reglab/housing_qa huggingface dataset:
MN Stat § 62R.03 (2021)
2021 Minnesota Statutes|Chapters 59A - 79A — Insurance|Chapter 62R — Health Care Cooperatives|Section 62R.03 — Applicability Of Other Laws.

62R.03 APPLICABILITY OF OTHER LAWS. Subdivision 1. Minnesota Cooperative Law. A health care cooperative is subject to chapter 308A unless otherwise provided in this chapter. After incorporation, a health care cooperative shall enjoy the powers and privileges and shall be subject to the duties and liabilities of other cooperatives organized under chapter 308A, to the extent applicable and except as limited or enlarged by this chapter. If any provision of this chapter conflicts with a provision of chapter 308A, the provision of this chapter takes precedence. Subd. 2. Health plan licensure and operation. A health care network cooperative must be licensed as a health maintenance organization licensed under chapter 62D, a nonprofit health service plan corporation licensed under chapter 62C, or a community integrated service network licensed under chapter 62N, at the election of the health care network cooperative. The health care network cooperative shall be subject to the duties and liabilities of health plans licensed pursuant to the chapter under which the cooperative elects to be licensed, to the extent applicable and except as limited or enlarged by this chapter. If any provision of any chapter under which the cooperative elects to be licensed conflicts with the provisions of this chapter, the provisions of this chapter take precedence. A health care network cooperative, upon licensure as provided in this subdivision, is a contributing member of the Minnesota Comprehensive Health Association, on the same basis as other entities having the same licensure. Subd. 3. Health provider cooperatives. A health provider cooperative shall not be considered a mutual insurance company under chapter 60A, a health maintenance organization under chapter 62D, a nonprofit health services corporation under chapter 62C, or a community integrated service network under chapter 62N. A health provider network shall not be considered to violate any limitations on the corporate practice of medicine. Health care service contracts under section 62R.06 shall not be considered to violate section 62J.23. History:  1994 c 625 art 11 s 3; 1997 c 225 art 2 s 62
MN Stat § 62R.04 (2021)
2021 Minnesota Statutes|Chapters 59A - 79A — Insurance|Chapter 62R — Health Care Cooperatives|Section 62R.04 — Definitions.

62R.04 DEFINITIONS. Subdivision 1. Scope. For purposes of this chapter, the terms defined in this section have the meanings given. Subd. 2. Health care cooperative. "Health care cooperative" means a health care network cooperative or a health provider cooperative. Subd. 3. Health care network cooperative. "Health care network cooperative" means a corporation organized under this chapter and licensed in accordance with section 62R.03, subdivision 2. A health care network cooperative shall not have more than 50,000 enrollees, unless exceeding the enrollment limit is necessary to comply with guaranteed issue or guaranteed renewal requirements of chapter 62L or section 62A.65. Subd. 4. Health provider cooperative. "Health provider cooperative" means a corporation organized under this chapter and operated on a cooperative plan to market health care services to purchasers of those services. Subd. 5. Commissioner. Unless otherwise specified, "commissioner" means the commissioner of health for a health care network cooperative licensed under chapter 62D or 62N and the commissioner of commerce for a health care network cooperative licensed under chapter 62C. Subd. 6. Health carrier. "Health carrier" has the meaning provided in section 62A.011. Subd. 7. Health care providing entity. "Health care providing entity" means a participating entity that provides health care to enrollees of a health care cooperative. History:   1994 c 625 art 11 s 4
MN Stat § 62R.05 (2021)
2021 Minnesota Statutes|Chapters 59A - 79A — Insurance|Chapter 62R — Health Care Cooperatives|Section 62R.05 — Powers.

62R.05 POWERS. In addition to the powers enumerated under section 308A.201, a health care cooperative shall have all of the powers granted a nonprofit corporation under section 317A.161, except to the extent expressly inconsistent with the provisions of chapter 308A. History:   1994 c 625 art 11 s 5
MN Stat § 62R.06 (2021)
2021 Minnesota Statutes|Chapters 59A - 79A — Insurance|Chapter 62R — Health Care Cooperatives|Section 62R.06 — Health Care Service Contracts.

62R.06 HEALTH CARE SERVICE CONTRACTS. Subdivision 1. Provider contracts. A health provider cooperative and its licensed members may execute marketing and service contracts requiring the provider members to provide some or all of their health care services through the provider cooperative to the enrollees, members, subscribers, or insureds, of a health care network cooperative, community integrated service network, nonprofit health service plan, health maintenance organization, accident and health insurance company, or any other purchaser, including the state of Minnesota and its agencies, instruments, or units of local government. Each purchasing entity is authorized to execute contracts for the purchase of health care services from a health provider cooperative in accordance with this section. A contract between a provider cooperative and a purchaser may provide for payment by the purchaser to the health provider cooperative on a capitated or similar risk-sharing basis, by fee-for-service arrangements, or by other financial arrangements authorized under state law. Each contract between a provider cooperative and a purchaser shall be filed by the provider network cooperative with the commissioner of health and is subject to the provisions of section 62D.19. Subd. 2. No network limitation. A health care network cooperative may contract with any health provider cooperative and may contract with any other licensed health care provider to provide health care services for its enrollees. Subd. 3. Restraint of trade. Subject to section 62R.08, a health care provider cooperative is not a combination in restraint of trade, and any contracts or agreements between a health care provider cooperative and its members regarding the price the cooperative will charge to purchasers of its services, or regarding the prices the members will charge to the cooperative, or regarding the allocation of gains or losses among the members, or regarding the delivery, quality, allocation, or location of services to be provided, are not contracts that unreasonably restrain trade. History:  1994 c 625 art 11 s 6; 1997 c 225 art 2 s 62; 1999 c 245 art 2 s 14
MN Stat § 62R.07 (2021)
2021 Minnesota Statutes|Chapters 59A - 79A — Insurance|Chapter 62R — Health Care Cooperatives|Section 62R.07 — Relicensure.

62R.07 RELICENSURE. (a) A health care network cooperative licensed under chapter 62C or 62D may relinquish that license and be granted a new license as a community integrated service network under chapter 62N in accordance with this section, provided that the cooperative meets all requirements for licensure as a network under chapter 62N, to the extent not expressly inconsistent with the provisions of chapter 308A. (b) The relicensure shall be effective at the time specified in the plan of relicensure, which must not be earlier than the date upon which the previous license is surrendered. (c) Upon the relicensure of the cooperative as a community integrated service network: (1) all existing group and individual enrollee benefit contracts in force on the effective date of the relicensure shall continue in effect and with the same terms and conditions, notwithstanding the cooperative's new licensure as a network, until the date of each contract's next renewal or amendment, but no later than one year from the date of the relicensure. At this time, each benefit contract then in force must be amended to comply with all statutory and regulatory requirements for network benefit contracts as of that date; and (2) all contracts between the cooperative and any health care providing entity, including a health care provider cooperative, in force on the effective date of relicensure shall remain in effect under the cooperative's new licensure as a network until the date of the next renewal or amendment of that contract, but no later than one year from the date of relicensure. (d) Except as otherwise provided in this section, nothing in the relicensure of a health care network cooperative shall in any way affect its corporate existence or any of its contracts, rights, privileges, immunities, powers or franchises, debts, duties or other obligations or liabilities. History:  1994 c 625 art 11 s 7; 1997 c 225 art 2 s 62
MN Stat § 62R.08 (2021)
2021 Minnesota Statutes|Chapters 59A - 79A — Insurance|Chapter 62R — Health Care Cooperatives|Section 62R.08 — Prohibited Practices.

62R.08 PROHIBITED PRACTICES. (a) It shall be unlawful for any person, company, or corporation, or any agent, officer, or employee thereof, to coerce or require any person to agree, either in writing or orally, not to join or become or remain a member of, any health care provider cooperative, as a condition of securing or retaining a contract for health care services with the person, firm, or corporation. (b) It shall be unlawful for any person, company, or corporation, or any combination of persons, companies, or corporations, or any agents, officers, or employees thereof, to engage in any acts of coercion, intimidation, or boycott of, or any refusal to deal with, any health care providing entity arising from that entity's actual or potential participation in a health care network cooperative or health care provider cooperative. (c) It shall be unlawful for any health care network cooperative, other than a health care network cooperative operating on an employed, staff model basis, to require that its participating providers provide health care services exclusively to or through the health care network cooperative. It shall be unlawful for any health care provider cooperative to require that its members provide health care services exclusively to or through the health care provider cooperative. (d) It shall be unlawful for any health care provider cooperative to engage in any acts of coercion, intimidation, or boycott of, or any concerted refusal to deal with, any health plan company seeking to contract with the cooperative on a competitive, reasonable, and nonexclusive basis. (e) The prohibitions in this section are in addition to any conduct that violates sections 325D.49 to 325D.66. (f) This section shall be enforced in accordance with sections 325D.56 to 325D.65. History:   1994 c 625 art 11 s 8
MN Stat § 62S.02 (2021)
2021 Minnesota Statutes|Chapters 59A - 79A — Insurance|Chapter 62S — Qualified Long-term Care Insurance Policies|Section 62S.02 — Qualified Long-term Care Insurance Policy.

62S.02 QUALIFIED LONG-TERM CARE INSURANCE POLICY. Subdivision 1. Requirements. A qualified long-term care insurance policy may not be offered, issued, delivered, or renewed in this state unless the policy satisfies the requirements of this chapter and the filing provisions of section 62A.02. A qualified long-term care insurance policy must cover qualified long-term care services. Subd. 2. Nonforfeiture requirement. An insurer shall offer a nonforfeiture provision available in the event of default in the payment of any premiums. The amount of the benefit may be adjusted after being initially granted, if necessary, to reflect changes in claims, persistency, and interest as reflected in changes in rates for premium paying contracts. The nonforfeiture provision must provide at least one of the following: (1) reduced paid-up insurance; (2) extended term insurance; or (3) shortened benefit period. Subd. 3. Refund restrictions. A qualified long-term care insurance policy shall not provide for a cash surrender value or other money that can be paid, assigned, pledged as collateral for a loan, or borrowed. The aggregate premium paid under the policy may be refunded in the event of death of the insured or a complete surrender or cancellation of the policy. Subd. 4. Nonreimbursable expenses. A qualified long-term care insurance policy shall not pay or reimburse expenses incurred for services or items if the expenses are reimbursable under Medicare or would be reimbursable if a deductible or coinsurance amount was not applied. This subdivision does not apply to expenses which are reimbursable under Medicare only as a secondary payor and does not prohibit the offering of a qualified long-term care insurance policy on the basis that the policy coordinates its benefits with those provided under Medicare. Notwithstanding this subdivision, payments may be made under a long-term care insurance policy on a per diem or other periodic basis without regard to the expenses incurred during the period to which the payments relate. Subd. 5. Activities of daily living. A qualified long-term care insurance policy shall take into account at least five of the activities of daily living in making the determination of whether an individual is chronically ill. Assessments of activities of daily living and cognitive impairment must be performed by a licensed or certified professional, such as a physician, nurse, or social worker. Subd. 6. Appeals process. A qualified long-term care insurance policy must include a clear description of the process for appealing and resolving benefit determinations. History:  1997 c 71 art 1 s 2; 2000 c 483 s 17
MN Stat § 62S.03 (2021)
2021 Minnesota Statutes|Chapters 59A - 79A — Insurance|Chapter 62S — Qualified Long-term Care Insurance Policies|Section 62S.03 — Extraterritorial Jurisdiction.

62S.03 EXTRATERRITORIAL JURISDICTION. Group long-term care insurance coverage may not be offered to a resident of this state under a group policy issued in another state to a group described in section 62S.01, subdivision 15, clause (4), unless this state or another state having statutory and regulatory long-term care insurance requirements substantially similar to those adopted in this state has made a determination that the requirements have been met. History:   1997 c 71 art 1 s 3
MN Stat § 62S.04 (2021)
2021 Minnesota Statutes|Chapters 59A - 79A — Insurance|Chapter 62S — Qualified Long-term Care Insurance Policies|Section 62S.04 — Prohibitions.

62S.04 PROHIBITIONS. A long-term care insurance policy may not: (1) be canceled, nonrenewed, or otherwise terminated on the grounds of the age or the deterioration of the mental or physical health of the insured individual or certificate holder; (2) contain a provision establishing a new waiting period in the event existing coverage is converted to or replaced by a new or other form within the same company, except with respect to an increase in benefits voluntarily selected by the insured individual or group policyholder; or (3) provide coverage for skilled nursing care only, or provide significantly more coverage for skilled care in a facility than coverage for lower levels of care in the same facility. History:   1997 c 71 art 1 s 4
MN Stat § 62S.05 (2021)
2021 Minnesota Statutes|Chapters 59A - 79A — Insurance|Chapter 62S — Qualified Long-term Care Insurance Policies|Section 62S.05 — Preexisting Condition.

62S.05 PREEXISTING CONDITION. Subdivision 1. Authorized definition. A long-term care insurance policy or certificate, other than a policy or certificate issued to a group as defined in section 62S.01, subdivision 15, clause (1), may not use a definition of preexisting condition that is more restrictive than the definition in this subdivision. "Preexisting condition" means a condition for which medical advice or treatment was recommended by, or received from a provider of health care services, within six months before the effective date of coverage of an insured person. Subd. 2. Prohibited exclusion. A long-term care insurance policy or certificate, other than a policy or certificate issued to a group as defined in section 62S.01, subdivision 15, clause (1), may not exclude coverage for a loss or confinement that is the result of a preexisting condition more than six months following the effective date of coverage of an insured person. Subd. 3. Underwriting standards. The definition of preexisting condition does not prohibit an insurer from using an application form designed to elicit the complete health history of an applicant and, on the basis of the answers on that application, from underwriting according to that insurer's established underwriting standards. Unless otherwise provided in the policy or certificate, a preexisting condition, regardless of whether it is disclosed on the application, need not be covered until the waiting period described in subdivision 2 expires. A long-term care insurance policy or certificate may not exclude or use waivers of any kind to exclude, limit, or reduce coverage or benefits for specifically named or described preexisting diseases or physical conditions beyond the waiting period described in subdivision 2. Subd. 4. Extension of limitation periods. The commissioner may extend the limitation periods set forth in subdivisions 1 and 2 as to specific age group categories in specific policy forms upon finding that the extension is in the best interest of the public. History:  1997 c 71 art 1 s 5; 1999 c 177 s 60; 2006 c 255 s 36; 2006 c 282 art 17 s 2
MN Stat § 62S.06 (2021)
2021 Minnesota Statutes|Chapters 59A - 79A — Insurance|Chapter 62S — Qualified Long-term Care Insurance Policies|Section 62S.06 — Prior Hospitalization Or Institutionalization.

62S.06 PRIOR HOSPITALIZATION OR INSTITUTIONALIZATION. Subdivision 1. Prohibited conditions. A long-term care insurance policy may not be delivered or issued for delivery in this state if the policy conditions eligibility for any benefits: (1) on a prior hospitalization requirement; (2) provided in an institutional care setting on the receipt of a higher level of institutional care; or (3) other than waiver of premium, postconfinement, postacute care, or recuperative benefits on a prior institutionalization requirement. Subd. 2. Benefit labeling. A long-term care insurance policy containing postconfinement, postacute care, or recuperative benefits must clearly label in a separate paragraph of the policy or certificate entitled "limitations or conditions on eligibility for benefits" the limitations or conditions, including any required number of days of confinement. Subd. 3. Benefit conditions. (a) A long-term care insurance policy or rider that conditions eligibility of noninstitutional benefits on the prior receipt of institutional care may not require a prior institutional stay of more than 30 days. (b) A long-term care insurance policy or rider that provides benefits only following institutionalization may not condition the benefits upon admission to a facility for the same or related conditions within a period of less than 30 days after discharge from the institution. History:   1997 c 71 art 1 s 6
MN Stat § 62S.07 (2021)
2021 Minnesota Statutes|Chapters 59A - 79A — Insurance|Chapter 62S — Qualified Long-term Care Insurance Policies|Section 62S.07 — Right To Return; Refund.

62S.07 RIGHT TO RETURN; REFUND. Subdivision 1. Right to return. A long-term care insurance applicant may return the policy or certificate within 30 days of its delivery and is entitled to a refund of the premium if, after examination of the policy or certificate, the applicant is not satisfied for any reason. Long-term care insurance policies and certificates must include a notice prominently printed on the first page or attached to the first page stating in substance that the applicant may return the policy or certificate within 30 days of its delivery and have the premium refunded if for any reason, after examination of the policy or certificate, other than a certificate issued under a policy issued to a group as defined in section 62S.01, subdivision 15, clause (1), the applicant is not satisfied. Subd. 2. Refund. If an application for a qualified long-term care insurance policy is denied, the issuer shall refund to the applicant any premium and fees submitted by the applicant within 30 days of the denial. History:   1997 c 71 art 1 s 7
MN Stat § 62S.09 (2021)
2021 Minnesota Statutes|Chapters 59A - 79A — Insurance|Chapter 62S — Qualified Long-term Care Insurance Policies|Section 62S.09 — Certificate Requirements.

62S.09 CERTIFICATE REQUIREMENTS. Subdivision 1. Content. A certificate issued under a group long-term care insurance policy delivered or issued for delivery in this state must include: (1) a description of the principal benefits and coverage provided in the policy; (2) a statement of the exclusions, reductions, and limitations contained in the policy; and (3) a statement that the group master policy determines governing contractual provisions. Subd. 2. Delivery. The issuer of a qualified long-term care insurance policy shall deliver to the applicant, policyholder, or certificate holder the contract or certificate no later than 30 days after the date of approval. History:   1997 c 71 art 1 s 9
MN Stat § 62S.10 (2021)
2021 Minnesota Statutes|Chapters 59A - 79A — Insurance|Chapter 62S — Qualified Long-term Care Insurance Policies|Section 62S.10 — Policy Summary.

62S.10 POLICY SUMMARY. Subdivision 1. Delivery. At the time of policy delivery, a policy summary must be delivered for an individual life insurance policy that provides long-term care benefits within the policy or by rider. In the case of direct response solicitations, the insurer must deliver the policy summary upon the applicant's request, but regardless of request, must make the delivery no later than at the time of policy delivery. Subd. 2. Contents. The summary must include the following information: (1) an explanation of how the long-term care benefit interacts with other components of the policy, including deductions from death benefits; (2) an illustration of the amount of benefits, the length of benefits, and the guaranteed lifetime benefits, if any, for each covered person; (3) any exclusions, reductions, and limitations on benefits of long-term care; and (4) a statement that any long-term care inflation protection option required by section 62S.23 is not available under this policy. Subd. 3. Additional information required. If applicable to the policy type, the summary must include the following information: (1) a disclosure of the effects of exercising other rights under the policy; (2) a disclosure of guarantees related to long-term care costs of insurance charges; and (3) current and projected maximum lifetime benefits. History:  1997 c 71 art 1 s 10; 2006 c 255 s 39; 2006 c 282 art 17 s 5
MN Stat § 62S.11 (2021)
2021 Minnesota Statutes|Chapters 59A - 79A — Insurance|Chapter 62S — Qualified Long-term Care Insurance Policies|Section 62S.11 — Monthly Report.

62S.11 MONTHLY REPORT. Subdivision 1. Required report. Any time a long-term care benefit, funded through a life insurance vehicle by the acceleration of the death benefit, is in benefit payment status, a monthly report must be provided to the policyholder. Subd. 2. Contents. The report must include the following information: (1) long-term care benefits paid out during the month; (2) an explanation of changes in the policy, such as death benefits or cash values, due to long-term care benefits being paid out; and (3) the amount of long-term care benefits existing or remaining. History:   1997 c 71 art 1 s 11
MN Stat § 62S.12 (2021)
2021 Minnesota Statutes|Chapters 59A - 79A — Insurance|Chapter 62S — Qualified Long-term Care Insurance Policies|Section 62S.12 — Claim Denial.

62S.12 CLAIM DENIAL. If a claim under a qualified long-term care insurance contract is denied, the issuer shall provide a written explanation of the reasons for the denial and make available all information directly related to the denial within 60 days of the date of a written request by the policyholder or certificate holder, or a representative of the policyholder or certificate holder. History:   1997 c 71 art 1 s 12