1.1.................... moves to amend H.F. No. 42 as follows:
1.2Delete everything after the enacting clause and insert:

1.3    "Section 1. Minnesota Statutes 2008, section 62A.65, subdivision 5, is amended to read:
1.4    Subd. 5. Portability and conversion of coverage. (a) No individual health plan
1.5may be offered, sold, issued, or with respect to children age 18 or under renewed, to a
1.6Minnesota resident that contains a preexisting condition limitation, preexisting condition
1.7exclusion, or exclusionary rider, unless the limitation or exclusion is permitted under this
1.8subdivision and under chapter 62L, provided that, except for children age 18 or under,
1.9underwriting restrictions may be retained on individual contracts that are issued without
1.10evidence of insurability as a replacement for prior individual coverage that was sold
1.11before May 17, 1993. The individual may be subjected to an 18-month preexisting
1.12condition limitation, unless the individual has maintained continuous coverage as defined
1.13in section 62L.02. The individual must not be subjected to an exclusionary rider. An
1.14individual who has maintained continuous coverage may be subjected to a onetime
1.15preexisting condition limitation of up to 12 months, with credit for time covered under
1.16qualifying coverage as defined in section 62L.02, at the time that the individual first is
1.17covered under an individual health plan by any health carrier. Credit must be given for
1.18all qualifying coverage with respect to all preexisting conditions, regardless of whether
1.19the conditions were preexisting with respect to any previous qualifying coverage. The
1.20individual must not be subjected to an exclusionary rider. Thereafter, the individual must
1.21not be subject to any preexisting condition limitation, preexisting condition exclusion,
1.22or exclusionary rider under an individual health plan by any health carrier, except an
1.23unexpired portion of a limitation under prior coverage, so long as the individual maintains
1.24continuous coverage as defined in section 62L.02.
1.25(b) A health carrier must offer an individual health plan to any individual previously
1.26covered under a group health plan issued by that health carrier, regardless of the size of
1.27the group, so long as the individual maintained continuous coverage as defined in section
2.162L.02 . If the individual has available any continuation coverage provided under sections
2.262A.146 ; 62A.148; 62A.17, subdivisions 1 and 2; 62A.20; 62A.21; 62C.142; 62D.101; or
2.362D.105 , or continuation coverage provided under federal law, the health carrier need not
2.4offer coverage under this paragraph until the individual has exhausted the continuation
2.5coverage. The offer must not be subject to underwriting, except as permitted under this
2.6paragraph. A health plan issued under this paragraph must be a qualified plan as defined
2.7in section 62E.02 and must not contain any preexisting condition limitation, preexisting
2.8condition exclusion, or exclusionary rider, except for any unexpired limitation or
2.9exclusion under the previous coverage. The individual health plan must cover pregnancy
2.10on the same basis as any other covered illness under the individual health plan. The offer
2.11of coverage by the health carrier must inform the individual that the coverage, including
2.12what is covered and the health care providers from whom covered care may be obtained,
2.13may not be the same as the individual's coverage under the group health plan. The offer
2.14of coverage by the health carrier must also inform the individual that the individual, if
2.15a Minnesota resident, may be eligible to obtain coverage from (i) other private sources
2.16of health coverage, or (ii) the Minnesota Comprehensive Health Association, without a
2.17preexisting condition limitation, and must provide the telephone number used by that
2.18association for enrollment purposes. The initial premium rate for the individual health
2.19plan must comply with subdivision 3. The premium rate upon renewal must comply with
2.20subdivision 2. In no event shall the premium rate exceed 100 percent of the premium
2.21charged for comparable individual coverage by the Minnesota Comprehensive Health
2.22Association, and the premium rate must be less than that amount if necessary to otherwise
2.23comply with this section. An individual health plan offered under this paragraph to a
2.24person satisfies the health carrier's obligation to offer conversion coverage under section
2.2562E.16 , with respect to that person. Coverage issued under this paragraph must provide
2.26that it cannot be canceled or nonrenewed as a result of the health carrier's subsequent
2.27decision to leave the individual, small employer, or other group market. Section 72A.20,
2.28subdivision 28 , applies to this paragraph.
2.29(c) A health carrier must offer, sell, issue, and renew an individual health plan on a
2.30guaranteed issue basis, without any preexisting condition limitation, to individuals and
2.31their family members who exhaust temporary MinnesotaCare coverage for unemployed
2.32individuals under section 256L.07, subdivision 8, and who are not eligible for regular
2.33MinnesotaCare coverage. For purposes of this paragraph, "guaranteed issue" means that
2.34a health carrier shall not decline to cover under a health plan any individual or eligible
2.35dependent, including persons who become eligible dependents after issuance of the health
3.1plan. For purposes of this paragraph, "family" has the meaning provided in section
3.2256L.07, subdivision 8. This paragraph expires July 1, 2011.
3.3EFFECTIVE DATE.This section is effective July 1, 2009, and applies to health
3.4plans offered, sold, issued, or renewed on or after that date.

3.5    Sec. 2. Minnesota Statutes 2008, section 256L.07, is amended by adding a subdivision
3.6to read:
3.7    Subd. 8. Temporary MinnesotaCare coverage for unemployed individuals. (a)
3.8An individual is eligible for temporary MinnesotaCare coverage under this subdivision if
3.9the individual:
3.10(1) is involuntarily unemployed, but not for cause, and had been employed for at
3.11least 18 consecutive months prior to the loss of employment;
3.12(2) is not eligible for continuation coverage as described by the Consolidated
3.13Omnibus Budget Reconciliation Act of 1985 (COBRA), Public Law 99-272, as amended;
3.14(3) has gross individual or family income that does not exceed 275 percent of the
3.15federal poverty guidelines; and
3.16(4) does not have available to them group health coverage through a spouse or
3.17through Medicare.
3.18(b) Members of the individual's family are also eligible for MinnesotaCare under
3.19this subdivision. For purposes of this subdivision "family" has the meaning provided
3.20in Minnesota Rules, part 9506.0010, subpart 11, but also includes any individual who
3.21had been covered under health coverage provided by the most recent employer of the
3.22individual receiving unemployment benefits.
3.23(c) Individuals and family members eligible under this subdivision are exempt from
3.24section 256L.07, subdivisions 2 and 3; and section 256L.17. All other requirements of
3.25this chapter apply.
3.26(d) The commissioner of employment and economic development shall provide all
3.27individuals eligible to receive unemployment benefits under chapter 268, a Minnesota
3.28emergency unemployment compensation program, or a federal emergency compensation
3.29program, with written notice that the individual and family members may be eligible
3.30under this subdivision for temporary MinnesotaCare coverage, and an application for
3.31this coverage. This information must be provided by the commissioner of employment
3.32and economic development at the same time that information about eligibility for
3.33unemployment benefits is provided.
3.34(e) Individuals and family members shall submit applications for temporary
3.35MinnesotaCare coverage to the commissioner of human services. The commissioner
4.1of human services shall determine eligibility for persons seeking coverage under this
4.2subdivision, using the procedures specified in this chapter, unless otherwise provided
4.3in this subdivision.
4.4(f) Individuals eligible under this subdivision shall receive coverage for the health
4.5services provided under section 256L.03 to nonpregnant adults with children, except
4.6that the annual limit on inpatient hospital services in section 256L.03, subdivision 3,
4.7shall not apply.
4.8(g) Individuals eligible under this subdivision shall receive coverage on a
4.9fee-for-service basis with state-only funds, and are exempt from managed care enrollment
4.10under section 256L.12. The commissioner of human services shall seek federal approval
4.11for matching funds within 30 days of the effective date of this subdivision.
4.12(h) Individuals eligible under this subdivision shall pay premiums as determined
4.13under section 256L.15. These individuals are subject to the cost-sharing requirements
4.14specified in section 256L.03, subdivision 5, except that the ten percent coinsurance
4.15requirement for inpatient hospital services shall not apply. Individuals eligible under this
4.16subdivision are exempt from disenrollment for failure to pay premiums.
4.17(i) Individuals and family members are eligible under this subdivision for 145 days
4.18of coverage, regardless of whether the eligibility criteria under paragraph (a) continue to
4.19be met after the initial determination of eligibility.
4.20(j) Coverage under this subdivision is secondary to a plan of insurance or benefit
4.21program under which an individual or family member has coverage, and the commissioner
4.22of human services shall apply the procedures in section 256L.05, subdivision 3, paragraph
4.23(d). To be eligible under this subdivision, individuals and family members must comply
4.24with section 256L.04, subdivision 2.
4.25(k) Individuals and family members who are no longer eligible under this
4.26subdivision may reapply for MinnesotaCare. The commissioner of human services shall
4.27provide individuals covered under this subdivision with reapplication materials no later
4.28than 115 days from the effective date of coverage. All eligibility, premium payment,
4.29and other requirements of this chapter shall apply at the time of reapplication. The
4.30effective date of coverage for persons reapplying shall be the day following the last day
4.31of coverage under this subdivision, for persons who have submitted a written request for
4.32retroactive MinnesotaCare coverage with a completed application within 30 days of the
4.33loss of eligibility. The applicant must provide all required verifications within 30 days of
4.34the written request for verification. For all other persons, the effective date of coverage is
4.35the day specified in section 256L.05, subdivision 3. Individuals denied MinnesotaCare
4.36coverage upon reapplication are eligible to purchase private sector individual health
5.1coverage on a guaranteed issue basis, as provided in section 62A.65, subdivision 5,
5.2paragraph (c), and health carriers as defined in that section must accept applicants and
5.3issue coverage on that basis.
5.4(l) This subdivision expires July 1, 2011.
5.5EFFECTIVE DATE.This section is effective July 1, 2009.

5.6    Sec. 3. [256L.20] MINNESOTACARE OPTION FOR SMALL EMPLOYERS.
5.7    Subdivision 1. Definitions. (a) For the purposes of this section, the terms used
5.8have the meanings given them.
5.9(b) "Dependent" means a spouse or an unmarried child under the age of 21.
5.10(c) "Eligible employee" means an employee who works at least 20 hours per week
5.11for an eligible employer. Eligible employee does not include an employee who works on a
5.12temporary or substitute basis or who does not work more than 26 weeks annually.
5.13(d) "Eligible employer" means a business that employs at least two, but not more
5.14than 20, eligible employees, the majority of whom are employed in the state.
5.15(e) "Participating employer" means an eligible employer who meets the requirements
5.16in subdivision 3 and applies to the commissioner to enroll its eligible employees and their
5.17dependents in the MinnesotaCare program.
5.18(f) "Program" means the MinnesotaCare program.
5.19    Subd. 2. Option. Eligible employees and their dependents may enroll in
5.20MinnesotaCare if the eligible employer meets the requirements of subdivision 3. The
5.21effective date of coverage is as defined in section 256L.05, subdivision 3.
5.22    Subd. 3. Employer requirements. The commissioner shall establish procedures for
5.23an eligible employer to apply for coverage through the program. In order to participate, an
5.24eligible employer must meet the following requirements:
5.25(1) agree to contribute at least 50 percent of the cost of the premium for the eligible
5.26employee and any dependents, according to subdivision 4;
5.27(2) certify that at least 75 percent of its eligible employees who do not have other
5.28creditable health coverage are enrolled in the program; and
5.29(3) offer coverage to all eligible employees and their dependents.
5.30    Subd. 4. Premiums. (a) The premium for coverage provided under this section is
5.31equal to the cost to the state, regardless of the household income of the eligible employee.
5.32(b) The participating employer shall pay at least 50 percent of premium cost for
5.33the eligible employee and any dependents, and shall require the employee to pay the
5.34remaining portion of the premium cost to the employer.
6.1(c) The commissioner shall collect premium payments from participating employers
6.2for eligible employees and dependents that are covered by the program as provided under
6.3this section. All premiums collected shall be deposited in the health care access fund.
6.4    Subd. 5. Coverage and cost-sharing. Individuals eligible under this section shall
6.5receive coverage for the health services provided under section 256L.03 to nonpregnant
6.6adults with children, except that the annual limit on inpatient hospital services in section
6.7256L.03, subdivision 3, shall not apply. These individuals are subject to the cost-sharing
6.8requirements specified in section 256L.03, subdivision 5, except that the ten percent
6.9coinsurance requirement for inpatient hospital services shall not apply.
6.10    Subd. 6. Enrollment. Upon payment of the initial premium, according to this
6.11section and section 256L.06, eligible employees and their dependents shall be enrolled
6.12in MinnesotaCare. For purposes of enrollment under this section, income eligibility
6.13limits established under sections 256L.04 and 256L.07, subdivision 1; and asset limits
6.14established under section 256L.17 do not apply. The barriers established under section
6.15256L.07, subdivision 2 or 3, do not apply to enrollees eligible under this section.
6.16    Subd. 7. Continuation of coverage. An eligible employer offering coverage to
6.17eligible employees under this section shall provide continuation of coverage as described
6.18by the Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA), Public Law
6.1999-272, as amended, and by state law. An eligible employer may provide subsidized
6.20continuation of coverage through MinnesotaCare as its designated continuation of
6.21coverage benefits for purposes of the federal subsidies authorized by the American
6.22Recovery and Reinvestment Act of 2009, Public Law 111-5. The eligible employer shall
6.23pay the required 65 percent subsidy payment to the commissioner. The eligible employee
6.24shall pay the required 35 percent employee share to the commissioner.
6.25EFFECTIVE DATE.This section is effective July 1, 2009.

6.26    Sec. 4. APPROPRIATION.
6.27$....... is appropriated from the health care access fund to the commissioner of
6.28human services for the biennium beginning July 1, 2009, to implement Minnesota
6.29Statutes, section 256L.07, subdivision 8."
6.30Delete the title and insert:
6.32relating to health; providing temporary MinnesotaCare eligibility for certain
6.33individuals receiving unemployment benefits; requiring guaranteed issue in the
6.34individual insurance market for certain individuals who had received temporary
6.35MinnesotaCare coverage; establishing a MinnesotaCare small employer option;
6.36expanding options for COBRA coverage; appropriating money;amending
7.1Minnesota Statutes 2008, sections 62A.65, subdivision 5; 256L.07, by adding a
7.2subdivision; proposing coding for new law in Minnesota Statutes, chapter 256L."