have between 51 and 100 employees.
Sponsorship: Partisan Bill (Republican 3)
Status: (Introduced - Dead) 2011-03-29 - Author added Kiffmeyer [HF1317 Detail]
Download: Minnesota-2011-HF1317-Introduced.html
1.2relating to insurance; providing a separate risk pool for employers that have
1.3between 51 and 100 employees;amending Minnesota Statutes 2010, sections
1.462L.02, subdivision 26, by adding a subdivision; 62L.08, subdivision 2.
1.5BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
1.6 Section 1. Minnesota Statutes 2010, section 62L.02, subdivision 26, is amended to read:
1.7 Subd. 26. Small employer. (a) "Small employer" means, with respect to a calendar
1.8year and a plan year, a person, firm, corporation, partnership, association, or other entity
1.9actively engaged in business in Minnesota, including a political subdivision of the state,
1.10that employed an average of no fewer than two nor more than50 100 current employees
1.11on business days during the preceding calendar year and that employs at least two current
1.12employees on the first day of the plan year. If an employer has only one eligible employee
1.13who has not waived coverage, the sale of a health plan to or for that eligible employee
1.14is not a sale to a small employer and is not subject to this chapter and may be treated as
1.15the sale of an individual health plan. A small employer plan may be offered through a
1.16domiciled association to self-employed individuals and small employers who are members
1.17of the association, even if the self-employed individual or small employer has fewer than
1.18two current employees. Entities that are treated as a single employer under subsection (b),
1.19(c), (m), or (o) of section 414 of the federal Internal Revenue Code are considered a single
1.20employer for purposes of determining the number of current employees. Small employer
1.21status must be determined on an annual basis as of the renewal date of the health benefit
1.22plan. The provisions of this chapter continue to apply to an employer who no longer meets
1.23the requirements of this definition until the annual renewal date of the employer's health
1.24benefit plan. If an employer was not in existence throughout the preceding calendar year,
2.1the determination of whether the employer is a small employer is based upon the average
2.2number of current employees that it is reasonably expected that the employer will employ
2.3on business days in the current calendar year. For purposes of this definition, the term
2.4employer includes any predecessor of the employer. An employer that has more than50
2.5100 current employees but has50 100 or fewer employees, as "employee" is defined under
2.6United States Code, title 29, section 1002(6), is a small employer under this subdivision.
2.7(b) Where an association, as defined in section62L.045 , comprised of employers
2.8contracts with a health carrier to provide coverage to its members who are small employers,
2.9the association and health benefit plans it provides to small employers, are subject to
2.10section62L.045 , with respect to small employers in the association, even though the
2.11association also provides coverage to its members that do not qualify as small employers.
2.12(c) If an employer has employees covered under a trust specified in a collective
2.13bargaining agreement under the federal Labor-Management Relations Act of 1947,
2.14United States Code, title 29, section 141, et seq., as amended, or employees whose health
2.15coverage is determined by a collective bargaining agreement and, as a result of the
2.16collective bargaining agreement, is purchased separately from the health plan provided
2.17to other employees, those employees are excluded in determining whether the employer
2.18qualifies as a small employer. Those employees are considered to be a separate small
2.19employer if they constitute a group that would qualify as a small employer in the absence
2.20of the employees who are not subject to the collective bargaining agreement.
2.21(d) For purposes of this chapter, or of any other chapter that references or otherwise
2.22affects this chapter, the definition of "small employer" provided in this subdivision
2.23does not apply with respect to employers that have more than 50 current employees,
2.24or to coverage provided to such employers, in connection with any provision of the
2.25federal Affordable Care Act that imposes requirements on, or otherwise affects, "small
2.26employers," the "small employer market," or similar terms. This paragraph does not limit
2.27the retention of small employer status until the next annual renewal date of the employer's
2.28health benefit plan, as provided under paragraph (a) for an employer that has grown to
2.29more than 50 employees. For purposes of this paragraph, "federal Affordable Care Act"
2.30means the federal Patient Protection and Affordable Care Act (Public Law 111-148), as
2.31amended by the federal Health Care and Education Reconciliation Act of 2010 (Public
2.32Law 111-152), and any amendments to, or regulations or guidance issued under, those acts.
2.33EFFECTIVE DATE.This section is effective January 1, 2012, and applies to health
2.34benefit plans offered, issued, or renewed on or after that date.
3.1 Sec. 2. Minnesota Statutes 2010, section 62L.02, is amended by adding a subdivision
3.2to read:
3.3 Subd. 1a. Separate risk pools for employers over 50 employees. Health carriers
3.4that choose to participate in the small employer market may participate in the market for
3.5employers that have 50 or fewer current employees, the market for employers that have
3.6more than 50, but not more than 100 current employees, or both of those segments of the
3.7small employer market. Health carriers that choose to participate in both segments of the
3.8small employer market must establish and maintain two separate risk pools under this
3.9chapter: one for small employers that have 50 or fewer current employees and the other
3.10for small employers that have more than 50, but not more than 100 current employees.
3.11EFFECTIVE DATE.This section is effective January 1, 2012, and applies to health
3.12benefit plans offered, issued, or renewed on or after that date.
3.13 Sec. 3. Minnesota Statutes 2010, section 62L.08, subdivision 2, is amended to read:
3.14 Subd. 2. General premium variations. Beginning July 1, 1993, each health carrier
3.15must offer to small employers that have 50 or fewer current employees premium rates
3.16to small employers that are no more than 25 percent above and no more than 25 percent
3.17below the index rate charged to small employers that have 50 or fewer current employees
3.18for the same or similar coverage, adjusted pro rata for rating periods of less than one year.
3.19Beginning January 1, 2012, each health carrier must offer to small employers that have
3.20more than 50 current employees premium rates that are no more than 30 percent above
3.21and no more than 30 percent below the index rate charged to small employers that have
3.22more than 50 current employees for the same or similar coverage, adjusted pro rata for
3.23rating periods of less than one year. The premium variations permitted by this subdivision
3.24must be based only on health status, claims experience, industry of the employer, and
3.25duration of coverage from the date of issue. For purposes of this subdivision, health status
3.26includes refraining from tobacco use or other actuarially valid lifestyle factors associated
3.27with good health, provided that the lifestyle factor and its effect upon premium rates have
3.28been determined to be actuarially valid and approved by the commissioner. Variations
3.29permitted under this subdivision must not be based upon age or applied differently at
3.30different ages. This subdivision does not prohibit use of a constant percentage adjustment
3.31for factors permitted to be used under this subdivision.
3.32EFFECTIVE DATE.This section is effective January 1, 2012, and applies to health
3.33benefit plans offered, issued, or renewed on or after that date.
1.3between 51 and 100 employees;amending Minnesota Statutes 2010, sections
1.462L.02, subdivision 26, by adding a subdivision; 62L.08, subdivision 2.
1.5BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
1.6 Section 1. Minnesota Statutes 2010, section 62L.02, subdivision 26, is amended to read:
1.7 Subd. 26. Small employer. (a) "Small employer" means, with respect to a calendar
1.8year and a plan year, a person, firm, corporation, partnership, association, or other entity
1.9actively engaged in business in Minnesota, including a political subdivision of the state,
1.10that employed an average of no fewer than two nor more than
1.11on business days during the preceding calendar year and that employs at least two current
1.12employees on the first day of the plan year. If an employer has only one eligible employee
1.13who has not waived coverage, the sale of a health plan to or for that eligible employee
1.14is not a sale to a small employer and is not subject to this chapter and may be treated as
1.15the sale of an individual health plan. A small employer plan may be offered through a
1.16domiciled association to self-employed individuals and small employers who are members
1.17of the association, even if the self-employed individual or small employer has fewer than
1.18two current employees. Entities that are treated as a single employer under subsection (b),
1.19(c), (m), or (o) of section 414 of the federal Internal Revenue Code are considered a single
1.20employer for purposes of determining the number of current employees. Small employer
1.21status must be determined on an annual basis as of the renewal date of the health benefit
1.22plan. The provisions of this chapter continue to apply to an employer who no longer meets
1.23the requirements of this definition until the annual renewal date of the employer's health
1.24benefit plan. If an employer was not in existence throughout the preceding calendar year,
2.1the determination of whether the employer is a small employer is based upon the average
2.2number of current employees that it is reasonably expected that the employer will employ
2.3on business days in the current calendar year. For purposes of this definition, the term
2.4employer includes any predecessor of the employer. An employer that has more than
2.5100 current employees but has
2.6United States Code, title 29, section 1002(6), is a small employer under this subdivision.
2.7(b) Where an association, as defined in section
2.8contracts with a health carrier to provide coverage to its members who are small employers,
2.9the association and health benefit plans it provides to small employers, are subject to
2.10section
2.11association also provides coverage to its members that do not qualify as small employers.
2.12(c) If an employer has employees covered under a trust specified in a collective
2.13bargaining agreement under the federal Labor-Management Relations Act of 1947,
2.14United States Code, title 29, section 141, et seq., as amended, or employees whose health
2.15coverage is determined by a collective bargaining agreement and, as a result of the
2.16collective bargaining agreement, is purchased separately from the health plan provided
2.17to other employees, those employees are excluded in determining whether the employer
2.18qualifies as a small employer. Those employees are considered to be a separate small
2.19employer if they constitute a group that would qualify as a small employer in the absence
2.20of the employees who are not subject to the collective bargaining agreement.
2.21(d) For purposes of this chapter, or of any other chapter that references or otherwise
2.22affects this chapter, the definition of "small employer" provided in this subdivision
2.23does not apply with respect to employers that have more than 50 current employees,
2.24or to coverage provided to such employers, in connection with any provision of the
2.25federal Affordable Care Act that imposes requirements on, or otherwise affects, "small
2.26employers," the "small employer market," or similar terms. This paragraph does not limit
2.27the retention of small employer status until the next annual renewal date of the employer's
2.28health benefit plan, as provided under paragraph (a) for an employer that has grown to
2.29more than 50 employees. For purposes of this paragraph, "federal Affordable Care Act"
2.30means the federal Patient Protection and Affordable Care Act (Public Law 111-148), as
2.31amended by the federal Health Care and Education Reconciliation Act of 2010 (Public
2.32Law 111-152), and any amendments to, or regulations or guidance issued under, those acts.
2.33EFFECTIVE DATE.This section is effective January 1, 2012, and applies to health
2.34benefit plans offered, issued, or renewed on or after that date.
3.1 Sec. 2. Minnesota Statutes 2010, section 62L.02, is amended by adding a subdivision
3.2to read:
3.3 Subd. 1a. Separate risk pools for employers over 50 employees. Health carriers
3.4that choose to participate in the small employer market may participate in the market for
3.5employers that have 50 or fewer current employees, the market for employers that have
3.6more than 50, but not more than 100 current employees, or both of those segments of the
3.7small employer market. Health carriers that choose to participate in both segments of the
3.8small employer market must establish and maintain two separate risk pools under this
3.9chapter: one for small employers that have 50 or fewer current employees and the other
3.10for small employers that have more than 50, but not more than 100 current employees.
3.11EFFECTIVE DATE.This section is effective January 1, 2012, and applies to health
3.12benefit plans offered, issued, or renewed on or after that date.
3.13 Sec. 3. Minnesota Statutes 2010, section 62L.08, subdivision 2, is amended to read:
3.14 Subd. 2. General premium variations. Beginning July 1, 1993, each health carrier
3.15must offer to small employers that have 50 or fewer current employees premium rates
3.16
3.17below the index rate charged to small employers that have 50 or fewer current employees
3.18for the same or similar coverage, adjusted pro rata for rating periods of less than one year.
3.19Beginning January 1, 2012, each health carrier must offer to small employers that have
3.20more than 50 current employees premium rates that are no more than 30 percent above
3.21and no more than 30 percent below the index rate charged to small employers that have
3.22more than 50 current employees for the same or similar coverage, adjusted pro rata for
3.23rating periods of less than one year. The premium variations permitted by this subdivision
3.24must be based only on health status, claims experience, industry of the employer, and
3.25duration of coverage from the date of issue. For purposes of this subdivision, health status
3.26includes refraining from tobacco use or other actuarially valid lifestyle factors associated
3.27with good health, provided that the lifestyle factor and its effect upon premium rates have
3.28been determined to be actuarially valid and approved by the commissioner. Variations
3.29permitted under this subdivision must not be based upon age or applied differently at
3.30different ages. This subdivision does not prohibit use of a constant percentage adjustment
3.31for factors permitted to be used under this subdivision.
3.32EFFECTIVE DATE.This section is effective January 1, 2012, and applies to health
3.33benefit plans offered, issued, or renewed on or after that date.
