Title Minnesota Statutes, Minnesota Statutes

62Q.751 COLLECTING DEDUCTIBLES AND COINSURANCE. A health plan company shall not prohibit providers from collecting deductibles and coinsurance from patients at or prior to the time of service. Providers may not withhold a service to a health plan company enrollee based on a patie…

62Q.76 DEFINITIONS. § Subdivision 1.Applicability. For purposes of sections 62Q.76 to 62Q.79, the terms defined in this section have the meanings given them. § Subd. 2.Dental care services. "Dental care services" means services performed by a licensed dentist or any person workin…

62Q.77 TERMS OF COVERAGE DISCLOSURE. A dental organization shall make available to an enrollee, upon request, a clear and concise description of the following terms of coverage: (1) the dental care services and other benefits to which the enrollee is entitled under the dental pla…

62Q.78 DENTAL BENEFIT PLAN REQUIREMENTS. § Subdivision 1.Utilization profiling. (a) A dental organization that uses utilization profiling as a method of differentiating provider reimbursement or as a requirement for continued participation in the organization's provider network s…

62Q.79 LIMITATIONS. (a) The provisions contained in section 62Q.77 shall not require a dental organization to disclose information which the dental organization is already obligated to disclose under applicable Minnesota law governing the operation of the dental organization. (b)…

62Q.80 COMMUNITY-BASED HEALTH CARE COVERAGE PROGRAM. § Subdivision 1.Scope. (a) Any community-based health care initiative may develop and operate community-based health care coverage programs that offer to eligible individuals and their dependents the option of purchasing throug…

62Q.81 ESSENTIAL HEALTH BENEFIT PACKAGE REQUIREMENTS. § Subdivision 1.Essential health benefits package. (a) Health plan companies offering individual and small group health plans must include the essential health benefits package required under section 1302(a) of the Affordable …

62Q.82 BENEFITS AND COVERAGE EXPLANATION. § Subdivision 1.Summary. Health plan companies offering health plans shall provide a summary of benefits and coverage explanation as required by the Affordable Care Act to: (1) an applicant at the time of application; (2) an enrollee prio…

62Q.83 FORMULARY CHANGES. § Subdivision 1.Definitions. (a) For purposes of this section, the following terms have the meanings given. (b) "Drug" has the meaning given in section 151.01, subdivision 5. (c) "Enrollee" has the meaning given in section 62Q.01, subdivision 2b. (d) "Fo…

62R.01 STATEMENT OF LEGISLATIVE PURPOSE AND INTENT. The legislature finds that the goals of containing health care costs, improving the quality of health care, and increasing the access of Minnesota citizens to health care services reflected under chapters 62J and 62N may be furt…

62R.02 CITATION. This chapter may be cited as the "Minnesota Health Care Cooperative Act." History: 1994 c 625 art 11 s 2

62R.03 APPLICABILITY OF OTHER LAWS. § Subdivision 1.Minnesota Cooperative Law. A health care cooperative is subject to chapter 308A unless otherwise provided in this chapter. After incorporation, a health care cooperative shall enjoy the powers and privileges and shall be subject…

62R.04 DEFINITIONS. § Subdivision 1.Scope. For purposes of this chapter, the terms defined in this section have the meanings given. § Subd. 2.Health care cooperative. "Health care cooperative" means a health care network cooperative or a health provider cooperative. § Subd. 3.Hea…

62R.05 POWERS. In addition to the powers enumerated under section 308A.201, a health care cooperative shall have all of the powers granted a nonprofit corporation under section 317A.161, except to the extent expressly inconsistent with the provisions of chapter 308A. History: 199…

62R.06 HEALTH CARE SERVICE CONTRACTS. § Subdivision 1.Provider contracts. A health provider cooperative and its licensed members may execute marketing and service contracts requiring the provider members to provide some or all of their health care services through the provider co…

62R.07 RELICENSURE. (a) A health care network cooperative licensed under chapter 62C or 62D may relinquish that license and be granted a new license as a community integrated service network under chapter 62N in accordance with this section, provided that the cooperative meets al…

62R.08 PROHIBITED PRACTICES. (a) It shall be unlawful for any person, company, or corporation, or any agent, officer, or employee thereof, to coerce or require any person to agree, either in writing or orally, not to join or become or remain a member of, any health care provider …

62R.09 STATE OVERSIGHT AND SUPERVISION. § Subdivision 1.Review and approval; monitoring. (a) The commissioner of health shall review and authorize contracts and business or financial arrangements under section 62R.06, subdivision 1, and any modification, renewal, or extension of …

62R.26 [Obsolete]

62S.01 DEFINITIONS. § Subdivision 1.Application. The definitions in this section apply to this chapter. § Subd. 2.Activities of daily living. "Activities of daily living" means eating, toileting, transferring, bathing, dressing, and continence. § Subd. 3.Acute condition. "Acute c…

62S.02 QUALIFIED LONG-TERM CARE INSURANCE POLICY. § Subdivision 1.Requirements. A qualified long-term care insurance policy may not be offered, issued, delivered, or renewed in this state unless the policy satisfies the requirements of this chapter and the filing provisions of se…

62S.021 LONG-TERM CARE INSURANCE; INITIAL FILING. § Subdivision 1.Applicability. This section applies to any long-term care policy issued in this state on or after January 1, 2002, under this chapter or sections 62A.46 to 62A.56. § Subd. 2.Required submission to commissioner. An …

62S.03 EXTRATERRITORIAL JURISDICTION. Group long-term care insurance coverage may not be offered to a resident of this state under a group policy issued in another state to a group described in section 62S.01, subdivision 15, clause (4), unless this state or another state having …

62S.04 PROHIBITIONS. A long-term care insurance policy may not: (1) be canceled, nonrenewed, or otherwise terminated on the grounds of the age or the deterioration of the mental or physical health of the insured individual or certificate holder; (2) contain a provision establishi…

62S.05 PREEXISTING CONDITION. § Subdivision 1.Authorized definition. A long-term care insurance policy or certificate, other than a policy or certificate issued to a group as defined in section 62S.01, subdivision 15, clause (1), may not use a definition of preexisting condition …

62S.06 PRIOR HOSPITALIZATION OR INSTITUTIONALIZATION. § Subdivision 1.Prohibited conditions. A long-term care insurance policy may not be delivered or issued for delivery in this state if the policy conditions eligibility for any benefits: (1) on a prior hospitalization requireme…

62S.07 RIGHT TO RETURN; REFUND. § Subdivision 1.Right to return. A long-term care insurance applicant may return the policy or certificate within 30 days of its delivery and is entitled to a refund of the premium if, after examination of the policy or certificate, the applicant i…

62S.08 COVERAGE OUTLINE. § Subdivision 1.Delivery. An outline of coverage must be delivered to a prospective applicant for long-term care insurance at the time of initial solicitation through means that prominently direct the attention of the recipient to the document and its pur…

62S.081 REQUIRED DISCLOSURE OF RATING PRACTICES TO CONSUMERS. § Subdivision 1.Application. This section applies as follows: (a) Except as provided in paragraph (b), this section applies to any long-term care policy or certificate issued in this state on or after January 1, 2002. …

62S.09 CERTIFICATE REQUIREMENTS. § Subdivision 1.Content. A certificate issued under a group long-term care insurance policy delivered or issued for delivery in this state must include: (1) a description of the principal benefits and coverage provided in the policy; (2) a stateme…

62S.10 POLICY SUMMARY. § Subdivision 1.Delivery. At the time of policy delivery, a policy summary must be delivered for an individual life insurance policy that provides long-term care benefits within the policy or by rider. In the case of direct response solicitations, the insur…

62S.11 MONTHLY REPORT. § Subdivision 1.Required report. Any time a long-term care benefit, funded through a life insurance vehicle by the acceleration of the death benefit, is in benefit payment status, a monthly report must be provided to the policyholder. § Subd. 2.Contents. Th…

62S.12 CLAIM DENIAL. If a claim under a qualified long-term care insurance contract is denied, the issuer shall provide a written explanation of the reasons for the denial and make available all information directly related to the denial within 60 days of the date of a written re…

62S.13 INCONTESTABILITY PERIOD. § Subdivision 1.Rescission before six months. For a policy or certificate that has been in force for less than six months, an insurer may rescind a long-term care insurance policy or certificate or deny an otherwise valid long-term care insurance c…

62S.14 RENEWABILITY. § Subdivision 1.Guaranteed renewable. A qualified long-term care insurance policy must be guaranteed renewable. § Subd. 2.Terms. The terms "guaranteed renewable" and "noncancelable" may not be used in an individual long-term care insurance policy without furt…

62S.15 AUTHORIZED LIMITATIONS AND EXCLUSIONS. (a) No policy may be delivered or issued for delivery in this state as long-term care insurance if the policy limits or excludes coverage by type of illness, treatment, medical condition, or accident, except as follows: (1) preexistin…

62S.16 EXTENSION OF BENEFITS. Termination of long-term care insurance must be without prejudice to any benefits payable for institutionalization if the institutionalization began while the long-term care insurance was in force and continues without interruption after termination.…

62S.17 CONTINUATION OR CONVERSION. § Subdivision 1.Requirement. Group long-term care insurance shall provide covered individuals with a basis for continuation or conversion of coverage. § Subd. 2.Basis for continuation of coverage. A basis for continuation of coverage policy prov…

62S.18 DISCONTINUANCE AND REPLACEMENT. § Subdivision 1.Required coverage. If a group long-term care policy is replaced by another group long-term care policy issued to the same policyholder, the succeeding insurer shall offer coverage to all persons covered under the previous gro…

62S.181 ELECTRONIC ENROLLMENT FOR GROUP POLICIES. § Subdivision 1.Employers or labor unions. In the case of a group defined in section 62S.01, subdivision 15, clause (1), any requirement that a signature of an insured be obtained by an agent or insurer is satisfied if: (1) the co…

62S.19 UNINTENTIONAL LAPSE. § Subdivision 1.Notice before lapse or termination. No individual long-term care policy or certificate shall be issued until the insurer has received from the applicant either a written designation of at least one person, in addition to the applicant, …

62S.20 REQUIRED DISCLOSURE PROVISIONS. § Subdivision 1.Renewability. (a) Individual long-term care insurance policies must contain a renewability provision that is appropriately captioned, appears on the first page of the policy, and clearly states that the coverage is guaranteed…

62S.21 PROHIBITION AGAINST POSTCLAIMS UNDERWRITING. § Subdivision 1.Health condition. All applications for long-term care insurance policies or certificates, except those which are guaranteed issue must contain clear and unambiguous questions designed to ascertain the health cond…

62S.22 MINIMUM STANDARDS FOR HOME HEALTH AND COMMUNITY CARE BENEFITS. § Subdivision 1.Prohibited limitations. A long-term care insurance policy or certificate shall not, if it provides benefits for home health care or community care services, limit or exclude benefits by: (1) req…

62S.23 REQUIREMENT TO OFFER INFLATION PROTECTION. § Subdivision 1.Inflation protection feature. (a) No insurer may offer a long-term care insurance policy unless the insurer also offers to the policyholder, in addition to any other inflation protection, the option to purchase a p…

62S.24 REQUIREMENTS FOR APPLICATION FORMS AND REPLACEMENT COVERAGE. § Subdivision 1.Required questions. An application form must include the following questions designed to elicit information as to whether, as of the date of the application, the applicant has another long-term ca…