1.1.................... moves to amend H.F. No. 2680, the first engrossment, as follows:
1.2Page 31, after line 33, insert:

1.3    "Sec. .... [256L.031] DEFINED CONTRIBUTION PROGRAM.
1.4    Subdivision 1. Defined contributions to enrollees. Beginning January 1,
1.52011, or upon federal approval, whichever is later, the commissioner shall provide
1.6each MinnesotaCare enrollee eligible under section 256L.04 with a monthly defined
1.7contribution to purchase health coverage under a health plan, as defined in section
1.862A.011, subdivision 3. The defined contribution must be paid to a qualified third-party
1.9administrator.
1.10    Subd. 2. Use of defined contribution. An enrollee may use the monthly defined
1.11contribution only to pay premiums for coverage under a health plan, as defined in section
1.1262A.011, subdivision 3, and to pay any deductibles and cost-sharing required by the health
1.13plan. The defined contribution may be used to pay the enrollee share of premiums, and
1.14deductibles and cost-sharing, for a health plan that is offered by an employer.
1.15    Subd. 3. Determination of defined contribution amount. The commissioner shall
1.16determine the defined contribution for each enrollee using a sliding scale that takes into
1.17account age, health status, and household income. The commissioner shall design the
1.18sliding scale so that the average defined contribution increases with age, poor health status,
1.19and lower household income. The commissioner shall make the defined contribution
1.20sliding scale available to applicants and enrollees by October 1, 2010. The commissioner
1.21shall design the defined contribution sliding scale so that the average per-enrollee cost
1.22for the MinnesotaCare program does not exceed ....... percent of the average per-enrollee
1.23cost that would have been projected if MinnesotaCare had not been converted into a
1.24defined contribution program.
1.25    Subd. 4. Third-party administrator. The commissioner shall contract with a
1.26qualified third-party administrator to administer the defined contributions. The third-party
1.27administrator shall:
2.1    (1) collect and process defined contributions for enrollees;
2.2    (2) pay premiums to health plan companies or employers, as applicable, for enrollee
2.3health plan coverage, including any enrollee share of premiums;
2.4    (3) pay enrollee deductibles and cost-sharing, if the defined contributions for an
2.5enrollee exceed the premium cost of the health plan; and
2.6    (4) report premium and other payments made on behalf of each enrollee to the
2.7commissioner, and other information as required by the commissioner.
2.8    Subd. 5. Assistance to enrollees. The commissioner of human services, in
2.9consultation with the commissioner of commerce, shall develop an efficient and
2.10cost-effective method of referring eligible applicants to professional insurance agent
2.11associations. For purposes of this requirement, "professional insurance agent associations"
2.12means the Minnesota Association of Health Underwriters, the National Association of
2.13Independent Financial Advisors (MN), and the Minnesota Independent Insurance Agents
2.14and Brokers. Professional insurance agent associations are authorized to receive an
2.15appropriate per member per month override for each MinnesotaCare enrollee. The agent
2.16or broker shall elect a professional association of choice for each MinnesotaCare enrollee.
2.17Agents and brokers serving MinnesotaCare enrollees shall earn the standard commercial
2.18compensation fees for each policy placed, including MinnesotaCare enrollees receiving
2.19coverage through the Minnesota Comprehensive Health Association.
2.20    Subd. 6. MCHA. Beginning January 1, 2011, or upon federal approval, whichever
2.21is later, MinnesotaCare enrollees who are denied coverage under an individual health plan
2.22by a health plan company are eligible for coverage through a health plan offered by the
2.23Minnesota Comprehensive Health Association, as provided under section 256L.033.
2.24The cost to the Minnesota Comprehensive Health Association related to coverage of
2.25MinnesotaCare enrollees denied coverage under an individual health plan shall be paid
2.26from the health care access fund.
2.27    Subd. 7. Federal approval. The commissioner shall seek all federal waivers and
2.28approvals necessary to implement this section."
2.29Page 32, delete section 21, and insert:

2.30    "Sec. .... Minnesota Statutes 2008, section 256L.05, subdivision 3, is amended to read:
2.31    Subd. 3. Effective date of coverage. (a) The effective date of coverage shall be
2.32as provided in the terms of the contract for the health plan under which an enrollee is
2.33coveredis the first day of the month following the month in which eligibility is approved
2.34and the first premium payment has been received. As provided in section 256B.057,
2.35coverage for newborns is automatic from the date of birth and must be coordinated with
2.36other health coverage. The effective date of coverage for eligible newly adoptive children
3.1added to a family receiving covered health services is the month of placement. The
3.2effective date of coverage for other new members added to the family is the first day of
3.3the month following the month in which the change is reported. All eligibility criteria
3.4must be met by the family at the time the new family member is added. The income of the
3.5new family member is included with the family's gross income and the adjusted premium
3.6begins in the month the new family member is added.
3.7    (b) The initial premium must be received by the last working day of the month for
3.8coverage to begin the first day of the following month.
3.9    (c) Benefits are not available until the day following discharge if an enrollee is
3.10hospitalized on the first day of coverage.
3.11    (d) Notwithstanding any other law to the contrary, benefits under sections 256L.01 to
3.12256L.18 are secondary to a plan of insurance or benefit program under which an eligible
3.13person may have coverage and the commissioner shall use cost avoidance techniques to
3.14ensure coordination of any other health coverage for eligible persons. The commissioner
3.15shall identify eligible persons who may have coverage or benefits under other plans of
3.16insurance or who become eligible for medical assistance.
3.17    (e) The effective date of coverage for single adults and households with no children
3.18formerly enrolled in general assistance medical care and enrolled in MinnesotaCare
3.19according to section 256D.03, subdivision 3, is the first day of the month following the
3.20last day of general assistance medical care coverage.
3.21EFFECTIVE DATE.This section is effective January 1, 2011, or upon federal
3.22approval, whichever is later."
3.23Page 33, delete sections 23 and 24
3.24Page 33, after line 23, insert:

3.25    "Sec. .... Minnesota Statutes 2008, section 256L.07, subdivision 1, is amended to read:
3.26    Subdivision 1. General requirements. (a) Children enrolled in the original
3.27children's health plan as of September 30, 1992, children who enrolled in the
3.28MinnesotaCare program after September 30, 1992, pursuant to Laws 1992, chapter 549,
3.29article 4, section 17, and children who have family gross incomes that are equal to or
3.30less than 150 percent of the federal poverty guidelines are eligible without meeting
3.31the requirements of subdivision 2 and the four-month requirement in subdivision 3, as
3.32long as they maintain continuous coverage in the MinnesotaCare program or medical
3.33assistance. Children who apply for MinnesotaCare on or after the implementation date
3.34of the employer-subsidized health coverage program as described in Laws 1998, chapter
3.35407, article 5, section 45, who have family gross incomes that are equal to or less than 150
4.1percent of the federal poverty guidelines, must meet the requirements of subdivision 2 to
4.2be eligible for MinnesotaCare.
4.3    Families enrolled in MinnesotaCare under section 256L.04, subdivision 1, whose
4.4income increases above 275 percent of the federal poverty guidelines, are no longer
4.5eligible for the program and shall be disenrolled by the commissioner. Beginning January
4.61, 2008, individuals enrolled in MinnesotaCare under section 256L.04, subdivision
4.77 , whose income increases above 200 percent of the federal poverty guidelines or 250
4.8percent of the federal poverty guidelines on or after July 1, 2009, are no longer eligible for
4.9the program and shall be disenrolled by the commissioner. For persons disenrolled under
4.10this subdivision, MinnesotaCare coverage terminates the last day of the calendar month
4.11following the month in which the commissioner determines that the income of a family or
4.12individual exceeds program income limits.
4.13    (b) Notwithstanding paragraph (a), children may remain enrolled in MinnesotaCare
4.14if ten percent of their gross individual or gross family income as defined in section
4.15256L.01, subdivision 4 , is less than the annual premium for a policy with a $500
4.16deductible available through the Minnesota Comprehensive Health Association. Children
4.17who are no longer eligible for MinnesotaCare under this clause shall be given a 12-month
4.18notice period from the date that ineligibility is determined before disenrollment. The
4.19premium defined contribution for children remaining eligible under this clause shall be the
4.20maximum premium minimum contribution determined under section 256L.15, subdivision
4.212 , paragraph (b) 256L.031.
4.22    (c) Notwithstanding paragraphs (a) and (b), parents are not eligible for
4.23MinnesotaCare if gross household income exceeds $57,500 for the 12-month period
4.24of eligibility.
4.25EFFECTIVE DATE.This section is effective January 1, 2011, or upon federal
4.26approval, whichever is later."
4.27Page 37, after line 6, insert:

4.28    "Sec. .... REPEALER.
4.29Minnesota Statutes 2008, sections 256L.03, subdivisions 1, 1a, 1b, 2, 3, 3a, 4, and
4.306; 256L.05, subdivision 5; 256L.06, subdivision 3; 256L.07, subdivisions 2, 3, 6, and
4.317; 256L.11, subdivisions 2, 2a, 3, 4, 5, 6, and 7; 256L.12; and 256L.15, are repealed,
4.32effective January 1, 2011, or upon federal approval, whichever is later.
4.33Minnesota Statutes 2009 Supplement, sections 256L.03, subdivision 5; and 256L.11,
4.34subdivision 1, are repealed, effective January 1, 2011, or upon federal approval, whichever
4.35is later."
5.1Renumber the sections in sequence and correct the internal references
5.2Amend the title accordingly