1.1    .................... moves to amend S. F. No. 2171, the second unofficial engrossment
1.2(UES2171-2), as follows:
1.3Page 377, delete Article 8, and insert:


1.6    Section 1. Minnesota Statutes 2006, section 13.46, subdivision 2, is amended to read:
1.7    Subd. 2. General. (a) Unless the data is summary data or a statute specifically
1.8provides a different classification, data on individuals collected, maintained, used, or
1.9disseminated by the welfare system is private data on individuals, and shall not be
1.10disclosed except:
1.11    (1) according to section 13.05;
1.12    (2) according to court order;
1.13    (3) according to a statute specifically authorizing access to the private data;
1.14    (4) to an agent of the welfare system, including a law enforcement person, attorney,
1.15or investigator acting for it in the investigation or prosecution of a criminal or civil
1.16proceeding relating to the administration of a program;
1.17    (5) to personnel of the welfare system who require the data to verify an individual's
1.18identity; determine eligibility, amount of assistance, and the need to provide services to
1.19an individual or family across programs; evaluate the effectiveness of programs; and
1.20investigate suspected fraud;
1.21    (6) to administer federal funds or programs;
1.22    (7) between personnel of the welfare system working in the same program;
1.23    (8) to the Department of Revenue to administer and evaluate tax refund or tax credit
1.24programs and to identify individuals who may benefit from these programs. The following
1.25information may be disclosed under this paragraph: an individual's and their dependent's
1.26names, dates of birth, Social Security numbers, income, addresses, and other data as
1.27required, upon request by the Department of Revenue. Disclosures by the commissioner
2.1of revenue to the commissioner of human services for the purposes described in this clause
2.2are governed by section 270B.14, subdivision 1. Tax refund or tax credit programs include,
2.3but are not limited to, the dependent care credit under section 290.067, the Minnesota
2.4working family credit under section 290.0671, the property tax refund and rental credit
2.5under section 290A.04, and the Minnesota education credit under section 290.0674;
2.6    (9) between the Department of Human Services, the Department of Education, and
2.7the Department of Employment and Economic Development for the purpose of monitoring
2.8the eligibility of the data subject for unemployment benefits, for any employment or
2.9training program administered, supervised, or certified by that agency, for the purpose of
2.10administering any rehabilitation program or child care assistance program, whether alone
2.11or in conjunction with the welfare system, or to monitor and evaluate the Minnesota
2.12family investment program by exchanging data on recipients and former recipients of food
2.13support, cash assistance under chapter 256, 256D, 256J, or 256K, child care assistance
2.14under chapter 119B, or medical programs under chapter 256B, 256D, or 256L;
2.15    (10) to appropriate parties in connection with an emergency if knowledge of
2.16the information is necessary to protect the health or safety of the individual or other
2.17individuals or persons;
2.18    (11) data maintained by residential programs as defined in section 245A.02 may
2.19be disclosed to the protection and advocacy system established in this state according
2.20to Part C of Public Law 98-527 to protect the legal and human rights of persons with
2.21developmental disabilities or other related conditions who live in residential facilities for
2.22these persons if the protection and advocacy system receives a complaint by or on behalf
2.23of that person and the person does not have a legal guardian or the state or a designee of
2.24the state is the legal guardian of the person;
2.25    (12) to the county medical examiner or the county coroner for identifying or locating
2.26relatives or friends of a deceased person;
2.27    (13) data on a child support obligor who makes payments to the public agency
2.28may be disclosed to the Minnesota Office of Higher Education to the extent necessary to
2.29determine eligibility under section 136A.121, subdivision 2, clause (5);
2.30    (14) participant Social Security numbers and names collected by the telephone
2.31assistance program may be disclosed to the Department of Revenue to conduct an
2.32electronic data match with the property tax refund database to determine eligibility under
2.33section 237.70, subdivision 4a;
2.34    (15) the current address of a Minnesota family investment program participant
2.35may be disclosed to law enforcement officers who provide the name of the participant
2.36and notify the agency that:
3.1    (i) the participant:
3.2    (A) is a fugitive felon fleeing to avoid prosecution, or custody or confinement after
3.3conviction, for a crime or attempt to commit a crime that is a felony under the laws of the
3.4jurisdiction from which the individual is fleeing; or
3.5    (B) is violating a condition of probation or parole imposed under state or federal law;
3.6    (ii) the location or apprehension of the felon is within the law enforcement officer's
3.7official duties; and
3.8    (iii) the request is made in writing and in the proper exercise of those duties;
3.9    (16) the current address of a recipient of general assistance or general assistance
3.10medical care may be disclosed to probation officers and corrections agents who are
3.11supervising the recipient and to law enforcement officers who are investigating the
3.12recipient in connection with a felony level offense;
3.13    (17) information obtained from food support applicant or recipient households may
3.14be disclosed to local, state, or federal law enforcement officials, upon their written request,
3.15for the purpose of investigating an alleged violation of the Food Stamp Act, according
3.16to Code of Federal Regulations, title 7, section 272.1(c);
3.17    (18) the address, Social Security number, and, if available, photograph of any
3.18member of a household receiving food support shall be made available, on request, to a
3.19local, state, or federal law enforcement officer if the officer furnishes the agency with the
3.20name of the member and notifies the agency that:
3.21    (i) the member:
3.22    (A) is fleeing to avoid prosecution, or custody or confinement after conviction, for a
3.23crime or attempt to commit a crime that is a felony in the jurisdiction the member is fleeing;
3.24    (B) is violating a condition of probation or parole imposed under state or federal
3.25law; or
3.26    (C) has information that is necessary for the officer to conduct an official duty related
3.27to conduct described in subitem (A) or (B);
3.28    (ii) locating or apprehending the member is within the officer's official duties; and
3.29    (iii) the request is made in writing and in the proper exercise of the officer's official
3.30duty;
3.31    (19) the current address of a recipient of Minnesota family investment program,
3.32general assistance, general assistance medical care, or food support may be disclosed to
3.33law enforcement officers who, in writing, provide the name of the recipient and notify the
3.34agency that the recipient is a person required to register under section 243.166, but is not
3.35residing at the address at which the recipient is registered under section 243.166;
4.1    (20) certain information regarding child support obligors who are in arrears may be
4.2made public according to section 518A.74;
4.3    (21) data on child support payments made by a child support obligor and data on
4.4the distribution of those payments excluding identifying information on obligees may be
4.5disclosed to all obligees to whom the obligor owes support, and data on the enforcement
4.6actions undertaken by the public authority, the status of those actions, and data on the
4.7income of the obligor or obligee may be disclosed to the other party;
4.8    (22) data in the work reporting system may be disclosed under section 256.998,
4.9subdivision 7 ;
4.10    (23) to the Department of Education for the purpose of matching Department of
4.11Education student data with public assistance data to determine students eligible for free
4.12and reduced price meals, meal supplements, and free milk according to United States
4.13Code, title 42, sections 1758, 1761, 1766, 1766a, 1772, and 1773; to allocate federal and
4.14state funds that are distributed based on income of the student's family; and to verify
4.15receipt of energy assistance for the telephone assistance plan;
4.16    (24) the current address and telephone number of program recipients and emergency
4.17contacts may be released to the commissioner of health or a local board of health as
4.18defined in section 145A.02, subdivision 2, when the commissioner or local board of health
4.19has reason to believe that a program recipient is a disease case, carrier, suspect case, or at
4.20risk of illness, and the data are necessary to locate the person;
4.21    (25) to other state agencies, statewide systems, and political subdivisions of this
4.22state, including the attorney general, and agencies of other states, interstate information
4.23networks, federal agencies, and other entities as required by federal regulation or law for
4.24the administration of the child support enforcement program;
4.25    (26) to personnel of public assistance programs as defined in section 256.741, for
4.26access to the child support system database for the purpose of administration, including
4.27monitoring and evaluation of those public assistance programs;
4.28    (27) to monitor and evaluate the Minnesota family investment program by
4.29exchanging data between the Departments of Human Services and Education, on
4.30recipients and former recipients of food support, cash assistance under chapter 256, 256D,
4.31256J, or 256K, child care assistance under chapter 119B, or medical programs under
4.32chapter 256B, 256D, or 256L;
4.33    (28) to evaluate child support program performance and to identify and prevent
4.34fraud in the child support program by exchanging data between the Department of Human
4.35Services, Department of Revenue under section 270B.14, subdivision 1, paragraphs (a)
4.36and (b), without regard to the limitation of use in paragraph (c), Department of Health,
5.1Department of Employment and Economic Development, and other state agencies as is
5.2reasonably necessary to perform these functions; or
5.3    (29) counties operating child care assistance programs under chapter 119B may
5.4disseminate data on program participants, applicants, and providers to the commissioner
5.5of education.; or
5.6    (30) pursuant to section 256L.02, subdivision 6, between the welfare system and
5.7the Minnesota Health Insurance Exchange, under section 62A.67, in order to enroll and
5.8collect premiums from individuals in the MinnesotaCare program under chapter 256L and
5.9to administer the individual's and their families' participation in the program.
5.10    (b) Information on persons who have been treated for drug or alcohol abuse may
5.11only be disclosed according to the requirements of Code of Federal Regulations, title
5.1242, sections 2.1 to 2.67.
5.13    (c) Data provided to law enforcement agencies under paragraph (a), clause (15),
5.14(16), (17), or (18), or paragraph (b), are investigative data and are confidential or protected
5.15nonpublic while the investigation is active. The data are private after the investigation
5.16becomes inactive under section 13.82, subdivision 5, paragraph (a) or (b).
5.17    (d) Mental health data shall be treated as provided in subdivisions 7, 8, and 9, but is
5.18not subject to the access provisions of subdivision 10, paragraph (b).
5.19    For the purposes of this subdivision, a request will be deemed to be made in writing
5.20if made through a computer interface system.

5.21    Sec. 2. [62A.67] MINNESOTA HEALTH INSURANCE EXCHANGE.
5.22    Subdivision 1. Title; citation. This section may be cited as the "Minnesota Health
5.23Insurance Exchange."
5.24    Subd. 2. Creation; tax exemption. The Minnesota Health Insurance Exchange
5.25is created for the limited purpose of providing individuals with greater access, choice,
5.26portability, and affordability of health insurance products. The Minnesota Health
5.27Insurance Exchange is a not-for-profit corporation under chapter 317A and section 501(c)
5.28of the Internal Revenue Code.
5.29    Subd. 3. Definitions. The following terms have the meanings given them unless
5.30otherwise provided in text.
5.31    (a) "Board" means the board of directors of the Minnesota Health Insurance
5.32Exchange under subdivision 13.
5.33    (b) "Commissioner" means:
5.34    (1) the commissioner of commerce for health insurers subject to the jurisdiction
5.35of the Department of Commerce;
6.1    (2) the commissioner of health for health insurers subject to the jurisdiction of the
6.2Department of Health; or
6.3    (3) either commissioner's designated representative.
6.4    (c) "Exchange" means the Minnesota Health Insurance Exchange.
6.5    (d) "HIPAA" means the Health Insurance Portability and Accountability Act of 1996.
6.6    (e) "Individual market health plans," unless otherwise specified, means individual
6.7market health plans defined in section 62A.011 and MinnesotaCare II products as defined
6.8in chapter 256L.
6.9    (f) "Section 125 Plan" means a Premium Only Plan under section 125 of the Internal
6.10Revenue Code.
6.11    Subd. 4. Insurer and health plan participation. All health plans as defined
6.12in section 62A.011, subdivision 3, issued or renewed in the individual market shall
6.13participate in the exchange. No health plans in the individual market may be issued
6.14or renewed outside of the exchange. Group health plans as defined in section 62A.10
6.15shall not be offered through the exchange. Health plans offered through the Minnesota
6.16Comprehensive Health Association as defined in section 62E.10 are offered through the
6.17exchange to eligible enrollees as determined by the Minnesota Comprehensive Health
6.18Association. Health plans offered through MinnesotaCare and MinnesotaCare II under
6.19chapter 256L are offered through the exchange to eligible enrollees as determined by the
6.20commissioner of human services.
6.21    Subd. 5. Approval of health plans. No health plan may be offered through the
6.22exchange unless the commissioner has first certified that:
6.23    (1) the insurer seeking to offer the health plan is licensed to issue health insurance in
6.24the state; and
6.25    (2) the health plan meets the requirements of this section, and the health plan and the
6.26insurer are in compliance with all other applicable health insurance laws.
6.27    Subd. 6. Individual market health plans. Individual market health plans offered
6.28through the exchange continue to be regulated by the commissioner as specified in
6.29chapters 62A, 62C, 62D, 62E, 62Q, and 72A, and must include the following provisions
6.30that apply to all health plans issued or renewed through the exchange:
6.31    (1) premiums for children under the age of 19 shall not vary by age in the exchange;
6.32and
6.33    (2) premiums for children under the age of 19 must be excluded from rating factors
6.34requirements under section 62A.65, subdivision 3, paragraph (b).
7.1    Subd. 7. MinnesotaCare II health plans. Health plans approved for MinnesotaCare
7.2II under section 256L.075 shall be offered by participating insurers to exchange
7.3participants not enrolled in MinnesotaCare II.
7.4    Subd. 8. Individual participation and eligibility. Individuals are eligible to
7.5purchase health plans directly through the exchange or through an employer Section
7.6125 Plan under section 62A.68. Nothing in this section requires guaranteed issue of
7.7individual market health plans offered through the exchange. Individuals are eligible to
7.8purchase individual market health plans through the exchange by meeting one or more
7.9of the following qualifications:
7.10    (1) the individual is a Minnesota resident, meaning the individual is physically
7.11residing on a permanent basis in a place that is the person's principal residence and from
7.12which the person is absent only for temporary purposes;
7.13    (2) the individual is a student attending an institution outside of Minnesota and
7.14maintains Minnesota residency;
7.15    (3) the individual is not a Minnesota resident but is employed by an employer
7.16physically located within the state and the individual's employer does not offer a group
7.17health insurance plan as defined in section 62A.10, but does offer a Section 125 Plan
7.18through the exchange under section 62A.68;
7.19    (4) the individual is not a Minnesota resident but is self-employed and the
7.20individual's principal place of business is in the state; or
7.21    (5) the individual is a dependent as defined in section 62L.02, of another individual
7.22who is eligible to participate in the exchange.
7.23    Subd. 9. Continuation of coverage. Enrollment in a health plan may be canceled
7.24for nonpayment of premiums, fraud, or changes in eligibility for MinnesotaCare under
7.25chapter 256L. Enrollment in an individual market health plan may not be canceled or
7.26renewed because of any change in employer or employment status, marital status, health
7.27status, age, residence, or any other change that does not affect eligibility as defined
7.28in this section.
7.29    Subd. 10. Responsibilities of the exchange. The exchange shall serve as the sole
7.30entity for enrollment and collection and transfer of premium payments for health plans
7.31offered through the exchange. The exchange shall be responsible for the following
7.32functions:
7.33    (1) publicize the exchange, including but not limited to its functions, eligibility
7.34rules, and enrollment procedures;
8.1    (2) provide assistance to employers to set up an employer Section 125 Plan under
8.2section 62A.68;
8.3    (3) create a system to allow individuals to compare and enroll in health plans offered
8.4through the exchange;
8.5    (4) create a system to collect and transmit to the applicable plans all premium
8.6payments or contributions made by or on behalf of individuals, including developing
8.7mechanisms to receive and process automatic payroll deductions for individuals enrolled
8.8in employer Section 125 Plans;
8.9    (5) refer individuals interested in MinnesotaCare or MinnesotaCare II under chapter
8.10256L to the Department of Human Services to determine eligibility;
8.11    (6) establish a mechanism with the Department of Human Services to transfer
8.12premiums and subsidies for MinnesotaCare and MinnesotaCare II to qualify for federal
8.13matching payments;
8.14    (7) administer bonus accounts as defined in chapter 256L to reimburse
8.15MinnesotaCare II enrollees for qualified medical expenses under section 213(d) of the
8.16Internal Revenue Code;
8.17    (8) collect and assess information for eligibility for bonus accounts and premium
8.18incentives under chapter 256L;
8.19    (9) upon request, issue certificates of previous coverage according to the provisions
8.20of HIPAA and as referenced in section 62Q.181 to all such individuals who cease to be
8.21covered by a participating health plan through the exchange;
8.22    (10) establish procedures to account for all funds received and disbursed by the
8.23exchange for individual participants of the exchange; and
8.24    (11) make available to the public, at the end of each calendar year, a report of an
8.25independent audit of the exchange's accounts.
8.26    Subd. 11. Powers of the exchange. The exchange shall have the power to:
8.27    (1) contract with insurance producers licensed in accident and health insurance
8.28under chapter 60K and vendors to perform one or more of the functions specified in
8.29subdivision 10;
8.30    (2) contract with employers to act as the plan administrator for participating
8.31employer Section 125 Plans and to undertake the obligations required by federal law
8.32of a plan administrator;
8.33    (3) establish and assess fees on health plan premiums of health plans purchased
8.34through the exchange to fund the cost of administering the exchange;
8.35    (4) seek and directly receive grant funding from government agencies or private
8.36philanthropic organizations to defray the costs of operating the exchange;
9.1    (5) establish and administer rules and procedures governing the operations of the
9.2exchange;
9.3    (6) establish one or more service centers within Minnesota;
9.4    (7) sue or be sued or otherwise take any necessary or proper legal action;
9.5    (8) establish bank accounts and borrow money; and
9.6    (9) enter into agreements with the commissioners of commerce, health, human
9.7services, revenue, employment and economic development, and other state agencies as
9.8necessary for the exchange to implement the provisions of this section.
9.9    Subd. 12. Dispute resolution. The exchange shall establish procedures for
9.10resolving disputes with respect to the eligibility of an individual to participate in the
9.11exchange. The exchange does not have the authority or responsibility to intervene in or
9.12resolve disputes between an individual and a health plan or health insurer. The exchange
9.13shall refer complaints from individuals participating in the exchange to the commissioner
9.14of human services to be resolved according to sections 62Q.68 to 62Q.73.
9.15    Subd. 13. Governance. The exchange shall be governed by a board of directors
9.16with 11 members. The board shall convene on or before July 1, 2007, after the initial board
9.17members have been selected. The initial board membership consists of the following:
9.18    (1) the commissioner of commerce;
9.19    (2) the commissioner of human services;
9.20    (3) the commissioner of health;
9.21    (4) four members appointed by a joint committee of the Minnesota senate and the
9.22Minnesota house of representatives to serve three-year terms; and
9.23    (5) four members appointed by the governor to serve three-year terms.
9.24    Subd. 14. Subsequent board membership. Ongoing membership of the exchange
9.25consists of the following effective July 1, 2010:
9.26    (1) the commissioner of commerce;
9.27    (2) the commissioner of human services;
9.28    (3) the commissioner of health;
9.29    (4) four members appointed by the governor with the approval of a joint committee
9.30of the senate and house of representatives to serve two- or three-year terms. Appointed
9.31members may serve more than one term; and
9.32    (5) four members elected by the membership of the exchange of which two are
9.33elected to serve a two-year term and two are elected to serve a three-year term. Elected
9.34members may serve more than one term.
10.1    Subd. 15. Operations of the board. Officers of the board of directors are elected by
10.2members of the board and serve one-year terms. Six members of the board constitutes a
10.3quorum, and the affirmative vote of six members of the board is necessary and sufficient
10.4for any action taken by the board. Board members serve without pay, but are reimbursed
10.5for actual expenses incurred in the performance of their duties.
10.6    Subd. 16. Operations of the exchange. The board of directors shall appoint an
10.7exchange director who shall:
10.8    (1) be a full-time employee of the exchange;
10.9    (2) administer all of the activities and contracts of the exchange; and
10.10    (3) hire and supervise the staff of the exchange.
10.11    Subd. 17. Insurance producers. When a producer licensed in accident and health
10.12insurance under chapter 60K enrolls an eligible individual in the exchange, the health plan
10.13chosen by an individual may pay the producer a commission.
10.14    Subd. 18. Implementation. Health plan coverage through the exchange begins on
10.15January 1, 2009. The exchange must be operational to assist employers and individuals
10.16by September 1, 2008, and be prepared for enrollment by December 1, 2008. Enrollees
10.17of individual market health plans, MinnesotaCare, and the Minnesota Comprehensive
10.18Health Association as of December 2, 2008, are automatically enrolled in the exchange
10.19on January 1, 2009, in the same health plan and at the same premium that they were
10.20enrolled as of December 2, 2008, subject to the provisions of this section. As of January 1,
10.212009, all enrollees of individual market health plans, MinnesotaCare, and the Minnesota
10.22Comprehensive Health Association shall make premium payments to the exchange.
10.23    Subd. 19. Study of insurer issue requirements. In consultation with
10.24the commissioners of commerce and health, the exchange shall study and make
10.25recommendations on rating requirements and risk adjustment mechanisms that could
10.26be implemented to facilitate increased enrollment in the exchange by employers and
10.27employees through employer Section 125 Plans. The exchange shall report study findings
10.28and recommendations to the chairs of house and senate committees having jurisdiction
10.29over commerce and health by January 15, 2011.

10.30    Sec. 3. [62A.68] SECTION 125 PLANS.
10.31    Subdivision 1. Definitions. The following terms have the meanings given unless
10.32otherwise provided in text:
10.33    (a) "Current employee" means an employee currently on an employer's payroll other
10.34than a retiree or disabled former employee.
11.1    (b) "Employer" means a person, firm, corporation, partnership, association, business
11.2trust, or other entity employing one or more persons, including a political subdivision of
11.3the state, filing payroll tax information on such employed person or persons.
11.4    (c) "Section 125 Plan" means a Premium Only Plan under section 125 of the Internal
11.5Revenue Code.
11.6    (d) "Exchange" means the Minnesota Health Insurance Exchange under section
11.762A.67.
11.8    (e) "Exchange director" means the appointed director under section 62A.67,
11.9subdivision 16.
11.10    Subd. 2. Section 125 Plan requirement. Effective January 1, 2009, all employers
11.11with 11 or more current employees shall offer a Section 125 Plan through the exchange
11.12to allow their employees to pay for health insurance premiums with pretax dollars. The
11.13following employers are exempt from the Section 125 Plan requirement:
11.14    (1) employers that offer a group health insurance plan as defined in 62A.10;
11.15    (2) employers that offer group health insurance through a self-insured plan as
11.16defined in section 62E.02; and
11.17    (3) employers with fewer than 11 current employees, except that employers under
11.18this clause may voluntarily offer a Section 125 Plan.
11.19    Subd. 3. Tracking compliance. By July 1, 2008, the exchange, in consultation with
11.20the commissioners of commerce, health, employment and economic development, and
11.21revenue shall establish a method for tracking employer compliance with the Section 125
11.22Plan requirement.
11.23    Subd. 4. Employer requirements. Employers that are required to offer or choose
11.24to offer a Section 125 Plan through the exchange shall enter into an annual binding
11.25agreement with the exchange, which includes the terms in paragraphs (a) to (h).
11.26    (a) The employer shall designate the exchange director to be the plan's administrator
11.27for the employer's plan and the exchange director agrees to undertake the obligations
11.28required of a plan administrator under federal law.
11.29    (b) Only the coverage and benefits offered by participating insurers in the exchange
11.30constitutes the coverage and benefits of the participating employer plan.
11.31    (c) Any individual eligible to participate in the exchange may elect coverage under
11.32any participating health plan for which they are eligible, and neither the employer nor
11.33the exchange shall limit choice of coverage from among all the participating insurance
11.34plans for which the individual is eligible.
12.1    (d) The employer shall deduct premium amounts on a pretax basis in an amount
12.2not to exceed an employee's wages and make payments to the exchange as directed by
12.3employees for health plans employees enroll in through the exchange.
12.4    (e) The employer shall not offer individuals eligible to participate in the exchange
12.5any separate or competing group health plan under section 62A.10.
12.6    (f) The employer reserves the right to determine the terms and amounts of the
12.7employer's contribution to the plan, if any.
12.8    (g) The employer shall make available to the exchange any of the employer's
12.9documents, records, or information, including copies of the employer's federal and state
12.10tax and wage reports that are necessary for the exchange to verify:
12.11    (1) that the employer is in compliance with the terms of its agreement with the
12.12exchange governing the participating employer plan;
12.13    (2) that the participating employer plan is in compliance with applicable state and
12.14federal laws, including those relating to nondiscrimination in coverage; and
12.15    (3) the eligibility of those individuals enrolled in the participating employer plan.
12.16    (h) The exchange shall not provide the participating employer plan with any
12.17additional or different services or benefits not otherwise provided or offered to all other
12.18participating employer plans.
12.19    Subd. 5. Section 125 eligible health plans. Individuals eligible to enroll in health
12.20plans through an employer Section 125 Plan through the exchange may enroll in any
12.21health plan offered through the exchange for which the individual is eligible including
12.22individual market health plans, MinnesotaCare and MinnesotaCare II, and the Minnesota
12.23Comprehensive Health Association.

12.24    Sec. 4. Minnesota Statutes 2006, section 62E.141, is amended to read:
12.2562E.141 INCLUSION IN EMPLOYER-SPONSORED PLAN.
12.26    No employee of an employer that offers a group health plan, under which the
12.27employee is eligible for coverage, is eligible to enroll, or continue to be enrolled, in
12.28the comprehensive health association, except for enrollment or continued enrollment
12.29necessary to cover conditions that are subject to an unexpired preexisting condition
12.30limitation, preexisting condition exclusion, or exclusionary rider under the employer's
12.31health plan. This section does not apply to persons enrolled in the Comprehensive Health
12.32Association as of June 30, 1993. With respect to persons eligible to enroll in the health
12.33plan of an employer that has more than 29 current employees, as defined in section
12.3462L.02 , this section does not apply to persons enrolled in the Comprehensive Health
12.35Association as of December 31, 1994.

13.1    Sec. 5. Minnesota Statutes 2006, section 62L.12, subdivision 2, is amended to read:
13.2    Subd. 2. Exceptions. (a) A health carrier may sell, issue, or renew individual
13.3conversion policies to eligible employees otherwise eligible for conversion coverage under
13.4section 62D.104 as a result of leaving a health maintenance organization's service area.
13.5    (b) A health carrier may sell, issue, or renew individual conversion policies to
13.6eligible employees otherwise eligible for conversion coverage as a result of the expiration
13.7of any continuation of group coverage required under sections 62A.146, 62A.17, 62A.21,
13.862C.142 , 62D.101, and 62D.105.
13.9    (c) A health carrier may sell, issue, or renew conversion policies under section
13.1062E.16 to eligible employees.
13.11    (d) A health carrier may sell, issue, or renew individual continuation policies to
13.12eligible employees as required.
13.13    (e) A health carrier may sell, issue, or renew individual health plans if the coverage
13.14is appropriate due to an unexpired preexisting condition limitation or exclusion applicable
13.15to the person under the employer's group health plan or due to the person's need for health
13.16care services not covered under the employer's group health plan.
13.17    (f) A health carrier may sell, issue, or renew an individual health plan, if the
13.18individual has elected to buy the individual health plan not as part of a general plan to
13.19substitute individual health plans for a group health plan nor as a result of any violation of
13.20subdivision 3 or 4.
13.21    (g) Nothing in this subdivision relieves a health carrier of any obligation to provide
13.22continuation or conversion coverage otherwise required under federal or state law.
13.23    (h) Nothing in this chapter restricts the offer, sale, issuance, or renewal of coverage
13.24issued as a supplement to Medicare under sections 62A.3099 to 62A.44, or policies or
13.25contracts that supplement Medicare issued by health maintenance organizations, or those
13.26contracts governed by sections 1833, 1851 to 1859, 1860D, or 1876 of the federal Social
13.27Security Act, United States Code, title 42, section 1395 et seq., as amended.
13.28    (i) Nothing in this chapter restricts the offer, sale, issuance, or renewal of individual
13.29health plans necessary to comply with a court order.
13.30    (j) A health carrier may offer, issue, sell, or renew an individual health plan to
13.31persons eligible for an employer group health plan, if the individual health plan is a high
13.32deductible health plan for use in connection with an existing health savings account, in
13.33compliance with the Internal Revenue Code, section 223. In that situation, the same or
13.34a different health carrier may offer, issue, sell, or renew a group health plan to cover
13.35the other eligible employees in the group.
14.1    (k) A health carrier may offer, sell, issue, or renew an individual health plan to one
14.2or more employees of a small employer if the individual health plan is marketed directly to
14.3all employees of the small employer and the small employer does not contribute directly
14.4or indirectly to the premiums or facilitate the administration of the individual health plan.
14.5The requirement to market an individual health plan to all employees does not require the
14.6health carrier to offer or issue an individual health plan to any employee. For purposes
14.7of this paragraph, an employer is not contributing to the premiums or facilitating the
14.8administration of the individual health plan if the employer does not contribute to the
14.9premium and merely collects the premiums from an employee's wages or salary through
14.10payroll deductions and submits payment for the premiums of one or more employees in a
14.11lump sum to the health carrier. Except for coverage under section 62A.65, subdivision 5,
14.12paragraph (b), or 62E.16, at the request of an employee, the health carrier may bill the
14.13employer for the premiums payable by the employee, provided that the employer is not
14.14liable for payment except from payroll deductions for that purpose. If an employer is
14.15submitting payments under this paragraph, the health carrier shall provide a cancellation
14.16notice directly to the primary insured at least ten days prior to termination of coverage for
14.17nonpayment of premium. Individual coverage under this paragraph may be offered only
14.18if the small employer has not provided coverage under section 62L.03 to the employees
14.19within the past 12 months.
14.20    The employer must provide a written and signed statement to the health carrier that
14.21the employer is not contributing directly or indirectly to the employee's premiums. The
14.22health carrier may rely on the employer's statement and is not required to guarantee-issue
14.23individual health plans to the employer's other current or future employees.
14.24    (l) Nothing in this chapter restricts the offer, sale, issuance, or renewal of individual
14.25health plans through the Minnesota Health Insurance Exchange under section 62A.67
14.26or 62A.68.

14.27    Sec. 6. [256.962] MINNESOTA HEALTH CARE PROGRAMS OUTREACH.
14.28    Subdivision 1. Public awareness and education. The commissioner shall design
14.29and implement a statewide campaign to raise public awareness on the availability
14.30of health coverage through medical assistance, general assistance medical care, and
14.31MinnesotaCare and to educate the public on the importance of obtaining and maintaining
14.32health care coverage. The campaign shall include multimedia messages directed to the
14.33general population.
14.34    Subd. 2. Outreach grants. (a) The commissioner shall award grants to public
14.35and private organizations or regional collaboratives for outreach activities, including,
14.36but not limited to:
15.1    (1) providing information, applications, and assistance in obtaining coverage
15.2through Minnesota public health care programs;
15.3    (2) collaborating with public and private entities such as hospitals, providers, health
15.4plans, legal aid offices, pharmacies, insurance agencies, and faith-based organizations to
15.5develop outreach activities and partnerships to ensure the distribution of information
15.6and applications and provide assistance in obtaining coverage through Minnesota health
15.7care programs; and
15.8    (3) providing or collaborating with public and private entities to provide multilingual
15.9and culturally specific information and assistance to applicants in areas of high
15.10uninsurance in the state or populations with high rates of uninsurance.
15.11    (b) The commissioner shall ensure that all outreach materials are available in
15.12languages other than English.
15.13    (c) The commissioner shall establish an outreach trainer program to provide
15.14training to designated individuals from the community and public and private entities on
15.15application assistance in order for these individuals to provide training to others in the
15.16community on an as-needed basis.
15.17    Subd. 3. Application and assistance. (a) The Minnesota health care programs
15.18application must be made available at provider offices, local human services agencies,
15.19school districts, public and private elementary schools in which 25 percent or more of
15.20the students receive free or reduced price lunches, community health offices, Women,
15.21Infants and Children (WIC) program sites, Head Start program sites, public housing
15.22councils, child care centers, early childhood education and preschool program sites, legal
15.23aid offices, and libraries. The commissioner shall ensure that applications are available
15.24in languages other than English.
15.25    (b) Local human service agencies, hospitals, and health care community clinics
15.26receiving state funds must provide direct assistance in completing the application
15.27form, including the free use of a copy machine and a drop box for applications. These
15.28locations must ensure that the drop box is checked at least weekly and any applications
15.29are submitted to the commissioner. The commissioner shall provide these entities with
15.30an identification number to stamp on each application to identify the entity that provided
15.31assistance. Other locations where applications are required to be available shall either
15.32provide direct assistance in completing the application form or provide information on
15.33where an applicant can receive application assistance.
15.34    (c) Counties must offer applications and application assistance when providing
15.35child support collection services.
16.1    (d) Local public health agencies and counties that provide immunization clinics must
16.2offer applications and application assistance during these clinics.
16.3    (e) The commissioner shall coordinate with the commissioner of health to ensure
16.4that maternal and child health outreach efforts include information on Minnesota health
16.5care programs and application assistance, when needed.
16.6    Subd. 4. Statewide toll-free telephone number. The commissioner shall provide
16.7funds for a statewide toll-free telephone number to provide information on public and
16.8private health coverage options and sources of free and low-cost health care. The
16.9statewide telephone number must provide the option of obtaining this information in
16.10languages other than English.
16.11    Subd. 5. Incentive program. The commissioner shall establish an incentive
16.12program for organizations that directly identify and assist potential enrollees in filling
16.13out and submitting an application. For each applicant who is successfully enrolled in
16.14MinnesotaCare, medical assistance, or general assistance medical care, the commissioner
16.15shall pay the organization a $25 application assistance bonus. The organization may
16.16provide an applicant a gift certificate or other incentive upon enrollment.
16.17    Subd. 6. School districts. (a) At the beginning of each school year, a school district
16.18shall provide information to each student on the availability of health care coverage
16.19through the Minnesota health care programs.
16.20    (b) For each child who is determined to be eligible for a free or reduced priced lunch,
16.21the district shall provide the child's family with an application for the Minnesota health
16.22care programs and information on how to obtain application assistance.
16.23    (c) A district shall also ensure that applications and information on application
16.24assistance are available at early childhood education sites and public schools located
16.25within the district's jurisdiction.
16.26    (d) Each district shall designate an enrollment specialist to provide application
16.27assistance and follow-up services with families who are eligible for the reduced or free
16.28lunch program or who have indicated an interest in receiving information or an application
16.29for the Minnesota health care program.
16.30    (e) Each school district shall provide on their Web site a link to information on how
16.31to obtain an application and application assistance.
16.32    Subd. 7. Renewal notice. (a) The commissioner shall mail a renewal notice to
16.33enrollees notifying the enrollees that the enrollees eligibility must be renewed. A notice
16.34shall be sent at least 90 days prior to the renewal date and at least 60 days prior to the
16.35renewal date.
17.1    (b) For enrollees who are receiving services through managed care plans, the
17.2managed care plan must provide a follow-up renewal call at least 60 days prior to the
17.3enrollees' renewal dates.
17.4    (c) The commissioner shall include the end of coverage dates on the monthly rosters
17.5of enrollees provided to managed care organizations.

17.6    Sec. 7. Minnesota Statutes 2006, section 256B.057, subdivision 8, is amended to read:
17.7    Subd. 8. Children under age two. Medical assistance may be paid for a child under
17.8two years of age whose countable family income is above 275 percent of the federal
17.9poverty guidelines for the same size family but less than or equal to 280 305 percent of the
17.10federal poverty guidelines for the same size family.
17.11EFFECTIVE DATE.This section is effective January 1, 2009, or upon federal
17.12approval, whichever is later. The commissioner of human services shall notify the Office
17.13of the Revisor of Statutes when federal approval is obtained.

17.14    Sec. 8. Minnesota Statutes 2006, section 256L.02, subdivision 3, is amended to read:
17.15    Subd. 3. Financial management. (a) The commissioner shall manage spending
17.16for the MinnesotaCare program in a manner that maintains a minimum reserve. As
17.17part of each state revenue and expenditure forecast, the commissioner must make an
17.18assessment of the expected expenditures for the covered services for the remainder of the
17.19current biennium and for the following biennium. The estimated expenditure, including
17.20the reserve, shall be compared to an estimate of the revenues that will be available in
17.21the health care access fund. Based on this comparison, and after consulting with the
17.22chairs of the house Ways and Means Committee and the senate Finance Committee,
17.23and the Legislative Commission on Health Care Access, the commissioner shall, as
17.24necessary, make the adjustments specified in paragraph (b) to ensure that expenditures
17.25remain within the limits of available revenues for the remainder of the current biennium
17.26and for the following biennium. The commissioner shall not hire additional staff using
17.27appropriations from the health care access fund until the commissioner of finance makes
17.28a determination that the adjustments implemented under paragraph (b) are sufficient to
17.29allow MinnesotaCare expenditures to remain within the limits of available revenues for
17.30the remainder of the current biennium and for the following biennium.
17.31    (b) The adjustments the commissioner shall use must be implemented in this order:
17.32first, stop enrollment of single adults and households without children; second, upon 45
17.33days' notice, stop coverage of single adults and households without children already
17.34enrolled in the MinnesotaCare program; third, upon 90 days' notice, decrease the premium
17.35subsidy amounts by ten percent for families with gross annual income above 200 percent
18.1of the federal poverty guidelines; fourth, upon 90 days' notice, decrease the premium
18.2subsidy amounts by ten percent for families with gross annual income at or below 200
18.3percent; and fifth, require applicants to be uninsured for at least six months prior to
18.4eligibility in the MinnesotaCare program. If these measures are insufficient to limit the
18.5expenditures to the estimated amount of revenue, the commissioner shall further limit
18.6enrollment or decrease premium subsidies.
18.7    (c) The commissioner shall work in cooperation with the Minnesota Health
18.8Insurance Exchange under section 62A.67 to make adjustments under paragraph (b) as
18.9required under this subdivision.
18.10EFFECTIVE DATE.This section is effective January 1, 2009.

18.11    Sec. 9. Minnesota Statutes 2006, section 256L.02, is amended by adding a subdivision
18.12to read:
18.13    Subd. 5. Enrollment responsibilities. According to section 256L.05, subdivision 6,
18.14effective January 1, 2009, the Minnesota Health Insurance Exchange under section 62A.67
18.15shall assume responsibility for enrolling eligible applicants and enrollees in a health
18.16plan for MinnesotaCare coverage. The commissioner shall maintain responsibility for
18.17determining eligibility for MinnesotaCare.
18.18EFFECTIVE DATE.This section is effective January 1, 2009.

18.19    Sec. 10. Minnesota Statutes 2006, section 256L.02, is amended by adding a subdivision
18.20to read:
18.21    Subd. 6. Exchange of data. An entity that is part of the welfare system as defined
18.22in section 13.46, subdivision 1, paragraph (c), and the Minnesota Health Insurance
18.23Exchange under section 62A.67 may exchange private data about individuals without
18.24the individual's consent in order to enroll and collect premiums from individuals in the
18.25MinnesotaCare program under chapter 256L and to administer the individual's and the
18.26individual's family's participation in the program. This subdivision only applies if the
18.27entity that is part of the welfare system and the Minnesota Health Insurance Exchange
18.28have entered into an agreement that complies with the requirements in Code of Federal
18.29Regulations, title 45, section 164.314.

18.30    Sec. 11. Minnesota Statutes 2006, section 256L.04, subdivision 1, is amended to read:
18.31    Subdivision 1. Families with children. (a) A child in a family with family income
18.32equal to or less than 300 percent of the federal poverty guidelines for the applicable family
18.33size is eligible for MinnesotaCare under this section. Adults in families with children with
18.34family income equal to or less than 275 percent of the federal poverty guidelines for the
19.1applicable family size shall be eligible for MinnesotaCare according to this section. All
19.2other provisions of sections 256L.01 to 256L.18, including the insurance-related barriers
19.3to enrollment under section 256L.07, shall apply unless otherwise specified.
19.4    (b) Parents who enroll in the MinnesotaCare program must also enroll their children,
19.5if the children are eligible. Children may be enrolled separately without enrollment by
19.6parents. However, if one parent in the household enrolls, both parents must enroll, unless
19.7other insurance is available. If one child from a family is enrolled, all children must
19.8be enrolled, unless other insurance is available. If one spouse in a household enrolls,
19.9the other spouse in the household must also enroll, unless other insurance is available.
19.10Families cannot choose to enroll only certain uninsured members.
19.11    (c) Beginning October 1, 2003, the dependent sibling definition no longer applies
19.12to the MinnesotaCare program. These persons are no longer counted in the parental
19.13household and may apply as a separate household.
19.14    (d) Beginning July 1, 2003, or upon federal approval, whichever is later, parents are
19.15not eligible for MinnesotaCare if their gross income exceeds $50,000.
19.16EFFECTIVE DATE.This section is effective January 1, 2009, or upon federal
19.17approval, whichever is later. The commissioner of human services shall notify the Office
19.18of the Revisor of Statutes when federal approval is obtained.

19.19    Sec. 12. Minnesota Statutes 2006, section 256L.05, subdivision 5, is amended to read:
19.20    Subd. 5. Availability of private insurance. (a) The commissioner, in consultation
19.21with the commissioners of health and commerce, shall provide information regarding the
19.22availability of private health insurance coverage and the possibility of disenrollment under
19.23section 256L.07, subdivision 1, paragraphs (b) and (c), to all: (1) families enrolled in the
19.24MinnesotaCare program whose gross family income is equal to or more than 225 percent
19.25of the federal poverty guidelines; and (2) single adults and households without children
19.26enrolled in the MinnesotaCare program whose gross family income is equal to or more
19.27than 165 percent of the federal poverty guidelines. This information must be provided
19.28Minnesota Health Insurance Exchange under section 62A.67 upon initial enrollment
19.29and annually thereafter. The commissioner shall also include information regarding the
19.30availability of private health insurance coverage in
19.31    (b) The notice of ineligibility provided to persons subject to disenrollment under
19.32section 256L.07, subdivision 1, paragraphs (b) and (c), must include information about
19.33assistance with identifying and selecting private health insurance coverage provided by
19.34the Minnesota Health Insurance Exchange under section 62A.67.
19.35EFFECTIVE DATE.This section is effective January 1, 2009.

20.1    Sec. 13. Minnesota Statutes 2006, section 256L.05, is amended by adding a subdivision
20.2to read:
20.3    Subd. 6. Minnesota Health Insurance Exchange. The commissioner shall refer
20.4all MinnesotaCare applicants and enrollees to the Minnesota Health Insurance Exchange
20.5under section 62A.67. The Minnesota Health Insurance Exchange shall provide those
20.6referred with assistance in selecting a managed care plan through which to receive
20.7MinnesotaCare covered services and in analyzing health plans available through the
20.8private market. MinnesotaCare applicants and enrollees shall effect enrollment in a
20.9managed care plan or a private market health plan through the Minnesota Health Insurance
20.10Exchange.
20.11EFFECTIVE DATE.This section is effective January 1, 2009.

20.12    Sec. 14. Minnesota Statutes 2006, section 256L.06, subdivision 3, is amended to read:
20.13    Subd. 3. Commissioner's duties and payment. (a) Premiums are dedicated to the
20.14commissioner for MinnesotaCare.
20.15    (b) The commissioner shall develop and implement procedures to: (1) require
20.16enrollees to report changes in income; (2) adjust sliding scale premium payments at the
20.17time of eligibility renewal, based upon both increases and decreases in enrollee income, at
20.18the time the change in income is reported; and (3) disenroll enrollees from MinnesotaCare
20.19for failure to pay required premiums. Failure to pay includes payment with a dishonored
20.20check, a returned automatic bank withdrawal, or a refused credit card or debit card
20.21payment. The commissioner may demand a guaranteed form of payment, including a
20.22cashier's check or a money order, as the only means to replace a dishonored, returned,
20.23or refused payment.
20.24    (c) Premiums are calculated on a calendar month basis and may be paid on a
20.25monthly, quarterly, or semiannual basis, with the first payment due upon notice from the
20.26commissioner of the premium amount required. The commissioner shall inform applicants
20.27and enrollees of these premium payment options. Premium payment is required before
20.28enrollment is complete and to maintain eligibility in MinnesotaCare. Premium payments
20.29received before noon are credited the same day. Premium payments received after noon
20.30are credited on the next working day.
20.31    (d) Nonpayment of the premium will result in disenrollment from the plan effective
20.32for the calendar month for which the premium was due. Persons disenrolled for
20.33nonpayment or who voluntarily terminate coverage from the program may not reenroll
20.34until four calendar months have elapsed. Persons disenrolled for nonpayment who pay
20.35all past due premiums as well as current premiums due, including premiums due for the
21.1period of disenrollment, within 20 days of disenrollment, shall be reenrolled retroactively
21.2to the first day of disenrollment. Persons disenrolled for nonpayment or who voluntarily
21.3terminate coverage from the program may not reenroll for four calendar months unless
21.4the person demonstrates good cause for nonpayment. Good cause does not exist if a
21.5person chooses to pay other family expenses instead of the premium. The commissioner
21.6shall define good cause in rule.
21.7EFFECTIVE DATE.This section is effective January 1, 2009, or upon federal
21.8approval, whichever is later. The commissioner shall notify the Office of the Revisor of
21.9Statutes when federal approval is obtained.

21.10    Sec. 15. [256L.075] MINNESOTACARE II OPTION ESTABLISHED.
21.11    Subdivision 1. Program established; enrollment. The Minnesota Health Insurance
21.12Exchange under section 62A.67, in consultation with the commissioner, shall establish
21.13and administer a program that subsidizes the purchase of private market health plans
21.14for children eligible for MinnesotaCare in families with family income above 200
21.15percent, but not exceeding 300 percent, of the federal poverty guidelines. The program
21.16established under this section is referred to as MinnesotaCare II. The private market
21.17health coverage provided under this section is an alternative to coverage under section
21.18256L.03. Notwithstanding section 256L.12, children obtaining coverage under this
21.19section shall enroll in a health plan, as defined in section 62A.011, subdivision 3, through
21.20the individual market, that covers, at a minimum, the standard benefit set established in
21.21subdivision 2. Enrollment under this section is administered by the Minnesota Health
21.22Insurance Exchange. Eligibility under this section is determined by the commissioner. All
21.23other provisions of sections 256L.01 to 256L.18, including the insurance-related barriers
21.24to enrollment under section 256L.07, apply to this section unless otherwise specified.
21.25    Subd. 2. Benefit set. The Minnesota Health Insurance Exchange, in consultation
21.26with the commissioner, shall establish a standard benefit set for health plans that qualify
21.27for a subsidy under this section. The standard benefit set must be reviewed, and, if
21.28necessary, modified on an annual basis. Notwithstanding section 256L.03, subdivision 5,
21.29the benefit set may require co-payments, deductibles, and maximum annual out-of-pocket
21.30enrollee cost-sharing limits.
21.31    Subd. 3. Health carrier participation. (a) Health insurers with at least three
21.32percent of the market share of premium volume from individual market health plans as
21.33determined from loss ratio reports filed under section 62A.021, subdivision 1, paragraph
21.34(h), shall offer at least one health plan that covers the standard benefit set, or its actuarial
21.35equivalent as determined by the commissioner of commerce, to children enrolled under
22.1this section. Health issuers shall offer a health plan that covers the standard benefit set,
22.2without a subsidy, to adults so that families can enroll in a single plan. Health insurers
22.3that are not required to participate may participate voluntarily. The Minnesota Health
22.4Insurance Exchange shall certify those health plans that meet the standards in subdivision
22.52 and qualify for a subsidy under this section.
22.6    (b) Health insurers offering coverage under this section may offer up to three
22.7additional health plan products approved by the commissioner of commerce as actuarially
22.8equivalent or better than the standard plan established in subdivision 2. The additional
22.9products must also qualify for a subsidy if purchased to cover children eligible under
22.10this section.
22.11    (c) Nothing in this subdivision requires guaranteed issue of MinnesotaCare II health
22.12plans.
22.13    Subd. 4. State subsidy; premium. The cost of coverage for children enrolled under
22.14this section is subsidized based on a sliding scale. The amount of the subsidy provided
22.15for a child is equal to the cost of the least expensive health plan certified to participate
22.16under this section less an amount equal to one-half of the premium that would be paid for
22.17the child under section 256L.15, subdivision 2. The commissioner shall pay the subsidy
22.18to the Minnesota Health Insurance Exchange. The premium for a child enrolled under
22.19this section is equal to the difference between the cost of the health plan through which
22.20the coverage is provided and the amount of the subsidy. The premium must be paid to
22.21the Minnesota Health Insurance Exchange.
22.22    Subd. 5. Enrollment; limitation on changing plans. Notwithstanding section
22.23256L.04, subdivision 1, individual children in a family may enroll under this section or
22.24under section 256L.03. A child enrolled under this section may change health plans or
22.25switch to coverage under section 256L.03 at the time of annual renewal. An enrollee may
22.26change health plans or switch to coverage under section 256L.03 at other times during the
22.27year if the family of the child experiences a qualifying life event, including, but not limited
22.28to, marriage, divorce, a change in dependent status, change in family size, or a change in
22.29eligibility for state health care programs under this chapter or chapter 256B or 256D.
22.30    Subd. 6. Bonus accounts incentive. The Minnesota Health Insurance Exchange
22.31shall administer bonus accounts for families with children enrolled under this section.
22.32Funds must be credited to a bonus account when a child covered under this section
22.33achieves specific goals for preventive services or healthy behaviors. Funds credited to
22.34an account can be used by a family to reimburse qualified medical expenses as defined
22.35in Internal Revenue Code, section 213(d). The commissioner, in consultation with the
23.1Minnesota Health Insurance Exchange, shall establish a schedule of preventive service
23.2and healthy behavior goals that qualify for a credit and corresponding credit amounts.
23.3Families with children enrolled under this section can qualify for credits of up to $50 per
23.4year per child, up to a maximum of $150 per year per family. Funds held in the account
23.5are available to a family until:
23.6    (1) there is no longer a child under age 21 in the family; or
23.7    (2) no child in the family has been enrolled under chapter 256B or 256L, or in a
23.8health plan through the Minnesota Health Insurance Exchange for the past six months.
23.9    Subd. 7. Federal approval. The commissioner shall seek all federal waivers
23.10and approvals necessary to implement and receive federal financial participation for
23.11expenditures under this section.
23.12EFFECTIVE DATE.This section is effective January 1, 2009.

23.13    Sec. 16. Minnesota Statutes 2006, section 256L.12, subdivision 7, is amended to read:
23.14    Subd. 7. Managed care plan vendor requirements. The following requirements
23.15apply to all counties or vendors who contract with the Department of Human Services to
23.16serve MinnesotaCare recipients. Managed care plan contractors:
23.17    (1) shall authorize and arrange for the provision of the full range of services listed in
23.18section 256L.03 in order to ensure appropriate health care is delivered to enrollees;
23.19    (2) shall accept the prospective, per capita payment or other contractually defined
23.20payment from the commissioner in return for the provision and coordination of covered
23.21health care services for eligible individuals enrolled in the program;
23.22    (3) may contract with other health care and social service practitioners to provide
23.23services to enrollees;
23.24    (4) shall provide for an enrollee grievance process as required by the commissioner
23.25and set forth in the contract with the department;
23.26    (5) shall retain all revenue from enrollee co-payments;
23.27    (6) shall accept all eligible MinnesotaCare enrollees, without regard to health status
23.28or previous utilization of health services;
23.29    (7) shall demonstrate capacity to accept financial risk according to requirements
23.30specified in the contract with the department. A health maintenance organization licensed
23.31under chapter 62D, or a nonprofit health plan licensed under chapter 62C, is not required
23.32to demonstrate financial risk capacity, beyond that which is required to comply with
23.33chapters 62C and 62D; and
23.34    (8) shall submit information as required by the commissioner, including data required
23.35for assessing enrollee satisfaction, quality of care, cost, and utilization of services.; and
24.1    (9) shall participate in the Minnesota Health Insurance Exchange under section
24.262A.67 for the purpose of enrolling individuals under this chapter.
24.3EFFECTIVE DATE.This section is effective January 1, 2009.

24.4    Sec. 17. Minnesota Statutes 2006, section 256L.15, subdivision 1a, is amended to read:
24.5    Subd. 1a. Payment options. (a) The commissioner may offer the following
24.6payment options to an enrollee:
24.7    (1) payment by check;
24.8    (2) payment by credit card;
24.9    (3) payment by recurring automatic checking withdrawal;
24.10    (4) payment by onetime electronic transfer of funds;
24.11    (5) payment by wage withholding with the consent of the employer and the
24.12employee; or
24.13    (6) payment by using state tax refund payments.
24.14    At application or reapplication, a MinnesotaCare applicant or enrollee may authorize
24.15the commissioner to use the Revenue Recapture Act in chapter 270A to collect funds
24.16from the applicant's or enrollee's refund for the purposes of meeting all or part of the
24.17applicant's or enrollee's MinnesotaCare premium obligation. The applicant or enrollee
24.18may authorize the commissioner to apply for the state working family tax credit on behalf
24.19of the applicant or enrollee. The setoff due under this subdivision shall not be subject to
24.20the $10 fee under section 270A.07, subdivision 1.
24.21    (b) Effective January 1, 2009, the Minnesota Health Insurance Exchange under
24.22section 62A.67 is responsible for collecting MinnesotaCare premiums.
24.23EFFECTIVE DATE.This section is effective January 1, 2009.

24.24    Sec. 18. Minnesota Statutes 2006, section 256L.15, subdivision 2, is amended to read:
24.25    Subd. 2. Sliding fee scale; monthly gross individual or family income. (a) The
24.26commissioner shall establish a sliding fee scale to determine the percentage of monthly
24.27gross individual or family income that households at different income levels must pay
24.28to obtain coverage through the MinnesotaCare program. The sliding fee scale must be
24.29based on the enrollee's monthly gross individual or family income. The sliding fee scale
24.30must contain separate tables based on enrollment of one, two, or three or more persons.
24.31The sliding fee scale begins with a premium of 1.5 percent of monthly gross individual or
24.32family income for individuals or families with incomes below the limits for the medical
24.33assistance program for families and children in effect on January 1, 1999, and proceeds
24.34through the following evenly spaced steps: 1.8, 2.3, 3.1, 3.8, 4.8, 5.9, 7.4, and 8.8 percent.
24.35These percentages are matched to evenly spaced income steps ranging from the medical
25.1assistance income limit for families and children in effect on January 1, 1999, to 275
25.2percent of the federal poverty guidelines for the applicable family size, up to a family size
25.3of five. The sliding fee scale for a family of five must be used for families of more than
25.4five. Effective October 1, 2003, the commissioner shall increase each percentage by 0.5
25.5percentage points for enrollees with income greater than 100 percent but not exceeding
25.6200 percent of the federal poverty guidelines and shall increase each percentage by 1.0
25.7percentage points for families and children with incomes greater than 200 percent of the
25.8federal poverty guidelines. The sliding fee scale and percentages are not subject to the
25.9provisions of chapter 14. If a family or individual reports increased a change in income
25.10after enrollment, premiums shall not be adjusted at the time the change in income is
25.11reported until eligibility renewal.
25.12    (b) Beginning January 1, 2009, a new sliding fee scale premium schedule is
25.13established for children. The premium schedule for children must be used in conjunction
25.14with the premium schedule in paragraph (a) for adults to calculate a single MinnesotaCare
25.15premium for a family. The sliding fee scale begins with a premium of $11 per child
25.16for households with incomes equal to or greater than 150 percent of the federal poverty
25.17guidelines. Premiums must be adjusted at evenly spaced income steps at increments of
25.18five percent of the federal poverty guidelines to a maximum premium of $88 per child
25.19for households with incomes equal to 300 percent of the federal poverty guidelines.
25.20Premiums must be calculated for up to three children per family. Premiums for children
25.21must be adjusted annually at an amount that is proportional to the annual adjustment in
25.22premiums for adults. The sliding fee scale in this paragraph does not apply to children
25.23enrolled under section 256L.075.
25.24    (b) (c) Children in families whose gross income is above 275 300 percent of the
25.25federal poverty guidelines shall pay the maximum premium. The maximum premium
25.26is defined as a base charge for one, two, or three or more enrollees so that if all
25.27MinnesotaCare cases paid the maximum premium, the total revenue would equal the
25.28total cost of MinnesotaCare medical coverage and administration. In this calculation,
25.29administrative costs shall be assumed to equal ten percent of the total. The costs of
25.30medical coverage for pregnant women and children under age two and the enrollees in
25.31these groups shall be excluded from the total. The maximum premium for two enrollees
25.32shall be twice the maximum premium for one, and the maximum premium for three or
25.33more enrollees shall be three times the maximum premium for one.
25.34    (c) After calculating the percentage of premium each enrollee shall pay under
25.35paragraph (a), eight percent shall be added to the premium.
26.1EFFECTIVE DATE.Paragraphs (a) and (b) are effective January 1, 2009, or
26.2upon federal approval, whichever is later. The commissioner shall notify the Office of
26.3the Revisor of Statutes when federal approval is obtained. Paragraph (c) is effective
26.4July 1, 2007.

26.5    Sec. 19. Minnesota Statutes 2006, section 256L.15, is amended by adding a subdivision
26.6to read:
26.7    Subd. 5. Premium discount incentive. Adults and families with children are
26.8eligible for a premium reduction of $3 per month for each child who met goals for
26.9preventive care or an adult who met goals for cardiac or diabetes care in the previous
26.10calendar year. The maximum premium reduction may not exceed $15 per month per
26.11family. The commissioner, in consultation with the Minnesota Health Insurance Exchange,
26.12shall establish specific goals for preventive care, including cardiac and diabetes care, that
26.13make an enrollee eligible for the premium reduction. The premium discount incentive is
26.14administered by the Minnesota Health Insurance Exchange under section 62A.67. Children
26.15enrolled under section 256L.075 are not eligible for the premium discount incentive.
26.16EFFECTIVE DATE.This section is effective January 1, 2009.

26.17    Sec. 20. Minnesota Statutes 2006, section 295.52, is amended by adding a subdivision
26.18to read:
26.19    Subd. 8. Contingent reduction in tax rate. On September 1 of each odd-numbered
26.20year, beginning September 1, 2007, the commissioner of finance shall determine the
26.21projected balance of the health care access fund as of the end of the current biennium,
26.22based on the most recent February forecast adjusted for any legislative session changes.
26.23If the commissioner of finance projects a surplus in the health care access fund as of
26.24the end of the current biennium, the commissioner of finance, in consultation with the
26.25commissioner, shall reduce the tax rates specified in subdivisions 1, 1a, 2, 3, and 4 in
26.26one-tenth of one percent increments, making the largest reduction in tax rates consistent
26.27with ensuring that the health care access fund retains a surplus as of the end of the current
26.28biennium. The reduced tax rates take effect on the January 1 that immediately follows the
26.29September 1 on which the commissioner of finance determines the projected balance and
26.30remain in effect for two tax years. The tax rates specified in subdivisions 1, 1a, 2, 3, and 4
26.31apply for subsequent tax years, unless the commissioner, based on a determination of the
26.32projected balance of the health care access fund made on September 1 of an odd-numbered
26.33year, reduces the tax rates. If the commissioner of finance does not project a surplus in
26.34the health care access fund as of the end of the current biennium, the tax rates specified
26.35in subdivisions 1, 1a, 2, 3, and 4 continue to apply. The commissioner of finance shall
27.1publish in the State Register by October 1 of each odd-numbered year the amount of tax to
27.2be imposed for the next two calendar years."
27.3Renumber the sections in sequence and correct the internal references
27.4Amend the title accordingly