1.1.................... moves to amend S.F. No. 4097, the second engrossment, as amended, as
1.2follows:
1.3Page 132, after line 11, insert:

1.4    "Sec. .... Minnesota Statutes 2023 Supplement, section 62Q.522, subdivision 1, is amended
1.5to read:
1.6    Subdivision 1. Definitions. (a) The definitions in this subdivision apply to this section.
1.7(b) "Closely held for-profit entity" means an entity that:
1.8(1) is not a nonprofit entity;
1.9(2) has more than 50 percent of the value of its ownership interest owned directly or
1.10indirectly by five or fewer owners; and
1.11(3) has no publicly traded ownership interest.
1.12For purposes of this paragraph:
1.13(i) ownership interests owned by a corporation, partnership, limited liability company,
1.14estate, trust, or similar entity are considered owned by that entity's shareholders, partners,
1.15members, or beneficiaries in proportion to their interest held in the corporation, partnership,
1.16limited liability company, estate, trust, or similar entity;
1.17(ii) ownership interests owned by a nonprofit entity are considered owned by a single
1.18owner;
1.19(iii) ownership interests owned by all individuals in a family are considered held by a
1.20single owner. For purposes of this item, "family" means brothers and sisters, including
1.21half-brothers and half-sisters, a spouse, ancestors, and lineal descendants; and
2.1(iv) if an individual or entity holds an option, warrant, or similar right to purchase an
2.2ownership interest, the individual or entity is considered to be the owner of those ownership
2.3interests.
2.4(c) (b) "Contraceptive method" means a drug, device, or other product approved by the
2.5Food and Drug Administration to prevent unintended pregnancy.
2.6(d) (c) "Contraceptive service" means consultation, examination, procedures, and medical
2.7services related to the prevention of unintended pregnancy, excluding vasectomies. This
2.8includes but is not limited to voluntary sterilization procedures, patient education, counseling
2.9on contraceptives, and follow-up services related to contraceptive methods or services,
2.10management of side effects, counseling for continued adherence, and device insertion or
2.11removal.
2.12(e) "Eligible organization" means an organization that opposes providing coverage for
2.13some or all contraceptive methods or services on account of religious objections and that
2.14is:
2.15(1) organized as a nonprofit entity and holds itself out to be religious; or
2.16(2) organized and operates as a closely held for-profit entity, and the organization's
2.17owners or highest governing body has adopted, under the organization's applicable rules of
2.18governance and consistent with state law, a resolution or similar action establishing that the
2.19organization objects to covering some or all contraceptive methods or services on account
2.20of the owners' sincerely held religious beliefs.
2.21(f) "Exempt organization" means an organization that is organized and operates as a
2.22nonprofit entity and meets the requirements of section 6033(a)(3)(A)(i) or (iii) of the Internal
2.23Revenue Code of 1986, as amended.
2.24(g) (d) "Medical necessity" includes but is not limited to considerations such as severity
2.25of side effects, difference in permanence and reversibility of a contraceptive method or
2.26service, and ability to adhere to the appropriate use of the contraceptive method or service,
2.27as determined by the attending provider.
2.28(h) (e) "Therapeutic equivalent version" means a drug, device, or product that can be
2.29expected to have the same clinical effect and safety profile when administered to a patient
2.30under the conditions specified in the labeling, and that:
2.31(1) is approved as safe and effective;
3.1(2) is a pharmaceutical equivalent: (i) containing identical amounts of the same active
3.2drug ingredient in the same dosage form and route of administration; and (ii) meeting
3.3compendial or other applicable standards of strength, quality, purity, and identity;
3.4(3) is bioequivalent in that:
3.5(i) the drug, device, or product does not present a known or potential bioequivalence
3.6problem and meets an acceptable in vitro standard; or
3.7(ii) if the drug, device, or product does present a known or potential bioequivalence
3.8problem, it is shown to meet an appropriate bioequivalence standard;
3.9(4) is adequately labeled; and
3.10(5) is manufactured in compliance with current manufacturing practice regulations.
3.11EFFECTIVE DATE.This section is effective January 1, 2025, and applies to health
3.12plans offered, sold, issued, or renewed on or after that date.

3.13    Sec. .... Minnesota Statutes 2023 Supplement, section 62Q.523, subdivision 1, is amended
3.14to read:
3.15    Subdivision 1. Scope of coverage. Except as otherwise provided in section 62Q.522
3.1662Q.679, subdivisions 2 and 3 and 4, all health plans that provide prescription coverage
3.17must comply with the requirements of this section.
3.18EFFECTIVE DATE.This section is effective January 1, 2025, and applies to health
3.19plans offered, sold, issued, or renewed on or after that date."
3.20Page 132, line 30, delete "Gender affirming" and insert "Gender-affirming"
3.21Page 133, after line 4, insert:
3.22"EFFECTIVE DATE.This section is effective January 1, 2025.

3.23    Sec. .... [62Q.679] RELIGIOUS OBJECTIONS.
3.24    Subdivision 1. Definitions. (a) The definitions in this subdivision apply to this section.
3.25(b) "Closely held for-profit entity" means an entity that is not a nonprofit entity, has
3.26more than 50 percent of the value of its ownership interest owned directly or indirectly by
3.27five or fewer owners, and has no publicly traded ownership interest. For purposes of this
3.28paragraph:
3.29(1) ownership interests owned by a corporation, partnership, limited liability company,
3.30estate, trust, or similar entity are considered owned by that entity's shareholders, partners,
4.1members, or beneficiaries in proportion to their interest held in the corporation, partnership,
4.2limited liability company, estate, trust, or similar entity;
4.3(2) ownership interests owned by a nonprofit entity are considered owned by a single
4.4owner;
4.5(3) ownership interests owned by all individuals in a family are considered held by a
4.6single owner. For purposes of this clause, "family" means brothers and sisters, including
4.7half-brothers and half-sisters, a spouse, ancestors, and lineal descendants; and
4.8(4) if an individual or entity holds an option, warrant, or similar right to purchase an
4.9ownership interest, the individual or entity is considered to be the owner of those ownership
4.10interests.
4.11(c) "Eligible organization" means an organization that opposes covering some or all
4.12health benefits under section 62Q.522 or 62Q.585 on account of religious objections and
4.13that is:
4.14(1) organized as a nonprofit entity and holds itself out to be religious; or
4.15(2) organized and operates as a closely held for-profit entity, and the organization's
4.16owners or highest governing body has adopted, under the organization's applicable rules of
4.17governance and consistent with state law, a resolution or similar action establishing that the
4.18organization objects to covering some or all health benefits under section 62Q.522 or
4.1962Q.585 on account of the owners' sincerely held religious beliefs.
4.20(d) "Exempt organization" means an organization that is organized and operates as a
4.21nonprofit entity and meets the requirements of section 6033(a)(3)(A)(i) or (iii) of the Internal
4.22Revenue Code of 1986, as amended.
4.23    Subd. 2. Exemption. (a) An exempt organization is not required to provide coverage
4.24under section 62Q.522 or 62Q.585 if the exempt organization has religious objections to
4.25the coverage. An exempt organization that chooses to not provide coverage pursuant to this
4.26paragraph must notify employees as part of the hiring process and must notify all employees
4.27at least 30 days before:
4.28(1) an employee enrolls in the health plan; or
4.29(2) the effective date of the health plan, whichever occurs first.
4.30(b) If the exempt organization provides partial coverage under section 62Q.522 or
4.3162Q.585, the notice required under paragraph (a) must provide a list of the portions of such
4.32coverage which the organization refuses to cover.
5.1    Subd. 3. Accommodation for eligible organizations. (a) A health plan established or
5.2maintained by an eligible organization complies with the coverage requirements of section
5.362Q.522 or 62Q.585, with respect to the health benefits identified in the notice under this
5.4paragraph, if the eligible organization provides notice to any health plan company with
5.5which the eligible organization contracts that it is an eligible organization and that the
5.6eligible organization has a religious objection to coverage for all or a subset of the health
5.7benefits under section 62Q.522 or 62Q.585.
5.8(b) The notice from an eligible organization to a health plan company under paragraph
5.9(a) must include: (1) the name of the eligible organization; (2) a statement that it objects to
5.10coverage for some or all of the health benefits under section 62Q.522 or 62Q.585, including
5.11a list of the health benefits to which the eligible organization objects, if applicable; and (3)
5.12the health plan name. The notice must be executed by a person authorized to provide notice
5.13on behalf of the eligible organization.
5.14(c) An eligible organization must provide a copy of the notice under paragraph (a) to
5.15prospective employees as part of the hiring process and to all employees at least 30 days
5.16before:
5.17(1) an employee enrolls in the health plan; or
5.18(2) the effective date of the health plan, whichever occurs first.
5.19(d) A health plan company that receives a copy of the notice under paragraph (a) with
5.20respect to a health plan established or maintained by an eligible organization must, for all
5.21future enrollments in the health plan:
5.22(1) expressly exclude coverage for those health benefits identified in the notice under
5.23paragraph (a) from the health plan; and
5.24(2) provide separate payments for any health benefits required to be covered under
5.25section 62Q.522 or 62Q.585 for enrollees as long as the enrollee remains enrolled in the
5.26health plan.
5.27(e) The health plan company must not impose any cost-sharing requirements, including
5.28co-pays, deductibles, or coinsurance, or directly or indirectly impose any premium, fee, or
5.29other charge for the health benefits under section 62Q.522 on the enrollee. The health plan
5.30company must not directly or indirectly impose any premium, fee, or other charge for the
5.31health benefits under section 62Q.522 or 62Q.585 on the eligible organization or health
5.32plan.
6.1(f) On January 1, 2024, and every year thereafter a health plan company must notify the
6.2commissioner, in a manner determined by the commissioner, of the number of eligible
6.3organizations granted an accommodation under this subdivision.
6.4EFFECTIVE DATE.This section is effective January 1, 2025, and applies to health
6.5plans offered, sold, issued, or renewed on or after that date."
6.6Page 144, delete section 17 and insert:

6.7    "Sec. .... REPEALER.
6.8(a) Minnesota Statutes 2022, section 332.3351, is repealed.
6.9(b) Minnesota Statutes 2023 Supplement, section 62Q.522, subdivisions 3 and 4, are
6.10repealed.
6.11EFFECTIVE DATE.Paragraph (b) is effective January 1, 2025, and applies to health
6.12plans offered, sold, issued, or renewed on or after that date."
6.13Renumber the sections in sequence and correct the internal references
6.14Amend the title accordingly