reglab/housing_qa huggingface dataset:
MN Stat § 62C.142 (2021)
2021 Minnesota Statutes|Chapters 59A - 79A — Insurance|Chapter 62C — Nonprofit Health Service Plan Corporations|Section 62C.142 — Continuation And Conversion Privileges For Former Spouses And Children.

62C.142 CONTINUATION AND CONVERSION PRIVILEGES FOR FORMER SPOUSES AND CHILDREN. Subdivision 1. Termination of coverage. No subscriber contract of a nonprofit health service plan corporation which, in addition to covering the subscriber, also covers the subscriber's spouse shall contain a provision for termination of coverage for a spouse covered under the subscriber contract solely as a result of a break in the marital relationship except by reason of an entry of a valid decree of dissolution of marriage between the parties. Subd. 2. Conversion privilege. An individual subscriber contract issued as conversion coverage shall be renewable at the option of the former spouse as long as the former spouse is not covered under another qualified plan as defined in section 62E.02, subdivision 4. Any revisions in the table of rate for the individual subscriber contract shall apply to the former spouse's original age at entry and shall apply equally to all similar contracts issued as conversion coverage by the corporation. Subd. 2a. Continuation privilege. Every subscriber contract, other than a contract whose continuance is contingent upon continued employment or membership, shall contain a provision which permits continuation of coverage under the contract for the subscriber's former spouse and children upon entry of a valid decree of dissolution of marriage. The coverage may be continued until the earlier of the following dates: (a) the subscriber's former spouse becomes covered under any other group health plan; or (b) the date coverage would otherwise terminate under the subscriber contract. The contract must require the group contract holder to, upon request, provide the insured with written verification from the insurer of the cost of this coverage promptly at the time of eligibility for this coverage and at any time during the continuation period. In no event shall the amount of premium charged exceed 102 percent of the cost to the plan for such period of coverage for other similarly situated spouses and dependent children with respect to whom the marital relationship has not dissolved, without regard to whether such cost is paid by the employer or employee. Subd. 3. Application. Subdivision 1 applies to every subscriber contract which is delivered, issued for delivery, renewed or amended on or after July 19, 1977. Subdivisions 2 and 2a apply to every subscriber contract which is delivered, issued for delivery, renewed, or amended on or after March 1, 1983. History:  1977 c 186 s 2; 1982 c 555 s 9; 1982 c 642 s 15; 1990 c 403 s 9; 1992 c 564 art 4 s 9; 2000 c 483 s 13; 2013 c 84 art 1 s 33
MN Stat § 62C.15 (2021)
2021 Minnesota Statutes|Chapters 59A - 79A — Insurance|Chapter 62C — Nonprofit Health Service Plan Corporations|Section 62C.15 — Subscription Charges.

62C.15 SUBSCRIPTION CHARGES. Subdivision 1. Establishment and adjustment. A service plan corporation shall establish and adjust from time to time subscription charges to be paid by or on behalf of its subscribers. The charges shall be reasonable, and not unfairly discriminatory, in relation to the benefits, considering actuarial projection of the cost of providing or paying for the health services, considering costs of administration, and in relation to reserves and surplus required by law. Subd. 2. Nongroup contracts; filing of schedule of charges. No service plan corporation shall deliver, issue for delivery, extend, continue, or renew any form of nongroup subscriber contract until schedules of charges applicable thereto, including any endorsement, rider, amendment or application which is a part thereof, have been filed with the commissioner; nor shall the corporation deliver, issue for delivery, extend, continue or renew any form of group subscriber contract until a schedule of the rating structures and formulae applicable thereto, including any endorsement, rider, amendment or application which is a part thereof, has been filed with the commissioner. The filing for a nongroup subscriber contract shall include the actuarial data needed to justify any increase in subscriber charges. The commissioner may disapprove the schedule of charges for any group or nongroup subscriber contract if: (a) the unencumbered reserve or surplus is less than the required minimum or more than the required maximum; or (b) the schedule charges meet the criteria specified in section 62A.02, subdivision 3. Subd. 3. Disapproval. If subscription charges become subject to disapproval, the commissioner shall within 30 days of filing render an order either disapproving the charges or extending time for review to a specified date, or the charges shall be deemed approved. An order disapproving a charge shall state the reasons therefor and shall be subject to the notice, hearing, and appeal provisions of section 62C.14. The burden of proving and actuarially demonstrating that the charges are not inadequate or excessive shall be on the corporation. Subd. 4. Issuance or delivery of disapproved contract. It shall be unlawful for a service plan corporation to deliver or issue a subscriber's contract with charges which have been disapproved by the commissioner. History:  1971 c 568 s 15; 1976 c 296 art 2 s 12
MN Stat § 62C.16 (2021)
2021 Minnesota Statutes|Chapters 59A - 79A — Insurance|Chapter 62C — Nonprofit Health Service Plan Corporations|Section 62C.16 — Service Agreements.

62C.16 SERVICE AGREEMENTS. Subdivision 1. Agreements with authorized providers. Service plan corporations, as agents for providers, may enter into service agreements only with providers authorized to practice their profession or conduct their business in this state or the state or foreign country in which the provider is located. Subd. 2. Enforcement. A service plan corporation shall enforce its service agreements, including agreements of providers to accept payment from the corporation as compensation for health service rendered or provided to subscribers who have prepaid for the health service. Provisions for review, by participating providers, of claims shall be a part of each service agreement. Subd. 3. Filing. Each type of service agreement shall be filed with the commissioner, prior to its use and those in effect on August 1, 1971, shall be filed within 60 days thereof. Subd. 4. Retaliatory action prohibited. No service plan corporation may take retaliatory action against a provider solely on the grounds that the provider disseminated accurate information regarding coverage of benefits or accurate benefit limitations of a subscriber's contract or accurate interpretations of the provider agreement that limit the prescribing, providing, or ordering of care. History:  1971 c 568 s 16; 1993 c 345 art 5 s 5
MN Stat § 62C.18 (2021)
2021 Minnesota Statutes|Chapters 59A - 79A — Insurance|Chapter 62C — Nonprofit Health Service Plan Corporations|Section 62C.18 — Personal Liability.

62C.18 PERSONAL LIABILITY. Subdivision 1. Limitation. No participating provider shall have any right of action against a subscriber for compensation for health services which such provider has rendered, except to the extent that the subscriber's contract does not provide coverage for the services or part of the services rendered. Subd. 2. Rights of nonparticipating providers; notice. Nothing herein shall affect the rights of a nonparticipating provider who gives the subscriber written notice prior to rendering service that the provider will bill the subscriber directly for service, provided that such notice shall not be required if (1) the nonparticipating provider is not informed by the subscriber and does not otherwise have knowledge that such subscriber has a subscriber contract covering such services, or (2) under the existing circumstances it is impossible or impractical for the nonparticipating provider to give such notice, or (3) the services are not provided in this state. Subd. 3. Failure of nonparticipating provider to give notice. A nonparticipating provider who fails to give the notice required in subdivision 2 shall not be entitled to recover compensation from a subscriber for health services rendered to such subscriber in an amount in excess of the aggregate of (1) the amount actually received by the subscriber from the service plan corporation as reimbursement for the costs of such service, and (2) the amount by which such nonparticipating provider's fee or charges for such service exceeds the coverage provided for such service in the subscriber's contract. History:  1971 c 568 s 18; 1986 c 444
MN Stat § 62C.19 (2021)
2021 Minnesota Statutes|Chapters 59A - 79A — Insurance|Chapter 62C — Nonprofit Health Service Plan Corporations|Section 62C.19 — Unfair Trade Practices.

62C.19 UNFAIR TRADE PRACTICES. Service plan corporations are subject to sections 72A.17 to 72A.30, regarding regulation of trade practices, and to all rules promulgated by the commissioner regarding advertisements for and marketing of accident and health insurance. History:  1971 c 568 s 19; 1985 c 248 s 70
MN Stat § 62C.20 (2021)
2021 Minnesota Statutes|Chapters 59A - 79A — Insurance|Chapter 62C — Nonprofit Health Service Plan Corporations|Section 62C.20 — Practice Not Authorized.

62C.20 PRACTICE NOT AUTHORIZED. Nothing in Laws 1971, chapter 568 shall authorize any person, association or corporation to engage, in any manner, in the practice of a profession required by this state to be licensed. History:   1971 c 568 s 20
MN Stat § 62C.21 (2021)
2021 Minnesota Statutes|Chapters 59A - 79A — Insurance|Chapter 62C — Nonprofit Health Service Plan Corporations|Section 62C.21 — Penalties.

62C.21 PENALTIES. If a service plan corporation violates Laws 1971, chapter 568 or other applicable law, the commissioner may suspend or revoke its certificate of authority, and impose a penalty not to exceed $5,000 for each offense. Such action shall be by order and subject to the notice, hearing and appeal provided as to an order disapproving a subscriber's contract. History:   1971 c 568 s 21
MN Stat § 62C.22 (2021)
2021 Minnesota Statutes|Chapters 59A - 79A — Insurance|Chapter 62C — Nonprofit Health Service Plan Corporations|Section 62C.22 — Violations.

62C.22 VIOLATIONS. Any person who violates Laws 1971, chapter 568, or who makes a material false statement with respect to a written report or statement required by Laws 1971, chapter 568, shall be punishable, for the first offense, by payment of a fine of not more than $1,000 or imprisonment for not more than 90 days or both and for the second and each subsequent offense by payment of a fine of not more than $3,000 or imprisonment for not more than one year or both. History:  1971 c 568 s 22; 1984 c 628 art 3 s 11; 2004 c 228 art 1 s 72
MN Stat § 62C.23 (2021)
2021 Minnesota Statutes|Chapters 59A - 79A — Insurance|Chapter 62C — Nonprofit Health Service Plan Corporations|Section 62C.23 — Rules.

62C.23 RULES. For the purpose of implementing and enforcing Laws 1971, chapter 568, the commissioner may adopt rules pursuant to chapter 14. History:  1971 c 568 s 23; 1982 c 424 s 130; 1985 c 248 s 70
MN Stat § 62D.01 (2021)
2021 Minnesota Statutes|Chapters 59A - 79A — Insurance|Chapter 62D — Health Maintenance Organizations|Section 62D.01 — Citation And Purpose.

62D.01 CITATION AND PURPOSE. Subdivision 1. Title. Sections 62D.01 to 62D.24 may be cited as the "Health Maintenance Act of 1973." Subd. 2. Legislative findings and intent; policy. (a) Faced with the continuation of mounting costs of health care coupled with its inaccessibility to large segments of the population, the legislature has determined that there is a need to explore alternative methods for the delivery of health care services, with a view toward achieving greater efficiency and economy in providing these services. (b) It is, therefore, the policy of the state to eliminate the barriers to the organization, promotion, and expansion of health maintenance organizations; to provide for their regulation by the state commissioner of health; and to exempt them from the operation of the insurance and nonprofit health service plan corporation laws of the state except as hereinafter provided. (c) It is further the intention of the legislature to closely monitor the development of health maintenance organizations in order to assess their impact on the costs of health care to consumers, the accessibility of health care to consumers, and the quality of health care provided to consumers. History:  1973 c 670 s 1; 1977 c 305 s 45; 1996 c 305 art 1 s 139
MN Stat § 62D.042 (2021)
2021 Minnesota Statutes|Chapters 59A - 79A — Insurance|Chapter 62D — Health Maintenance Organizations|Section 62D.042 — Initial Net Worth Requirement.

62D.042 INITIAL NET WORTH REQUIREMENT. Subdivision 1. Definition. For purposes of this section, if a health maintenance organization offers supplemental benefits as described in section 62D.05, subdivision 6, "expenses" does not include any expenses attributable to the supplemental benefit. Subd. 2. Initial net worth requirement. Beginning organizations shall maintain net worth of at least 8-1/3 percent of the sum of all expenses expected to be incurred in the 12 months following the date the certificate of authority is granted, or $1,500,000, whichever is greater. Subd. 3.  [Repealed, 1998 c 407 art 8 s 14] Subd. 4. Reduction for reinsurance. In calculating expenses for purposes of the net worth requirement, a health maintenance organization may subtract 90 percent of the cost of premiums it pays for insurance coverage specified in section 62D.04, subdivision 1, clause (f). Subd. 5.  [Repealed, 2004 c 285 art 3 s 11] Subd. 6.  [Repealed, 2004 c 285 art 3 s 11] Subd. 7.  [Repealed, 2004 c 285 art 3 s 11] History:  1988 c 612 s 14; 1989 c 282 art 2 s 5; 1993 c 345 art 2 s 1; 1995 c 234 art 7 s 7; 1997 c 205 s 5; 1998 c 407 art 8 s 2; 2004 c 285 art 3 s 5,6,10
MN Stat § 62D.06 (2021)
2021 Minnesota Statutes|Chapters 59A - 79A — Insurance|Chapter 62D — Health Maintenance Organizations|Section 62D.06 — Governing Body.

62D.06 GOVERNING BODY. Subdivision 1. Governing body composition; enrollee advisory body. The governing body of any health maintenance organization which is a corporation may include enrollees, providers, or other individuals; provided, however, that after a health maintenance organization which is a corporation has been authorized under sections 62D.01 to 62D.30 for one year, at least 40 percent of the governing body shall be composed of enrollees and members elected by the enrollees and members from among the enrollees and members. For purposes of this section, "member" means a consumer who receives health care services through a self-insured contract that is administered by the health maintenance organization or its related third-party administrator. The number of members elected to the governing body shall not exceed the number of enrollees elected to the governing body. An enrollee or member elected to the governing board may not be a person: (1) whose occupation involves, or before retirement involved, the administration of health activities or the provision of health services; (2) who is or was employed by a health care facility as a licensed health professional; or (3) who has or had a direct substantial financial or managerial interest in the rendering of a health service, other than the payment of a reasonable expense reimbursement or compensation as a member of the board of a health maintenance organization. After a health maintenance organization which is a local governmental unit has been authorized under sections 62D.01 to 62D.30 for one year, an enrollee advisory body shall be established. The enrollees who make up this advisory body shall be elected by the enrollees from among the enrollees. Subd. 2. Enrollee input. The governing body shall establish a mechanism to afford the enrollees an opportunity to express their opinions in matters of policy and operation through the establishment of advisory panels, by the use of advisory referenda on major policy decisions, or through the use of other mechanisms as may be prescribed or permitted by the commissioner of health. History:  1973 c 670 s 6; 1974 c 284 s 10; 1977 c 305 s 45; 1983 c 205 s 6; 1987 c 384 art 2 s 1; 1988 c 592 s 1; 1997 c 205 s 6; 2017 c 2 art 2 s 7
MN Stat § 62D.095 (2021)
2021 Minnesota Statutes|Chapters 59A - 79A — Insurance|Chapter 62D — Health Maintenance Organizations|Section 62D.095 — Enrollee Cost Sharing.

62D.095 ENROLLEE COST SHARING. Subdivision 1. General application. A health maintenance contract may contain enrollee cost-sharing provisions as specified in this section. Co-payment and deductible provisions in a group contract must not discriminate on the basis of age, sex, race, disability, economic status, or length of enrollment in the health plan. During an open enrollment period in which all offered health plans fully participate without any underwriting restrictions, co-payment and deductible provisions must not discriminate on the basis of preexisting health status. Subd. 2. Co-payments. A health maintenance contract may impose a co-payment and coinsurance consistent with the provisions of the Affordable Care Act as defined under section 62A.011, subdivision 1a. Subd. 3. Deductibles. A health maintenance contract may impose a deductible consistent with the provisions of the Affordable Care Act as defined under section 62A.011, subdivision 1a. Subd. 4. Annual out-of-pocket maximums. A health maintenance contract may impose an annual out-of-pocket maximum consistent with the provisions of the Affordable Care Act as defined under section 62A.011, subdivision 1a. Subd. 5. Exceptions. No co-payments or deductibles may be imposed on preventive health care services consistent with the provisions of the Affordable Care Act as defined under section 62A.011, subdivision 1a. Subd. 6. Public programs. This section does not apply to the prepaid medical assistance program, the MinnesotaCare program, the federal Medicare program, or the health plans provided through any of those programs. History:  2002 c 387 s 3; 1Sp2003 c 14 art 7 s 8,9; 2013 c 84 art 1 s 35
MN Stat § 62D.102 (2021)
2021 Minnesota Statutes|Chapters 59A - 79A — Insurance|Chapter 62D — Health Maintenance Organizations|Section 62D.102 — Family Therapy.

62D.102 FAMILY THERAPY. Covered treatment for a minor includes treatment for the family if family therapy is recommended by a health maintenance organization provider. For purposes of determining benefits under this section, "hours of treatment" means treatment rendered on an individual or single-family basis. If treatment is rendered on a group basis, the hours of covered group treatment must be provided at a ratio of no less than two group treatment sessions to one individual treatment hour. For a health maintenance contract that is offered as a companion to a health insurance subscriber contract, the benefits for mental or nervous disorders must be calculated in aggregate for the health maintenance contract and the health insurance subscriber contract. History:  1984 c 641 s 3; 1987 c 337 s 65; 1988 c 689 art 2 s 12; 1997 c 205 s 11
MN Stat § 62D.103 (2021)
2021 Minnesota Statutes|Chapters 59A - 79A — Insurance|Chapter 62D — Health Maintenance Organizations|Section 62D.103 — Second Opinion Related To Chemical Dependency And Mental Health.

62D.103 SECOND OPINION RELATED TO CHEMICAL DEPENDENCY AND MENTAL HEALTH. A health maintenance organization shall promptly evaluate the treatment needs of any enrollee who is seeking treatment for a problem related to chemical dependency or mental health conditions. In the event that the health maintenance organization or a participating provider determines that no type of structured treatment is necessary, the enrollee shall be immediately entitled to a second opinion paid for by the health maintenance organization, by a health care professional qualified in diagnosis and treatment of the problem and not affiliated with the health maintenance organization. The health maintenance organization or participating provider shall consider the second opinion but is not obligated to accept the conclusion of the second opinion. The health maintenance organization or participating provider shall document its consideration of the second opinion. History:   1984 c 641 s 4
MN Stat § 62D.104 (2021)
2021 Minnesota Statutes|Chapters 59A - 79A — Insurance|Chapter 62D — Health Maintenance Organizations|Section 62D.104 — Required Out-of-area Conversion.

62D.104 REQUIRED OUT-OF-AREA CONVERSION. Enrollees who have individual health maintenance organization contracts and who have become nonresidents of the health maintenance organization's service area but remain residents of the state of Minnesota shall be given the option, to be arranged by the health maintenance organization if an agreement with an insurer can reasonably be made, of a number three qualified plan, a number two qualified plan, or a number one qualified plan as provided by section 62E.06, subdivisions 1 to 3, or, if such enrollees are covered by title XVIII of the Social Security Act (Medicare), they shall be given the option of a Medicare supplement plan as provided by chapter 62A. This option shall be made available at the enrollee's expense, without further evidence of insurability and without interruption of coverage. If a health maintenance organization cannot make arrangements for conversion coverage, the health maintenance organization shall notify enrollees of health plans available in other service areas. History:  1988 c 434 s 8; 1989 c 258 s 9
MN Stat § 62D.105 (2021)
2021 Minnesota Statutes|Chapters 59A - 79A — Insurance|Chapter 62D — Health Maintenance Organizations|Section 62D.105 — Coverage Of Current Spouse, Former Spouse, And Children.

62D.105 COVERAGE OF CURRENT SPOUSE, FORMER SPOUSE, AND CHILDREN. Subdivision 1. Requirement. Every health maintenance contract, which in addition to covering the enrollee also provides coverage to the spouse, dependent children, which is defined as required by section 62A.302, and former spouse who was covered on the day before the entry of a valid decree of dissolution of marriage, of the enrollee shall: (1) permit the spouse, former spouse, and dependent children to elect to continue coverage when the enrollee becomes enrolled for benefits under title XVIII of the Social Security Act (Medicare); and (2) permit the dependent children to continue coverage when they cease to be dependent children under the generally applicable requirement of the plan. Subd. 2. Continuation privilege. The coverage described in subdivision 1 may be continued until the earlier of the following dates: (1) the date coverage would otherwise terminate under the contract; (2) 36 months after continuation by the spouse, former spouse, or dependent was elected; or (3) the date the spouse, former spouse, or dependent children become covered under another group health plan or Medicare. If coverage is provided under a group policy, any required fees for the coverage shall be paid by the enrollee on a monthly basis to the group contract holder for remittance to the health maintenance organization. In no event shall the fee charged exceed 102 percent of the cost to the plan for such coverage for other similarly situated spouse and dependent children to whom subdivision 1 is not applicable, without regard to whether such cost is paid by the employer or employee. History:  1988 c 434 s 9; 1Sp2017 c 6 art 5 s 4