Title Minnesota Statutes, Minnesota Statutes

62D.105 COVERAGE OF CURRENT SPOUSE, FORMER SPOUSE, AND CHILDREN. § Subdivision 1.Requirement. Every health maintenance contract, which in addition to covering the enrollee also provides coverage to the spouse, dependent children, which is defined as required by section 62A.302, a…

62D.107 EQUAL ACCESS TO ACUPUNCTURE SERVICES. § Subdivision 1.Coverage. All benefits provided by a health maintenance contract relating to expenses incurred for acupuncture services that are provided by a physician must also include acupuncture treatment and services of a license…

62D.1071 COVERAGE OF LICENSED PHARMACIST SERVICES. § Subdivision 1.Pharmacist. All benefits provided by a health maintenance contract relating to expenses incurred for medical treatment or services provided by a licensed physician must include services provided by a licensed phar…

62D.109 SERVICES ASSOCIATED WITH CLINICAL TRIALS. A health maintenance organization must inform an enrollee who is a participant in a clinical trial upon inquiry by the enrollee that coverage shall be provided as required under the enrollee's health maintenance contract or under …

62D.11 COMPLAINT SYSTEM. § Subdivision 1.Enrollee complaint system. Every health maintenance organization shall establish and maintain a complaint system, as required under sections 62Q.68 to 62Q.72 to provide reasonable procedures for the resolution of written complaints initiat…

62D.115 QUALITY OF CARE COMPLAINTS. § Subdivision 1.Quality of care complaint. For purposes of this section, "quality of care complaint" means an expressed dissatisfaction regarding health care services resulting in potential or actual harm to an enrollee. Quality of care complai…

62D.12 PROHIBITED PRACTICES. § Subdivision 1.False representations. No health maintenance organization or representative thereof may cause or knowingly permit the use of advertising or solicitation which is untrue or misleading, or any form of evidence of coverage which is decept…

62D.121 REQUIRED REPLACEMENT COVERAGE. § Subdivision 1.Replacement coverage. When membership of an enrollee who has individual health coverage is terminated by the health maintenance organization for a reason other than (a) failure to pay the charge for health care coverage; (b) …

62D.123 PROVIDER CONTRACTS. § Subdivision 1.Provider agreement. Except for an employment agreement between a provider and health maintenance organization, an agreement to provide health care services between a provider and a health maintenance organization entered into or renewed…

62D.124 GEOGRAPHIC ACCESSIBILITY. § Subdivision 1.Primary care; mental health services; general hospital services. Within the health maintenance organization's service area, the maximum travel distance or time shall be the lesser of 30 miles or 30 minutes to the nearest provider …

62D.13 POWERS OF INSURERS AND NONPROFIT HEALTH SERVICE PLANS. Notwithstanding any law to the contrary, an insurer or a hospital or medical service plan corporation may contract with a health maintenance organization to provide insurance or similar protection against the cost of c…

62D.14 EXAMINATIONS. § Subdivision 1.Examination authority. The commissioner of health may make an examination of the affairs of any health maintenance organization and its contracts, agreements, or other arrangements with any participating entity as often as the commissioner of …

62D.145 DISCLOSURE OF INFORMATION HELD BY HEALTH MAINTENANCE ORGANIZATIONS. § Subdivision 1.Personal and privileged information. The ability of a health maintenance organization to disclose personal information, as defined in section 72A.491, subdivision 17, and privileged inform…

62D.15 SUSPENSION OR REVOCATION OF CERTIFICATE OF AUTHORITY. § Subdivision 1.Grounds for suspension or revocation. The commissioner of health may suspend or revoke any certificate of authority issued to a health maintenance organization under sections 62D.01 to 62D.30 if the comm…

62D.16 DENIAL, SUSPENSION, AND REVOCATION; ADMINISTRATIVE PROCEDURES. § Subdivision 1.Notice and hearing. When the commissioner of health has cause to believe that grounds for the denial, suspension or revocation of a certificate of authority exists, the commissioner shall notify…

62D.17 PENALTIES AND ENFORCEMENT. § Subdivision 1.Administrative penalty. The commissioner of health may, for any violation of statute or rule applicable to a health maintenance organization, or in lieu of suspension or revocation of a certificate of authority under section 62D.1…

62D.18 REHABILITATION OR LIQUIDATION OF HEALTH MAINTENANCE ORGANIZATION. § Subdivision 1.Commissioner of health; order. The commissioner of health may apply by verified petition to the district court of Ramsey County or the county in which the principal office of the health maint…

62D.181 INSOLVENCY; MCHA ALTERNATIVE COVERAGE. § Subdivision 1.Definition. "Association" means the Minnesota Comprehensive Health Association created in section 62E.10. § Subd. 2.Eligible individuals. An individual is eligible for alternative coverage under this section if: (1) t…

62D.182 LIABILITIES. Every health maintenance organization shall maintain liabilities estimated in the aggregate to be sufficient to pay all reported or unreported claims incurred that are unpaid and for which the organization is liable. Liabilities are computed under rules adopt…

62D.19 UNREASONABLE EXPENSES. No health maintenance organization shall incur or pay for any expense of any nature which is unreasonably high in relation to the value of the service or goods provided. The commissioner of health shall implement and enforce this section by rules ado…

62D.20 RULES. § Subdivision 1.Rulemaking. The commissioner of health may, pursuant to chapter 14, promulgate such reasonable rules as are necessary or proper to carry out the provisions of sections 62D.01 to 62D.30. Included among such rules shall be those which provide minimum r…

62D.21 FEES. Every health maintenance organization subject to sections 62D.01 to 62D.30 shall pay to the commissioner of health the following fees: (1) filing an application for a certificate of authority: $10,000; (2) filing an amendment to a certificate of authority: $125; (3) …

62D.211 RENEWAL FEE. Each health maintenance organization subject to sections 62D.01 to 62D.30 shall submit to the commissioner of health each year before June 15 a certificate of authority renewal fee in the amount of $30,000 each plus 88 cents per person enrolled in the health …

62D.22 STATUTORY CONSTRUCTION AND RELATIONSHIP TO OTHER LAWS. § Subdivision 1.Applicability. Except as otherwise provided herein, sections 62D.01 to 62D.30 do not apply to an insurer or nonprofit health service plan corporation licensed and regulated pursuant to the laws governin…

62D.221 OVERSIGHT OF TRANSACTIONS. § Subdivision 1.Insurance provisions applicable to health maintenance organizations. Health maintenance organizations are subject to sections 60A.135, 60A.136, 60A.137, 60A.16, 60A.161, 60D.17, 60D.18, and 60D.20 and must comply with the provisi…

62D.23 FILINGS AND REPORTS AS PUBLIC DOCUMENTS. All applications, filings, and reports required under sections 62D.01 to 62D.30 shall be treated as public documents. History: 1973 c 670 s 23; 1987 c 384 art 2 s 1

62D.24 COMMISSIONER OF HEALTH'S AUTHORITY TO CONTRACT. The commissioner of health, in carrying out the obligations under sections 62D.01 to 62D.30, may contract with the commissioner of commerce or other qualified persons to make recommendations concerning the determinations requ…

62D.30 DEMONSTRATION PROJECTS. § Subdivision 1.Projects allowed. The commissioner of health may establish demonstration projects to allow health maintenance organizations to extend coverage to: (1) individuals enrolled in Part A or Part B, or both, of the Medicare program, Title …

62E.01 CITATION. Sections 62E.01 to 62E.17 may be cited as the "Minnesota Comprehensive Health Insurance Act of 1976." History: 1976 c 296 art 1 s 1

62E.02 DEFINITIONS. § Subdivision 1.Application. For the purposes of sections 62E.01 to 62E.19, the terms and phrases defined in this section have the meanings given them. § Subd. 2.Employer. "Employer" means any person, partnership, association, trust, estate or corporation, inc…

62E.04 DUTIES OF INSURERS. § Subdivision 1.Individual policies. For each type of qualified plan described in section 62E.06, an insurer or fraternal issuing individual policies of accident and health insurance in this state, other than group conversion policies, shall develop and…

62E.05 INFORMATION ON QUALIFIED PLANS. § Subdivision 1.Certification. Upon application by an insurer, fraternal, or employer for certification of a plan of health coverage as a qualified plan or a qualified Medicare supplement plan for the purposes of sections 62E.01 to 62E.19, t…

62E.06 MINIMUM BENEFITS OF QUALIFIED PLAN. § Subdivision 1.Number three plan. A plan of health coverage shall be certified as a number three qualified plan if it otherwise meets the requirements established by chapters 62A, 62C, and 62Q, and the other laws of this state, whether …

62E.07 QUALIFIED MEDICARE SUPPLEMENT PLAN. (a) Any plan which provides benefits may be certified as a qualified Medicare supplement plan if the plan is designed to supplement Medicare and provides coverage of 100 percent of the deductibles required under Medicare, with exclusion …

62E.08 STATE PLAN PREMIUM. § Subdivision 1.Establishment. The association shall establish the following maximum premiums to be charged for membership in the comprehensive health insurance plan: (a) the premium for the number one qualified plan shall range from a minimum of 101 pe…

62E.09 DUTIES OF COMMISSIONER. The commissioner may: (a) formulate general policies to advance the purposes of sections 62E.01 to 62E.19; (b) supervise the creation of the Minnesota Comprehensive Health Association within the limits described in section 62E.10; (c) approve the se…

62E.091 APPROVAL OF STATE PLAN PREMIUMS. The association shall submit to the commissioner any premiums it proposes to become effective for coverage under the comprehensive health insurance plan, pursuant to section 62E.08, subdivision 3. No later than 45 days before the effective…

62E.10 COMPREHENSIVE HEALTH ASSOCIATION. § Subdivision 1.Creation; tax exemption. There is established a Comprehensive Health Association to promote the public health and welfare of the state of Minnesota with membership consisting of all insurers; self-insurers; fraternals; join…

62E.101 MANAGED CARE DELIVERY METHOD. The association may form a preferred provider network or contract with an existing provider network, health maintenance organization, or nonprofit health service plan corporation to deliver the services and benefits provided for in the plans …

62E.11 OPERATION OF COMPREHENSIVE PLAN. § Subdivision 1.Enrollment. Upon certification as an eligible person in the manner provided by section 62E.14, an eligible person may enroll in the comprehensive health insurance plan by payment of the state plan premium to the writing carr…

62E.12 MINIMUM BENEFITS OF COMPREHENSIVE HEALTH INSURANCE PLAN. (a) The association through its comprehensive health insurance plan shall offer policies which provide the benefits of a number one qualified plan and a number two qualified plan, except that the maximum lifetime ben…

62E.13 ADMINISTRATION OF PLAN. § Subdivision 1.Submission of plans of coverage. Any member of the association may submit to the commissioner the policies of accident and health insurance or the health maintenance organization contracts which are being proposed to serve in the com…

62E.14 ENROLLMENT BY AN ELIGIBLE PERSON. § Subdivision 1.Application, contents. The comprehensive health insurance plan shall be open for enrollment by eligible persons. An eligible person shall enroll by submission of an application to the writing carrier. The application must p…

62E.141 INCLUSION IN EMPLOYER-SPONSORED PLAN. No employee of an employer that offers a health plan, under which the employee is eligible for coverage, is eligible to enroll, or continue to be enrolled, in the Comprehensive Health Association, except for enrollment or continued en…

62E.15 SOLICITATION OF ELIGIBLE PERSONS. § Subdivision 1.Commissioner's duty. The association pursuant to a plan approved by the commissioner shall disseminate appropriate information to the residents of this state regarding the existence of the comprehensive health insurance pla…

62E.18 HEALTH INSURANCE FOR RETIRED EMPLOYEES NOT ELIGIBLE FOR MEDICARE. A Minnesota resident who is age 65 or over and is not eligible for the health insurance benefits of the federal Medicare program is entitled to purchase the benefits of a qualified plan, one or two, or the $…