Bill Text: MN SF2139 | 2011-2012 | 87th Legislature | Introduced
NOTE: There are more recent revisions of this legislation. Read Latest Draft
Bill Title: Child prenatal care services insurance coverage and continuation coverage upon divorce regulations; health maintenance organizations (HMO) regulatory authority shift from the commissioner of health to the commissioner of commerce
Sponsorship: Partisan Bill (Republican 1)
Status: (Introduced - Dead) 2012-03-14 - Comm report: To pass as amended and re-refer to Finance [SF2139 Detail]
Download: Minnesota-2011-SF2139-Introduced.html
Bill Title: Child prenatal care services insurance coverage and continuation coverage upon divorce regulations; health maintenance organizations (HMO) regulatory authority shift from the commissioner of health to the commissioner of commerce
Sponsorship: Partisan Bill (Republican 1)
Status: (Introduced - Dead) 2012-03-14 - Comm report: To pass as amended and re-refer to Finance [SF2139 Detail]
Download: Minnesota-2011-SF2139-Introduced.html
1.2relating to insurance; shifting regulatory authority over health maintenance
1.3organizations from the commissioner of health to the commissioner of commerce;
1.4amending Minnesota Statutes 2010, sections 62D.02, subdivision 3; 62D.05,
1.5subdivision 6; 62D.12, subdivision 1.
1.6BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
1.7 Section 1. Minnesota Statutes 2010, section 62D.02, subdivision 3, is amended to read:
1.8 Subd. 3. Commissioner ofhealth commerce or commissioner. "Commissioner of
1.9health commerce" or "commissioner" means the state commissioner of health commerce
1.10or a designee.
1.11 Sec. 2. Minnesota Statutes 2010, section 62D.05, subdivision 6, is amended to read:
1.12 Subd. 6. Supplemental benefits. (a) A health maintenance organization may, as
1.13a supplemental benefit, provide coverage to its enrollees for health care services and
1.14supplies received from providers who are not employed by, under contract with, or
1.15otherwise affiliated with the health maintenance organization. Supplemental benefits may
1.16be provided if the following conditions are met:
1.17(1) a health maintenance organization desiring to offer supplemental benefits must at
1.18all times comply with the requirements of sections62D.041 and
62D.042 ;
1.19(2) a health maintenance organization offering supplemental benefits must maintain
1.20an additional surplus in the first year supplemental benefits are offered equal to the
1.21lesser of $500,000 or 33 percent of the supplemental benefit expenses. At the end of
1.22the second year supplemental benefits are offered, the health maintenance organization
1.23must maintain an additional surplus equal to the lesser of $1,000,000 or 33 percent of the
1.24supplemental benefit expenses. At the end of the third year benefits are offered and every
2.1year after that, the health maintenance organization must maintain an additional surplus
2.2equal to the greater of $1,000,000 or 33 percent of the supplemental benefit expenses.
2.3When in the judgment of the commissioner the health maintenance organization's surplus
2.4is inadequate, the commissioner may require the health maintenance organization to
2.5maintain additional surplus;
2.6(3) claims relating to supplemental benefits must be processed in accordance with
2.7the requirements of section72A.201 ; and
2.8(4) in marketing supplemental benefits, the health maintenance organization shall
2.9fully disclose and describe to enrollees and potential enrollees the nature and extent of the
2.10supplemental coverage, and any claims filing and other administrative responsibilities in
2.11regard to supplemental benefits.
2.12(b) The commissioner may, pursuant to chapter 14, adopt, enforce, and administer
2.13rules relating to this subdivision, including: rules insuring that these benefits are
2.14supplementary and not substitutes for comprehensive health maintenance services by
2.15addressing percentage of out-of-plan coverage; rules relating to the establishment of
2.16necessary financial reserves; rules relating to marketing practices; and other rules necessary
2.17for the effective and efficient administration of this subdivision.The commissioner, in
2.18adopting rules, shall give consideration to existing laws and rules administered and
2.19enforced by the Department of Commerce relating to health insurance plans.
2.20 Sec. 3. Minnesota Statutes 2010, section 62D.12, subdivision 1, is amended to read:
2.21 Subdivision 1. False representations. No health maintenance organization or
2.22representative thereof may cause or knowingly permit the use of advertising or solicitation
2.23which is untrue or misleading, or any form of evidence of coverage which is deceptive.
2.24Each health maintenance organization shall be subject to sections72A.17 to
72A.32 ,
2.25relating to the regulation of trade practices, except(a) to the extent that the nature of a
2.26health maintenance organization renders such sections clearly inappropriateand (b) that
2.27enforcement shall be by the commissioner of health and not by the commissioner of
2.28commerce. Every health maintenance organization shall be subject to sections
8.31 and
2.29325F.69
.
2.30 Sec. 4. REVISOR'S INSTRUCTION.
2.31The revisor of statutes shall, in conforming with section 1, change the terms
2.32"commissioner of health" or similar term to "commissioner of commerce" or similar term
2.33and "department of health" or similar term to "department of commerce" or similar term in
2.34each place it occurs in Minnesota Statutes, chapter 62D.
3.1 Sec. 5. EFFECTIVE DATE.
3.2Sections 1 to 4 are effective August 1, 2012.
1.3organizations from the commissioner of health to the commissioner of commerce;
1.4amending Minnesota Statutes 2010, sections 62D.02, subdivision 3; 62D.05,
1.5subdivision 6; 62D.12, subdivision 1.
1.6BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
1.7 Section 1. Minnesota Statutes 2010, section 62D.02, subdivision 3, is amended to read:
1.8 Subd. 3. Commissioner of
1.9
1.10or a designee.
1.11 Sec. 2. Minnesota Statutes 2010, section 62D.05, subdivision 6, is amended to read:
1.12 Subd. 6. Supplemental benefits. (a) A health maintenance organization may, as
1.13a supplemental benefit, provide coverage to its enrollees for health care services and
1.14supplies received from providers who are not employed by, under contract with, or
1.15otherwise affiliated with the health maintenance organization. Supplemental benefits may
1.16be provided if the following conditions are met:
1.17(1) a health maintenance organization desiring to offer supplemental benefits must at
1.18all times comply with the requirements of sections
1.19(2) a health maintenance organization offering supplemental benefits must maintain
1.20an additional surplus in the first year supplemental benefits are offered equal to the
1.21lesser of $500,000 or 33 percent of the supplemental benefit expenses. At the end of
1.22the second year supplemental benefits are offered, the health maintenance organization
1.23must maintain an additional surplus equal to the lesser of $1,000,000 or 33 percent of the
1.24supplemental benefit expenses. At the end of the third year benefits are offered and every
2.1year after that, the health maintenance organization must maintain an additional surplus
2.2equal to the greater of $1,000,000 or 33 percent of the supplemental benefit expenses.
2.3When in the judgment of the commissioner the health maintenance organization's surplus
2.4is inadequate, the commissioner may require the health maintenance organization to
2.5maintain additional surplus;
2.6(3) claims relating to supplemental benefits must be processed in accordance with
2.7the requirements of section
2.8(4) in marketing supplemental benefits, the health maintenance organization shall
2.9fully disclose and describe to enrollees and potential enrollees the nature and extent of the
2.10supplemental coverage, and any claims filing and other administrative responsibilities in
2.11regard to supplemental benefits.
2.12(b) The commissioner may, pursuant to chapter 14, adopt, enforce, and administer
2.13rules relating to this subdivision, including: rules insuring that these benefits are
2.14supplementary and not substitutes for comprehensive health maintenance services by
2.15addressing percentage of out-of-plan coverage; rules relating to the establishment of
2.16necessary financial reserves; rules relating to marketing practices; and other rules necessary
2.17for the effective and efficient administration of this subdivision.
2.18
2.19
2.20 Sec. 3. Minnesota Statutes 2010, section 62D.12, subdivision 1, is amended to read:
2.21 Subdivision 1. False representations. No health maintenance organization or
2.22representative thereof may cause or knowingly permit the use of advertising or solicitation
2.23which is untrue or misleading, or any form of evidence of coverage which is deceptive.
2.24Each health maintenance organization shall be subject to sections
2.25relating to the regulation of trade practices, except
2.26health maintenance organization renders such sections clearly inappropriate
2.27
2.28
2.30 Sec. 4. REVISOR'S INSTRUCTION.
2.31The revisor of statutes shall, in conforming with section 1, change the terms
2.32"commissioner of health" or similar term to "commissioner of commerce" or similar term
2.33and "department of health" or similar term to "department of commerce" or similar term in
2.34each place it occurs in Minnesota Statutes, chapter 62D.
3.1 Sec. 5. EFFECTIVE DATE.
3.2Sections 1 to 4 are effective August 1, 2012.
