Bill Text: MN SF2049 | 2011-2012 | 87th Legislature | Introduced
Bill Title: Small employer health insurance market expansion
Spectrum: Partisan Bill (Republican 2-0)
Status: (Introduced - Dead) 2012-02-23 - Referred to Commerce and Consumer Protection [SF2049 Detail]
Download: Minnesota-2011-SF2049-Introduced.html
1.2relating to insurance; expanding the small employer health insurance market;
1.3amending Minnesota Statutes 2010, sections 62L.02, subdivision 26, by adding
1.4a 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, is amended by adding a
1.7subdivision to read:
1.8 Subd. 25a. Separate risk pools for employers over 50 employees. Health carriers
1.9that choose to participate in the small employer market may participate in the market for
1.10employers that have 50 or fewer current employees; the market for employers that have
1.11more than 50, but not more than 100 current employees; or both of those segments of the
1.12small employer market. Health carriers that choose to participate in both segments of the
1.13small employer market must establish and maintain two separate risk pools under this
1.14chapter: one for small employers that have 50 or fewer current employees, and the other
1.15for small employers that have more than 50, but not more than 100, current employees.
1.16EFFECTIVE DATE.This section is effective January 1, 2013, and applies to health
1.17benefit plans offered, issued, or renewed on or after that date.
1.18 Sec. 2. Minnesota Statutes 2010, section 62L.02, subdivision 26, is amended to read:
1.19 Subd. 26. Small employer. (a) "Small employer" means, with respect to a calendar
1.20year and a plan year, a person, firm, corporation, partnership, association, or other entity
1.21actively engaged in business in Minnesota, including a political subdivision of the state,
1.22that employed an average of no fewer than two nor more than50 100 current employees
1.23on business days during the preceding calendar year and that employs at least two current
2.1employees on the first day of the plan year. If an employer has only one eligible employee
2.2who has not waived coverage, the sale of a health plan to or for that eligible employee
2.3is not a sale to a small employer and is not subject to this chapter and may be treated as
2.4the sale of an individual health plan. A small employer plan may be offered through a
2.5domiciled association to self-employed individuals and small employers who are members
2.6of the association, even if the self-employed individual or small employer has fewer than
2.7two current employees. Entities that are treated as a single employer under subsection (b),
2.8(c), (m), or (o) of section 414 of the federal Internal Revenue Code are considered a single
2.9employer for purposes of determining the number of current employees. Small employer
2.10status must be determined on an annual basis as of the renewal date of the health benefit
2.11plan. The provisions of this chapter continue to apply to an employer who no longer meets
2.12the requirements of this definition until the annual renewal date of the employer's health
2.13benefit plan. If an employer was not in existence throughout the preceding calendar year,
2.14the determination of whether the employer is a small employer is based upon the average
2.15number of current employees that it is reasonably expected that the employer will employ
2.16on business days in the current calendar year. For purposes of this definition, the term
2.17employer includes any predecessor of the employer. An employer that has more than50
2.18100 current employees but has50 100 or fewer employees, as "employee" is defined under
2.19United States Code, title 29, section 1002(6), is a small employer under this subdivision.
2.20(b) Where an association, as defined in section62L.045 , comprised of employers
2.21contracts with a health carrier to provide coverage to its members who are small employers,
2.22the association and health benefit plans it provides to small employers, are subject to
2.23section62L.045 , with respect to small employers in the association, even though the
2.24association also provides coverage to its members that do not qualify as small employers.
2.25(c) If an employer has employees covered under a trust specified in a collective
2.26bargaining agreement under the federal Labor-Management Relations Act of 1947,
2.27United States Code, title 29, section 141, et seq., as amended, or employees whose health
2.28coverage is determined by a collective bargaining agreement and, as a result of the
2.29collective bargaining agreement, is purchased separately from the health plan provided
2.30to other employees, those employees are excluded in determining whether the employer
2.31qualifies as a small employer. Those employees are considered to be a separate small
2.32employer if they constitute a group that would qualify as a small employer in the absence
2.33of the employees who are not subject to the collective bargaining agreement.
2.34(d) For purposes of this chapter, or of any other chapter that references or otherwise
2.35affects this chapter, the definition of "small employer" provided in this subdivision
2.36does not apply with respect to employers that have more than 50 current employees,
3.1or to coverage provided to such employers, in connection with any provision of the
3.2federal Affordable Care Act that imposes requirements on, or otherwise affects, "small
3.3employers," the "small employer market," or similar terms. This paragraph does not limit
3.4the retention of small employer status until the next annual renewal date of the employer's
3.5health benefit plan, as provided under paragraph (a), for an employer that has grown to
3.6more than 50 employees. For purposes of this paragraph, "federal Affordable Care Act"
3.7means the federal Patient Protection and Affordable Care Act, Public Law 111-148, as
3.8amended by the federal Health Care and Education Reconciliation Act of 2010, Public
3.9Law 111-152, and any amendments to, or regulations or guidance issued under, those acts.
3.10EFFECTIVE DATE.This section is effective January 1, 2013, and applies to health
3.11benefit plans offered, issued, or renewed on or after that date.
3.12 Sec. 3. Minnesota Statutes 2010, section 62L.08, subdivision 2, is amended to read:
3.13 Subd. 2. General premium variations. Beginning July 1, 1993, each health carrier
3.14must offer to small employers that have 50 or fewer current employees premium rates
3.15to small employers that are no more than 25 percent above and no more than 25 percent
3.16below the index rate charged to small employers that have 50 or fewer current employees
3.17for the same or similar coverage, adjusted pro rata for rating periods of less than one year.
3.18Beginning January 1, 2012, each health carrier must offer to small employers that have
3.19more than 50 current employees premium rates that are no more than 30 percent above
3.20and no more than 30 percent below the index rate charged to small employers that have
3.21more than 50 current employees for the same or similar coverage, adjusted pro rata for
3.22rating periods of less than one year. The premium variations permitted by this subdivision
3.23must be based only on health status, claims experience, industry of the employer, and
3.24duration of coverage from the date of issue. For purposes of this subdivision, health status
3.25includes refraining from tobacco use or other actuarially valid lifestyle factors associated
3.26with good health, provided that the lifestyle factor and its effect upon premium rates have
3.27been determined to be actuarially valid and approved by the commissioner. Variations
3.28permitted under this subdivision must not be based upon age or applied differently at
3.29different ages. This subdivision does not prohibit use of a constant percentage adjustment
3.30for factors permitted to be used under this subdivision.
3.31EFFECTIVE DATE.This section is effective January 1, 2013, and applies to health
3.32benefit plans offered, issued, or renewed on or after that date.
1.3amending Minnesota Statutes 2010, sections 62L.02, subdivision 26, by adding
1.4a 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, is amended by adding a
1.7subdivision to read:
1.8 Subd. 25a. Separate risk pools for employers over 50 employees. Health carriers
1.9that choose to participate in the small employer market may participate in the market for
1.10employers that have 50 or fewer current employees; the market for employers that have
1.11more than 50, but not more than 100 current employees; or both of those segments of the
1.12small employer market. Health carriers that choose to participate in both segments of the
1.13small employer market must establish and maintain two separate risk pools under this
1.14chapter: one for small employers that have 50 or fewer current employees, and the other
1.15for small employers that have more than 50, but not more than 100, current employees.
1.16EFFECTIVE DATE.This section is effective January 1, 2013, and applies to health
1.17benefit plans offered, issued, or renewed on or after that date.
1.18 Sec. 2. Minnesota Statutes 2010, section 62L.02, subdivision 26, is amended to read:
1.19 Subd. 26. Small employer. (a) "Small employer" means, with respect to a calendar
1.20year and a plan year, a person, firm, corporation, partnership, association, or other entity
1.21actively engaged in business in Minnesota, including a political subdivision of the state,
1.22that employed an average of no fewer than two nor more than
1.23on business days during the preceding calendar year and that employs at least two current
2.1employees on the first day of the plan year. If an employer has only one eligible employee
2.2who has not waived coverage, the sale of a health plan to or for that eligible employee
2.3is not a sale to a small employer and is not subject to this chapter and may be treated as
2.4the sale of an individual health plan. A small employer plan may be offered through a
2.5domiciled association to self-employed individuals and small employers who are members
2.6of the association, even if the self-employed individual or small employer has fewer than
2.7two current employees. Entities that are treated as a single employer under subsection (b),
2.8(c), (m), or (o) of section 414 of the federal Internal Revenue Code are considered a single
2.9employer for purposes of determining the number of current employees. Small employer
2.10status must be determined on an annual basis as of the renewal date of the health benefit
2.11plan. The provisions of this chapter continue to apply to an employer who no longer meets
2.12the requirements of this definition until the annual renewal date of the employer's health
2.13benefit plan. If an employer was not in existence throughout the preceding calendar year,
2.14the determination of whether the employer is a small employer is based upon the average
2.15number of current employees that it is reasonably expected that the employer will employ
2.16on business days in the current calendar year. For purposes of this definition, the term
2.17employer includes any predecessor of the employer. An employer that has more than
2.18100 current employees but has
2.19United States Code, title 29, section 1002(6), is a small employer under this subdivision.
2.20(b) Where an association, as defined in section
2.21contracts with a health carrier to provide coverage to its members who are small employers,
2.22the association and health benefit plans it provides to small employers, are subject to
2.23section
2.24association also provides coverage to its members that do not qualify as small employers.
2.25(c) If an employer has employees covered under a trust specified in a collective
2.26bargaining agreement under the federal Labor-Management Relations Act of 1947,
2.27United States Code, title 29, section 141, et seq., as amended, or employees whose health
2.28coverage is determined by a collective bargaining agreement and, as a result of the
2.29collective bargaining agreement, is purchased separately from the health plan provided
2.30to other employees, those employees are excluded in determining whether the employer
2.31qualifies as a small employer. Those employees are considered to be a separate small
2.32employer if they constitute a group that would qualify as a small employer in the absence
2.33of the employees who are not subject to the collective bargaining agreement.
2.34(d) For purposes of this chapter, or of any other chapter that references or otherwise
2.35affects this chapter, the definition of "small employer" provided in this subdivision
2.36does not apply with respect to employers that have more than 50 current employees,
3.1or to coverage provided to such employers, in connection with any provision of the
3.2federal Affordable Care Act that imposes requirements on, or otherwise affects, "small
3.3employers," the "small employer market," or similar terms. This paragraph does not limit
3.4the retention of small employer status until the next annual renewal date of the employer's
3.5health benefit plan, as provided under paragraph (a), for an employer that has grown to
3.6more than 50 employees. For purposes of this paragraph, "federal Affordable Care Act"
3.7means the federal Patient Protection and Affordable Care Act, Public Law 111-148, as
3.8amended by the federal Health Care and Education Reconciliation Act of 2010, Public
3.9Law 111-152, and any amendments to, or regulations or guidance issued under, those acts.
3.10EFFECTIVE DATE.This section is effective January 1, 2013, and applies to health
3.11benefit plans offered, issued, or renewed on or after that date.
3.12 Sec. 3. Minnesota Statutes 2010, section 62L.08, subdivision 2, is amended to read:
3.13 Subd. 2. General premium variations. Beginning July 1, 1993, each health carrier
3.14must offer to small employers that have 50 or fewer current employees premium rates
3.15
3.16below the index rate charged to small employers that have 50 or fewer current employees
3.17for the same or similar coverage, adjusted pro rata for rating periods of less than one year.
3.18Beginning January 1, 2012, each health carrier must offer to small employers that have
3.19more than 50 current employees premium rates that are no more than 30 percent above
3.20and no more than 30 percent below the index rate charged to small employers that have
3.21more than 50 current employees for the same or similar coverage, adjusted pro rata for
3.22rating periods of less than one year. The premium variations permitted by this subdivision
3.23must be based only on health status, claims experience, industry of the employer, and
3.24duration of coverage from the date of issue. For purposes of this subdivision, health status
3.25includes refraining from tobacco use or other actuarially valid lifestyle factors associated
3.26with good health, provided that the lifestyle factor and its effect upon premium rates have
3.27been determined to be actuarially valid and approved by the commissioner. Variations
3.28permitted under this subdivision must not be based upon age or applied differently at
3.29different ages. This subdivision does not prohibit use of a constant percentage adjustment
3.30for factors permitted to be used under this subdivision.
3.31EFFECTIVE DATE.This section is effective January 1, 2013, and applies to health
3.32benefit plans offered, issued, or renewed on or after that date.
