Title Minnesota Statutes, Minnesota Statutes

62A.4513 ISSUANCE OF CERTIFICATE OF AUTHORITY; DENIAL. § Subdivision 1.Issuance. Following receipt of an application filed under section 62A.4512, the commissioner shall review the application and notify the applicant of any deficiencies. The commissioner must approve or deny an …

62A.4514 FILING REQUIREMENTS FOR AUTHORIZED ENTITIES. (a) An entity authorized under the laws of this state to operate a health maintenance organization, an accident and health insurance company, a nonprofit health service plan corporation, a fraternal benefit society, or a multi…

62A.4515 MATERIAL MODIFICATIONS. § Subdivision 1.Material modifications. A prepaid limited health service organization shall file with the commissioner prior to use, a notice of any material modification of any matter or document furnished under section 62A.4512, together with su…

62A.4516 EVIDENCE OF COVERAGE. Every subscriber must be issued an evidence of coverage consistent with the requirements of Medicare Part D. History: 2005 c 17 art 2 s 7

62A.4517 CONSTRUCTION WITH OTHER LAWS. § Subdivision 1.Application of other insurance laws. (a) A prepaid limited health service organization organized under the laws of this state is deemed to be a domestic insurer for purposes of chapter 60D unless specifically exempted in writ…

62A.4518 NONDUPLICATION OF COVERAGE. Notwithstanding any other law of this state, a prepaid limited health service organization, health maintenance organization, accident and health insurance company, nonprofit health service plan corporation, or fraternal benefit society may exc…

62A.4519 COMPLAINT SYSTEM. Every prepaid limited health service organization shall establish and maintain a complaint system providing reasonable procedures for resolving written complaints initiated by enrollees and providers, consistent with the requirements of Medicare Part D.…

62A.4520 EXAMINATION OF ORGANIZATION. (a) The commissioner may examine the affairs of any prepaid limited health service organization as often as is reasonably necessary to protect the interests of the people of this state, but not less frequently than once every three years. (b)…

62A.4521 INVESTMENTS. The funds of a prepaid limited health service organization shall be invested only in accordance with the guidelines under chapter 62D for investments by health maintenance organizations. History: 2005 c 17 art 2 s 12

62A.4522 AGENTS. No individual may apply, procure, negotiate, or place for others any policy or contract of a prepaid limited health service organization unless that individual holds a license or is otherwise authorized to sell accident and health insurance policies, nonprofit he…

62A.4523 PROTECTION AGAINST INSOLVENCY; DEPOSIT. § Subdivision 1.Net equity. (a) Except as approved in accordance with subdivision 4, each prepaid limited health service organization shall at all times have and maintain tangible net equity equal to the greater of: (1) $100,000; o…

62A.4524 OFFICER'S AND EMPLOYEE'S FIDELITY BOND. (a) A prepaid limited health service organization shall maintain in force a fidelity bond in its own name on its officers and employees in an amount not less than $20,000,000 or in any other amount prescribed by the commissioner. E…

62A.4525 REPORTS. (a) Every prepaid limited health service organization shall file with the commissioner annually, on or before April 1, a report verified by at least two principal officers covering the preceding calendar year. (b) The report must be on forms prescribed by the co…

62A.4526 SUSPENSION OR REVOCATION OF CERTIFICATE OF AUTHORITY. § Subdivision 1.Grounds for suspension or revocation. The commissioner may suspend or revoke the certificate of authority issued to a prepaid limited health service organization under sections 62A.451 to 62A.4528 upon…

62A.4527 PENALTIES. In lieu of any penalty specified elsewhere in sections 62A.451 to 62A.4528, or when no penalty is specifically provided, whenever a prepaid limited health service organization or other person, corporation, partnership, or entity subject to those sections has b…

62A.4528 REHABILITATION, CONSERVATION, OR LIQUIDATION. (a) Any rehabilitation, conservation, or liquidation of a prepaid limited health service organization must be deemed to be the rehabilitation, conservation, or liquidation of an insurance company and must be conducted under c…

62A.46 DEFINITIONS. § Subdivision 1.Applicability. The definitions in this section apply to sections 62A.46 to 62A.56. § Subd. 2.Long-term care policy. "Long-term care policy" means an individual or group policy, certificate, subscriber contract, or other evidence of coverage tha…

62A.48 LONG-TERM CARE POLICIES. § Subdivision 1.Policy requirements. No individual or group policy, certificate, subscriber contract, or other evidence of coverage of nursing home care or other long-term care services shall be offered, issued, delivered, or renewed in this state,…

62A.49 HOME CARE SERVICES COVERAGE. § Subdivision 1.Generally. Section 62A.48 does not prohibit the sale of policies, certificates, subscriber contracts, or other evidences of coverage that provide home care services only. Home care services only policies may be sold, provided th…

62A.50 DISCLOSURES AND REPRESENTATIONS. § Subdivision 1.Seal or emblems. No graphic seal or emblem shall be displayed on any policy, or in connection with promotional materials on policy solicitations, that may reasonably be expected to convey to the purchaser that the policy for…

62A.52 REVIEW OF PLAN OF CARE. The insurer may review an insured's plan of care at reasonable intervals, but not more frequently than once every 30 days. History: 1986 c 397 s 6

62A.54 PROHIBITED PRACTICES. Unless otherwise provided for in sections 62A.46 to 62A.56, the solicitation or sale of long-term care policies is subject to the requirements and penalties applicable to the sale of Medicare supplement insurance policies as set forth in sections 62A.…

62A.56 RULEMAKING. § Subdivision 1.Permissive. The commissioner may adopt rules pursuant to chapter 14 to carry out the purposes of sections 62A.46 to 62A.56. The rules may: (1) establish additional disclosure requirements for long-term care policies designed to adequately inform…

62A.59 COVERAGE OF SERVICE; PRIOR AUTHORIZATION. § Subdivision 1.Service for which prior authorization not required. A health carrier must not retrospectively deny or limit coverage of a health care service for which prior authorization was not required by the health carrier, unl…

62A.60 RETROACTIVE DENIAL OF EXPENSES. In cases where the subscriber or insured is liable for costs beyond applicable co-payments or deductibles, no insurer may retroactively deny payment to a person who is covered when the services are provided for health care services that are …

62A.61 DISCLOSURE OF METHODS USED BY HEALTH CARRIERS TO DETERMINE USUAL AND CUSTOMARY FEES. (a) A health carrier that bases reimbursement to health care providers upon a usual and customary fee must maintain in its office a copy of a description of the methodology used to calcula…

62A.616 COVERAGE FOR NURSING HOME CARE FOR TERMINALLY ILL AND OTHER SERVICES. An insurer may offer a health plan that covers nursing home care for the terminally ill, personal care attendants, and hospice care. For the purposes of this section, "terminally ill" means a diagnosis …

62A.62 DEMONSTRATION PROJECT. § Subdivision 1.Establishment. The commissioner shall establish demonstration projects to allow health insurers regulated under this chapter and nonprofit health service plan corporations regulated under chapter 62C to extend coverage for health and …

62A.63 DEFINITIONS. § Subdivision 1.Application. For purposes of section 62A.64, the terms defined in this section have the meanings given them. § Subd. 2.Health care provider. "Health care provider" means a person, hospital, or health care facility, organization, or corporation …

62A.64 HEALTH INSURANCE; PROHIBITED AGREEMENTS. An agreement between an insurer and a health care provider may not: (1) prohibit, or grant the insurer an option to prohibit, the provider from contracting with other insurers or payors to provide services at a lower price than the …

62A.65 INDIVIDUAL MARKET REGULATION. § Subdivision 1.Applicability. No health carrier, as defined in section 62A.011, shall offer, sell, issue, or renew any individual health plan, as defined in section 62A.011, to a Minnesota resident except in compliance with this section. § Su…

62A.661 MS 2002 [Expired, 2002 c 378 s1]

62A.673 COVERAGE OF SERVICES PROVIDED THROUGH TELEHEALTH. § Subdivision 1.Citation. This section may be cited as the "Minnesota Telehealth Act." § Subd. 2.Definitions. (a) For purposes of this section, the terms defined in this subdivision have the meanings given. (b) "Distant si…