reglab/statecodes huggingface dataset:
2023 Minnesota Statutes › Chapters 59A - 79A — Insurance › Chapter 62A — Accident And Health Insurance › Section 62A.09 — Limitation.

62A.09 LIMITATION.
Nothing in sections 62A.01, 62A.02, 62A.03, 62A.04, 62A.05, 62A.06, 62A.07, and 62A.08 shall apply to or affect:
(1) any policy of workers' compensation insurance or any policy of casualty or fire and allied lines insurance with or without supplementary coverage therein; or
(2) any policy or contract of reinsurance; or
(3) any group policy of insurance, except when specifically referred to; or
(4) life insurance, endowment or annuity contracts, or contracts supplemental thereto which contain only such provisions relating to accident and sickness insurance as (a) provide additional benefits in case of death or dismemberment or loss of sight by accident, or as (b) operate to safeguard such contracts against lapse or to give a special surrender value or special benefit or an annuity in the event that the insured or annuitant shall become totally and permanently disabled, as defined by the contract or supplemental contract.
History:
1967 c 395 art 3 s 9; 1975 c 359 s 23; 1989 c 330 s 12
2023 Minnesota Statutes › Chapters 59A - 79A — Insurance › Chapter 62A — Accident And Health Insurance › Section 62A.095 — Subrogation Clauses Regulated.

62A.095 SUBROGATION CLAUSES REGULATED.
Subdivision 1.
Applicability.
(a) A health plan may not be offered, sold, or issued to a resident of this state, or to cover a resident of this state, unless the health plan complies with subdivision 2.
(b) Health plans providing benefits under health care programs administered by the commissioner of human services are not subject to the limits described in subdivision 2 but are subject to the right of subrogation provisions under section 256B.37 and the lien provisions under section 256.015; 256B.042; Minnesota Statutes 2010, section 256D.03, subdivision 8; or 256L.03, subdivision 6.
For purposes of this section, "health plan" includes coverage that is excluded under section 62A.011, subdivision 3, clauses (4), (6), (7), (8), (9), and (10).
Subd. 2.
Subrogation clause; limits.
No health plan described in subdivision 1 shall contain a subrogation, reimbursement, or similar clause that provides subrogation, reimbursement, or similar rights to the health carrier issuing the health plan, unless:
(1) the clause provides that it applies only after the covered person has received a full recovery from another source; and
(2) the clause provides that the health carrier's subrogation right is subject to subtraction for actual monies paid to account for the pro rata share of the covered person's costs, disbursements, and reasonable attorney fees, and other expenses incurred in obtaining the recovery from another source unless the health carrier is separately represented by an attorney.
If the health carrier is separately represented by an attorney, the health carrier and the covered person, by their attorneys, may enter into an agreement regarding allocation of the covered person's costs, disbursements, and reasonable attorney fees and other expenses. If the health carrier and covered person cannot reach agreement on allocation, the health carrier and covered person shall submit the matter to binding arbitration.
Nothing in this section shall limit a health carrier's right to recovery from another source which may otherwise exist at law.
For the purposes of this section, full recovery does not include payments made by a health plan to or for the benefit of a covered person.
Subd. 3.
Retroactive amendments regulated.
No addition of, or amendment of, a subrogation, reimbursement, or similar clause in a health plan shall be applied to the disadvantage of a covered person with respect to benefits provided by the health carrier in connection with an injury, illness, condition, or other covered situation that originated prior to the addition of or amendment to the clause.
History:
1995 c 219 s 1; 1Sp2001 c 9 art 2 s 1; 2002 c 379 art 1 s 113; 2006 c 255 s 10; 2011 c 108 s 32; 2016 c 158 art 2 s 9
2023 Minnesota Statutes › Chapters 59A - 79A — Insurance › Chapter 62A — Accident And Health Insurance › Section 62A.096 — Notice To Insurer Of Subrogation Claim Required.

62A.096 NOTICE TO INSURER OF SUBROGATION CLAIM REQUIRED.
A person covered by a health carrier who makes a claim against a collateral source for damages that include repayment for medical and medically related expenses incurred for the covered person's benefit shall provide timely notice, in writing, to the health carrier of the pending or potential claim. Notwithstanding any other law to the contrary, the statute of limitations applicable to the rights with respect to reimbursement or subrogation by the health carrier against the covered person does not commence to run until the notice has been given.
History:
1995 c 219 s 2
2023 Minnesota Statutes › Chapters 59A - 79A — Insurance › Chapter 62A — Accident And Health Insurance › Section 62A.105 — Coverages; Transfers To Substantially Similar Products.

62A.105 COVERAGES; TRANSFERS TO SUBSTANTIALLY SIMILAR PRODUCTS.
Subdivision 1.
Scope.
No individual policy of accident and sickness regulated under this chapter or subscriber contract regulated under chapter 62C shall be issued, renewed, or continued to provide coverage to a Minnesota resident unless it satisfies the requirements of subdivision 2.
Subd. 2.
Requirement.
If an issuer of policies or plans referred to in subdivision 1 ceases to offer a particular policy or subscriber contract to the general public or otherwise stops adding new insureds to the group of covered persons, the issuer shall allow any covered person to transfer to another substantially similar policy or contract currently being sold by the issuer. The issuer shall permit the transfer without any preexisting condition limitation, waiting period, or other restriction of any type other than those which applied to the insured under the prior policy or contract. This section does not apply to persons who were covered under an individual policy or contract prior to July 1, 1994.
History:
1994 c 485 s 27
2023 Minnesota Statutes › Chapters 59A - 79A — Insurance › Chapter 62A — Accident And Health Insurance › Section 62A.13 — Commercial Traveler Insurance Companies.

62A.13 COMMERCIAL TRAVELER INSURANCE COMPANIES.
Any domestic assessment, health or accident association now licensed to do business in this state, which confines its membership to commercial travelers, professionals, and others whose occupation is of such character as to be ordinarily classified as no more hazardous than commercial travelers, and which does not pay any other commissions or compensations, other than prizes to members of nominal value in proportion to the membership fees charged for securing new members, may issue certificates of membership, which, with the application of the member and the bylaws of the association, shall constitute the contract between the association and the member. A printed copy of the bylaws and a copy of the application shall be attached to the membership certificate when issued, and a copy of any amendment to the bylaws shall be mailed to the members following their adoption. Certified copies of certificate, bylaws and amendments shall be filed with the commissioner of commerce and subject to the commissioner's approval. The bylaws shall conform to the requirements of this chapter, so far as applicable, and wherever the word "policy" appears in this chapter, it shall, for the purpose of this section, be construed to mean the contract as herein defined.
History:
1967 c 395 art 3 s 13; 1983 c 289 s 114 subd 1; 1984 c 655 art 1 s 92; 1986 c 444
2023 Minnesota Statutes › Chapters 59A - 79A — Insurance › Chapter 62A — Accident And Health Insurance › Section 62A.136 — Hearing, Dental, And Vision Plan Coverage.

62A.136 HEARING, DENTAL, AND VISION PLAN COVERAGE.
The following provisions do not apply to health plans as defined in section 62A.011, subdivision 3, clause (6), providing hearing, dental, or vision coverage only: sections 62A.041; 62A.0411; 62A.047; 62A.149; 62A.151; 62A.152; 62A.154; 62A.155; 62A.17, subdivision 6; 62A.21, subdivision 2b; 62A.26; 62A.28; 62A.285; 62A.30; 62A.304; and 62A.3093.
History:
1994 c 485 s 28; 1995 c 258 s 25; 2000 c 483 s 11; 2005 c 132 s 9; 2009 c 178 art 1 s 21; 2013 c 84 art 1 s 17
2023 Minnesota Statutes › Chapters 59A - 79A — Insurance › Chapter 62A — Accident And Health Insurance › Section 62A.14 — Disabled Children.

62A.14 DISABLED CHILDREN.
Subdivision 1.
Individual family policies.
An individual hospital or medical expense insurance policy delivered or issued for delivery in this state more than 120 days after May 16, 1969, or an individual health maintenance contract delivered or issued for delivery in this state after August 1, 1984, which provides that coverage of a dependent child shall terminate upon attainment of the limiting age for dependent children specified in the policy or contract shall also provide in substance that attainment of such limiting age shall not operate to terminate the coverage of such child while the child is and continues to be both (a) incapable of self-sustaining employment by reason of developmental disability, mental illness or disorder, or physical disability and (b) chiefly dependent upon the policyholder for support and maintenance, provided proof of such incapacity and dependency is furnished to the insurer or health maintenance organization by the policyholder or enrollee within 31 days of the child's attainment of the limiting age and subsequently as may be required by the insurer or organization but not more frequently than annually after the two-year period following the child's attainment of the limiting age. Any notice regarding termination of coverage due to attainment of the limiting age must include all the information in this section.
Subd. 2.
Group policies.
A group hospital or medical expense insurance policy delivered or issued for delivery in this state more than 120 days after May 16, 1969, or a group health maintenance contract delivered or issued for delivery in this state after August 1, 1984, which provides that coverage of a dependent child of an employee or other member of the covered group shall terminate upon attainment of the limiting age for dependent children specified in the policy or contract shall also provide in substance that attainment of such limiting age shall not operate to terminate the coverage of such child while the child is and continues to be both (a) incapable of self-sustaining employment by reason of developmental disability, mental illness or disorder, or physical disability and (b) chiefly dependent upon the employee or member for support and maintenance, provided proof of such incapacity and dependency is furnished to the insurer or organization by the employee or member within 31 days of the child's attainment of the limiting age and subsequently as may be required by the insurer or organization but not more frequently than annually after the two-year period following the child's attainment of the limiting age. Any notice regarding termination of coverage due to attainment of the limiting age must include information about this provision.
History:
1969 c 436 s 1; 1984 c 464 s 5; 1995 c 258 s 26; 2003 c 40 s 1; 2005 c 56 s 1
2023 Minnesota Statutes › Chapters 59A - 79A — Insurance › Chapter 62A — Accident And Health Insurance › Section 62A.141 — Coverage For Disabled Dependents.

62A.141 COVERAGE FOR DISABLED DEPENDENTS.
No group policy or group plan of health and accident insurance regulated under this chapter, chapter 62C, or 62D, which provides for dependent coverage may be issued or renewed in this state after August 1, 1983, unless it covers the disabled dependents of the insured, subscriber, or enrollee of the policy or plan. For purposes of this section, a disabled dependent is a person that is and continues to be both: (1) incapable of self-sustaining employment by reason of developmental disability, mental illness or disorder, or physical disability; and (2) chiefly dependent upon the policyholder for support and maintenance. Consequently, the policy or plan shall not contain any provision concerning preexisting condition limitations, insurability, eligibility, or health underwriting approval concerning disabled dependents.
If ordered by the commissioner of commerce, the insurer of a Minnesota-domiciled nonprofit association which is composed solely of agricultural members may restrict coverage under this section to apply only to Minnesota residents.
History:
1983 c 263 s 8; 1Sp1985 c 10 s 58; 1987 c 337 s 47; 1995 c 258 s 27; 2005 c 56 s 1
2023 Minnesota Statutes › Chapters 59A - 79A — Insurance › Chapter 62A — Accident And Health Insurance › Section 62A.145 — Survivor; Definition.

62A.145 SURVIVOR; DEFINITION.
For the purposes of section 62A.146, "survivor" means a person who would be entitled to and be dependent upon economic support by an insured, subscriber or enrollee if that person were alive; including a spouse, child or children as defined by the policy or plan of accident and health protection.
History:
1973 c 339 s 1; 1982 c 555 s 5; 1986 c 444
2023 Minnesota Statutes › Chapters 59A - 79A — Insurance › Chapter 62A — Accident And Health Insurance › Section 62A.146 — Continuation Of Benefits To Survivors.

62A.146 CONTINUATION OF BENEFITS TO SURVIVORS.
No policy, contract, or plan of accident and health protection issued by an insurer, nonprofit health service plan corporation, or health maintenance organization, providing coverage of hospital or medical expense on either an expense incurred basis or other than an expense incurred basis which in addition to coverage of the insured, subscriber, or enrollee, also provides coverage to dependents, shall, except upon the written consent of the survivor or survivors of the deceased insured, subscriber, or enrollee, terminate, suspend, or otherwise restrict the participation in or the receipt of benefits otherwise payable under the policy, contract, or plan to the survivor or survivors until the earlier of the following dates:
(a) the date the surviving spouse becomes covered under another group health plan; or
(b) the date coverage would have terminated under the policy, contract, or plan had the insured, subscriber, or enrollee lived.
The survivor or survivors, in order to have the coverage and benefits extended, may be required to pay the entire cost of the protection on a monthly basis. The policy, contract, or plan must require the group policyholder or contract holder to, upon request, provide the insured, subscriber, or enrollee 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 or fee contributions charged exceed 102 percent of the cost to the plan for such period of coverage for other similarly situated spouses and dependent children who are not the survivors of a deceased insured, without regard to whether such cost is paid by the employer or employee. Failure of the survivor to make premium or fee payments within 90 days after notice of the requirement to pay the premiums or fees shall be a basis for the termination of the coverage without written consent. In event of termination by reason of the survivor's failure to make required premium or fee contributions, written notice of cancellation must be mailed to the survivor's last known address at least 30 days before the cancellation. If the coverage is provided under a group policy, contract, or plan, any required premium or fee contributions for the coverage shall be paid by the survivor to the group policyholder or contract holder for remittance to the insurer, nonprofit health service plan corporation, or health maintenance organization.
History:
1973 c 339 s 2; 1982 c 555 s 6; 1Sp1985 c 10 s 59; 1986 c 444; 1987 c 337 s 48; 1992 c 564 art 4 s 5
2023 Minnesota Statutes › Chapters 59A - 79A — Insurance › Chapter 62A — Accident And Health Insurance › Section 62A.147 — Disabled Employees' Benefits; Definitions.

62A.147 DISABLED EMPLOYEES' BENEFITS; DEFINITIONS.
Subdivision 1.
Scope.
For the purposes of this section and section 62A.148, the terms defined in this section shall have the meanings here given them.
Subd. 2.
Covered employee.
"Covered employee" means any person who, at the time that person suffered an injury resulting in total disability or became totally disabled by reason of illness, was employed by and receiving a salary, commission, hourly wage, or other remuneration for services by any employer providing, offering or contributing to group insurance coverage or group coverage through a health maintenance contract, for that employee who was so enrolled for the coverage.
Subd. 3.
Total disability.
"Total disability" means (a) the inability of an injured or ill employee to engage in or perform the duties of the employee's regular occupation or employment within the first two years of such disability and (b) after the first two years of such disability, the inability of the employee to engage in any paid employment or work for which the employee may, by education and training, including rehabilitative training, be or reasonably become qualified.
Subd. 4.
Group insurance.
"Group insurance" means any policy or contract of accident and health protection, including health maintenance contracts, regardless of by whom underwritten, which provides benefits, including cash payments for reimbursement of expenses or the provision of usual needed health care and medical services as the result of any injury, sickness, disability or disease suffered by a group of employees, or any one of them, and which protection is paid for or otherwise provided in full or in part by an employer.
Subd. 5.
Employer.
"Employer" means any natural person, company, corporation, partnership, association, firm, or franchise which employs any employee.
Subd. 6.
Insurer.
"Insurer" means any person, company, corporation including a nonprofit corporation and a health maintenance organization, partnership, association, firm or franchise which underwrites or is by contract or other agreement obligated to provide accident and health protection benefits to any group of employees of any employer.
History:
1973 c 340 s 1; 1984 c 464 s 6; 1986 c 444
2023 Minnesota Statutes › Chapters 59A - 79A — Insurance › Chapter 62A — Accident And Health Insurance › Section 62A.148 — Group Insurance; Provision Of Benefits For Disabled Employees.

62A.148 GROUP INSURANCE; PROVISION OF BENEFITS FOR DISABLED EMPLOYEES.
No employer or insurer of that employer shall terminate, suspend or otherwise restrict the participation in or the receipt of benefits otherwise payable under any program or policy of group insurance to any covered employee who becomes totally disabled while employed by the employer solely on account of absence caused by such total disability. This includes coverage of dependents of the employee. If the employee is required to pay all or any part of the premium for the extension of coverage, payment shall be made to the employer, by the employee.
History:
1973 c 340 s 2; 1994 c 485 s 29
2023 Minnesota Statutes › Chapters 59A - 79A — Insurance › Chapter 62A — Accident And Health Insurance › Section 62A.149 — Benefits For Alcoholics And Drug Dependents.

62A.149 BENEFITS FOR ALCOHOLICS AND DRUG DEPENDENTS.
Subdivision 1.
Application.
The provisions of this section apply to all group policies of accident and health insurance and group subscriber contracts offered by nonprofit health service plan corporations regulated under chapter 62C, and to a plan or policy that is individually underwritten or provided for a specific individual and family members as a nongroup policy, when the policies or subscriber contracts are issued or delivered in Minnesota or provide benefits to Minnesota residents enrolled thereunder.
This section does not apply to policies designed primarily to provide coverage payable on a per diem, fixed indemnity or nonexpense incurred basis or policies that provide accident only coverage.
Every insurance policy or subscriber contract included within the provisions of this subdivision, upon issuance or renewal, shall provide coverage that complies with the requirements of section 62Q.47, paragraphs (b) and (c), for the treatment of alcoholism, chemical dependency, or drug addiction to any Minnesota resident entitled to coverage.
Subd. 2.
[Repealed, 2008 c 344 s 56]
History:
1973 c 585 s 1,2; 1976 c 262 s 1; 1978 c 793 s 60; 1980 c 496 s 2; 1986 c 444; 2008 c 344 s 9; 2013 c 84 art 1 s 18; 2022 c 98 art 4 s 51
2023 Minnesota Statutes › Chapters 59A - 79A — Insurance › Chapter 62A — Accident And Health Insurance › Section 62A.151 — Health Insurance Benefits For Emotionally Disabled Children.

62A.151 HEALTH INSURANCE BENEFITS FOR EMOTIONALLY DISABLED CHILDREN.
No policy or plan of health, medical, hospitalization, or accident and sickness insurance regulated under this chapter, or nonprofit health service plan corporation regulated under chapter 62C, or health maintenance organization regulated under chapter 62D which provides coverage of or reimbursement for inpatient hospital and medical expenses shall be delivered, issued, executed or renewed in this state, or approved for issuance or renewal in this state by the commissioner of commerce, after July 1, 1975 unless the policy or plan includes and provides health service benefits to any subscriber or other person covered thereunder, on the same basis as other benefits, for the treatment of emotionally disabled children in a residential treatment facility licensed by the commissioner of human services. For purposes of this section "emotionally disabled child" shall have the meaning set forth by the commissioner of human services in the rules relating to residential treatment facilities. The restrictions and requirements of this section shall not apply to any plan or policy which is individually underwritten or provided for a specific individual and family members as a nongroup policy. The mandatory coverage under this section shall be on the same basis as inpatient hospital medical coverage provided under the policy or plan.
History:
1975 c 40 s 1; 1983 c 289 s 114 subd 1; 1984 c 654 art 5 s 58; 1984 c 655 art 1 s 92; 1985 c 248 s 70; 1986 c 444; 2005 c 56 s 1
2023 Minnesota Statutes › Chapters 59A - 79A — Insurance › Chapter 62A — Accident And Health Insurance › Section 62A.152 — Benefits For Ambulatory Mental Health Services.

62A.152 BENEFITS FOR AMBULATORY MENTAL HEALTH SERVICES.
Subdivision 1.
Scope.
The provisions of this section apply (a) to all group policies or subscriber contracts which provide benefits for at least 100 certificate holders who are residents of this state or groups of which more than 90 percent are residents of this state and are issued, delivered, or renewed by accident and health insurance companies regulated under this chapter, or by nonprofit health service plan corporations regulated under chapter 62C and (b), unless waived by the commissioner to the extent applicable to holders who are both nonresidents and employed outside this state, to all group policies or subscriber contracts which are issued, delivered, or renewed within this state by accident and health insurance companies regulated under this chapter, or by nonprofit health service plan corporations regulated under chapter 62C.
Subd. 2.
Minimum benefits.
All group policies and all group subscriber contracts providing benefits for mental or nervous disorder treatments in a hospital shall also provide coverage that complies with the requirements of section 62Q.47, paragraphs (b) and (c).
Subd. 3.
Provider discrimination prohibited.
All group policies and group subscriber contracts that provide benefits for mental or nervous disorder treatments in a hospital must provide direct reimbursement for those services at a hospital or psychiatric residential treatment facility if performed by a mental health professional qualified according to section 245I.04, subdivision 2, to the extent that the services and treatment are within the scope of mental health professional licensure.
This subdivision is intended to provide payment of benefits for mental or nervous disorder treatments performed by a licensed mental health professional in a hospital or psychiatric residential treatment facility and is not intended to change or add benefits for those services provided in policies or contracts to which this subdivision applies.
[See Note.]
History:
1975 c 89 s 1; 1981 c 265 s 1; 1Sp1981 c 4 art 1 s 49; 1983 c 354 s 1; 1984 c 654 art 5 s 58; 1987 c 337 s 49; 1987 c 384 art 2 s 1; 1988 c 689 art 2 s 7; 1989 c 330 s 15,16; 1991 c 255 s 1,2; 1993 c 81 s 1,2; 2008 c 344 s 10; 2021 c 30 art 17 s 1; 2023 c 57 art 2 s 6
NOTE:
The amendment to subdivision 3 by Laws 2021, chapter 30, article 17, section 1, is effective upon federal approval. The commissioner of human services shall notify the revisor of statutes when federal approval is obtained. Laws 2021, chapter 30, article 17, section 114.
NOTE:
The amendment to subdivision 3 by Laws 2023, chapter 57, article 2, section 6, is effective January 1, 2025. Laws 2023, chapter 57, article 2, section 6, the effective date.
2023 Minnesota Statutes › Chapters 59A - 79A — Insurance › Chapter 62A — Accident And Health Insurance › Section 62A.153 — Outpatient Medical And Surgical Services.

62A.153 OUTPATIENT MEDICAL AND SURGICAL SERVICES.
No policy or plan of health, medical, hospitalization, or accident and sickness insurance regulated under this chapter, or subscriber contract provided by a nonprofit health service plan corporation regulated under chapter 62C that provides coverage for services in a hospital shall be issued, renewed, continued, delivered, issued for delivery or executed in this state, or approved for issuance or renewal in this state by the commissioner of commerce unless the policy, plan or contract specifically provides coverage for a health care treatment or surgery on an outpatient basis at a facility equipped to perform these services, whether or not the facility is part of a hospital. Coverage shall be on the same basis as coverage provided for the same health care treatment or service in a hospital.
History:
1976 c 45 s 1; 1977 c 305 s 45; 1983 c 289 s 114 subd 1; 1984 c 655 art 1 s 92; 1994 c 485 s 30
2023 Minnesota Statutes › Chapters 59A - 79A — Insurance › Chapter 62A — Accident And Health Insurance › Section 62A.154 — Benefits For Des Related Conditions.

62A.154 BENEFITS FOR DES RELATED CONDITIONS.
Subdivision 1.
Definitions.
For the purposes of this section, the terms defined in this section have the meanings given them.
(a) "Covered person" means a natural person who is covered under a policy.
(b) "Insurer" means an insurer providing health, medical, hospitalization, or accident and sickness insurance regulated under this chapter, a nonprofit health services plan corporation regulated under chapter 62C, a health maintenance organization regulated under chapter 62D or a fraternal benefit society regulated under chapter 64B.
(c) "Policy" means a policy or plan of health, medical, hospitalization or accident and sickness insurance, a health maintenance contract, or a health benefit certificate provided by an insurer which provides coverage of, or reimbursement for, hospital, medical, or surgical expenses on a group or individual basis, but does not include a policy designed primarily to provide coverage payable on a per diem, fixed indemnity or nonexpense incurred basis, or a policy that provides only accident coverage.
Subd. 2.
Required coverage.
No policy shall be issued or renewed in this state after August 1, 1981 if it provides an exclusion, reduction, or other limitation as to coverage, deductible, coinsurance or co-payment applicable solely to conditions attributable to diethylstilbestrol or exposure to diethylstilbestrol, unless the covered person has been diagnosed as having diethylstilbestrol-related cancer prior to the date on which coverage for that person begins. In the absence of credible evidence of a higher morbidity rate due to exposure to diethylstilbestrol, no insurer shall surcharge or in any other manner increase the premium. If there is credible evidence of a higher morbidity rate due to exposure to diethylstilbestrol, no insurer shall surcharge or in any other manner increase the premium without the prior approval of the commissioner.
Subd. 3.
Refusal to issue or renew.
No insurer shall refuse to issue or renew a policy, or to provide coverage under a policy, in this state after August 1, 1981 solely because of conditions attributable to diethylstilbestrol or exposure to diethylstilbestrol, unless the covered person has been diagnosed as having diethylstilbestrol-related cancer prior to the date on which an initial premium payment is received by the insurer.
History:
1981 c 350 s 1; 1985 c 49 s 41; 1992 c 564 art 1 s 54
2023 Minnesota Statutes › Chapters 59A - 79A — Insurance › Chapter 62A — Accident And Health Insurance › Section 62A.155 — Coverage For Services Provided To Ventilator-dependent Persons.

62A.155 COVERAGE FOR SERVICES PROVIDED TO VENTILATOR-DEPENDENT PERSONS.
Subdivision 1.
Scope of coverage.
This section applies to all policies of accident and health insurance, group subscriber contracts offered by nonprofit health service plan corporations regulated under chapter 62C, health maintenance contracts regulated under chapter 62D, and health benefit certificates offered through a fraternal benefit society regulated under chapter 64B. This section does not apply to policies designed primarily to provide coverage payable on a per diem, fixed indemnity or nonexpense incurred basis, or policies that provide only accident coverage.
Subd. 2.
Required coverage.
If a policy, plan, certificate, or contract referred to in subdivision 1 issued or renewed after August 1, 1988, provides coverage for services provided by a home care nurse or personal care assistant to a ventilator-dependent person in the person's home, it must provide coverage for up to 120 hours of services provided by a home care nurse or personal care assistant to the ventilator-dependent person during the time the ventilator-dependent person is in a hospital licensed under chapter 144. The personal care assistant or home care nurse shall perform only the services of communicator or interpreter for the ventilator-dependent patient during a transition period of up to 120 hours to assure adequate training of the hospital staff to communicate with the patient and to understand the unique comfort, safety, and personal care needs of the patient.
History:
1988 c 656 s 3; 1992 c 564 art 1 s 54; 2014 c 291 art 9 s 5
2023 Minnesota Statutes › Chapters 59A - 79A — Insurance › Chapter 62A — Accident And Health Insurance › Section 62A.16 — Scope Of Certain Continuation And Conversion Requirements.

62A.16 SCOPE OF CERTAIN CONTINUATION AND CONVERSION REQUIREMENTS.
The provisions of this section and section 62A.17 shall apply to all group insurance policies or group subscriber contracts providing coverage for hospital or medical expenses incurred by a Minnesota resident employed within this state. This section and section 62A.17 shall also apply to health care plans established by employers in this state through health maintenance organizations certified under chapter 62D.
History:
1974 c 101 s 1; 1976 c 142 s 1
2023 Minnesota Statutes › Chapters 59A - 79A — Insurance › Chapter 62A — Accident And Health Insurance › Section 62A.18 — Prohibition Against Disability Offsets.

62A.18 PROHIBITION AGAINST DISABILITY OFFSETS.
No individual or group policy of accident and health insurance issued, amended, renewed, or delivered in this state on or after January 1, 1976 shall contain any provision offsetting, or in any other manner reducing, any benefit under the policy by the amount of, or in proportion to, any increase in disability benefits received or receivable under the federal Social Security Act, the Railroad Retirement Act, any Veteran's Disability Compensation and Survivor Benefits Act, Workers' Compensation, or any similar federal or state law, as amended subsequent to the date of commencement of such benefit.
History:
1975 c 323 s 1
2023 Minnesota Statutes › Chapters 59A - 79A — Insurance › Chapter 62A — Accident And Health Insurance › Section 62A.19 — Prohibition Against Nondiagnostic X-rays.

62A.19 PROHIBITION AGAINST NONDIAGNOSTIC X-RAYS.
No individual or group policy of dental insurance offered for sale to a Minnesota resident by an insurer regulated under this chapter, individual or group service plan or subscriber contract regulated under chapter 62C, health maintenance contract regulated under chapter 62D, or fraternal contract benefit regulated under chapter 64B, shall subject any policyholder, subscriber, or enrollee to undue exposure to radiation by requiring a health care provider to take or obtain x-rays that are not directly related to patient care.
Any health care provider receiving such a request may refuse to provide x-rays not necessary to the diagnosis and treatment of the patient. An insurer, nonprofit health service plan corporation, health maintenance organization, fraternal benefit society, or dental plan may not deny or withhold benefits based solely upon the refusal to provide x-rays. Nothing in this section prohibits requests for x-rays or other diagnostic aids routinely taken in conjunction with the diagnosis and treatment of injury or disease, or routinely required by the insurer for preapproval or predetermination of treatment. An insurer may not retroactively request new x-rays not taken in conjunction with the diagnosis or treatment of injury or disease.
History:
1991 c 101 s 1
2023 Minnesota Statutes › Chapters 59A - 79A — Insurance › Chapter 62A — Accident And Health Insurance › Section 62A.20 — Continuation Coverage Of Current Spouse And Children.

62A.20 CONTINUATION COVERAGE OF CURRENT SPOUSE AND CHILDREN.
Subdivision 1.
Requirement.
Every policy of accident and health insurance providing coverage of hospital or medical expense on either an expense-incurred basis or other than an expense-incurred basis, which in addition to covering the insured also provides coverage to the spouse and dependent children of the insured shall contain:
(1) a provision which allows the spouse and dependent children to elect to continue coverage when the insured becomes enrolled for benefits under Title XVIII of the Social Security Act (Medicare); and
(2) a provision which allows the dependent children to continue coverage when they cease to be dependent children under the generally applicable requirement of the plan.
Upon request by the insured or the insured's spouse or dependent child, a health carrier must provide the instructions necessary to enable the spouse or child to elect continuation of coverage.
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 policy;
(2) 36 months after continuation by the spouse or dependent was elected; or
(3) the spouse or dependent children become covered under another group health plan.
If coverage is provided under a group policy, any required premium contributions for the coverage shall be paid by the insured on a monthly basis to the group policyholder for remittance to the insurer. 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 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:
1987 c 337 s 51; 2001 c 215 s 10
2023 Minnesota Statutes › Chapters 59A - 79A — Insurance › Chapter 62A — Accident And Health Insurance › Section 62A.22 — Refusal To Provide Coverage Because Of Option Under Workers' Compensation.

62A.22 REFUSAL TO PROVIDE COVERAGE BECAUSE OF OPTION UNDER WORKERS' COMPENSATION.
No insurer offering an individual or group policy of accident or health coverage in this state shall refuse to provide or renew accident or health coverage because the insured has an option to elect workers' compensation coverage pursuant to section 176.041, subdivision 1a.
History:
1979 c 92 s 1; 1989 c 209 art 2 s 1
2023 Minnesota Statutes › Chapters 59A - 79A — Insurance › Chapter 62A — Accident And Health Insurance › Section 62A.23 — Group Disability Income Coverage; Termination Without Prejudice; Definitions.

62A.23 GROUP DISABILITY INCOME COVERAGE; TERMINATION WITHOUT PREJUDICE; DEFINITIONS.
Subdivision 1.
Scope.
For the purposes of this section and section 62A.24, the terms defined in this section have the meanings given them in this section.
Subd. 2.
Employer.
"Employer" means any natural person, company, corporation, partnership, association, firm or franchise which employs any employee.
Subd. 3.
Insurer.
"Insurer" means any person, company, corporation, including a nonprofit corporation, partnership, association, firm or franchise which underwrites or is by contract or other agreement obligated to provide group disability income insurance benefits to any group of employees of any employer.
History:
1980 c 377 s 1
2023 Minnesota Statutes › Chapters 59A - 79A — Insurance › Chapter 62A — Accident And Health Insurance › Section 62A.24 — Continuation Of Benefits.

62A.24 CONTINUATION OF BENEFITS.
No employer or insurer of that employer may offer or provide a policy of group disability income insurance unless the master policy provides that the termination of the policy shall be without prejudice to any claims originating prior to the time of the termination.
Section 62A.23 and this section may be superseded by a rule promulgated by the commissioner of commerce.
History:
1980 c 377 s 2; 1983 c 289 s 114 subd 1; 1984 c 655 art 1 s 92
2023 Minnesota Statutes › Chapters 59A - 79A — Insurance › Chapter 62A — Accident And Health Insurance › Section 62A.25 — Reconstructive Surgery.

62A.25 RECONSTRUCTIVE SURGERY.
Subdivision 1.
Scope of coverage.
This section applies to all policies of accident and health insurance, health maintenance contracts regulated under chapter 62D, health benefit certificates offered through a fraternal benefit society regulated under chapter 64B, and group subscriber contracts offered by nonprofit health service plan corporations regulated under chapter 62C but does not apply to policies designed primarily to provide coverage payable on a per diem, fixed indemnity or nonexpense incurred basis, or policies that provide only accident coverage.
Subd. 2.
Required coverage.
(a) Every policy, plan, certificate or contract to which this section applies shall provide benefits for reconstructive surgery when such service is incidental to or follows surgery resulting from injury, sickness or other diseases of the involved part or when such service is performed on a covered dependent child because of congenital disease or anomaly which has resulted in a functional defect as determined by the attending physician.
(b) The coverage limitations on reconstructive surgery in paragraph (a) do not apply to reconstructive breast surgery following mastectomies. In these cases, coverage for reconstructive surgery must be provided if the mastectomy is medically necessary as determined by the attending physician.
(c) Reconstructive surgery benefits include all stages of reconstruction of the breast on which the mastectomy has been performed, surgery and reconstruction of the other breast to produce a symmetrical appearance, and prosthesis and physical complications at all stages of a mastectomy, including lymphedemas, in a manner determined in consultation with the attending physician and patient. Coverage may be subject to annual deductible, co-payment, and coinsurance provisions as may be deemed appropriate and as are consistent with those established for other benefits under the plan or coverage. Coverage may not:
(1) deny to a patient eligibility, or continued eligibility, to enroll or to renew coverage under the terms of the plan, solely for the purpose of avoiding the requirements of this section; and
(2) penalize or otherwise reduce or limit the reimbursement of an attending provider, or provide monetary or other incentives to an attending provider to induce the provider to provide care to an individual participant or beneficiary in a manner inconsistent with this section.
Written notice of the availability of the coverage must be delivered to the participant upon enrollment and annually thereafter.
History:
1980 c 496 s 1; 1985 c 49 s 41; 1992 c 564 art 1 s 54; 2002 c 330 s 10
2023 Minnesota Statutes › Chapters 59A - 79A — Insurance › Chapter 62A — Accident And Health Insurance › Section 62A.26 — Coverage For Phenylketonuria Treatment.

62A.26 COVERAGE FOR PHENYLKETONURIA TREATMENT.
Subdivision 1.
Scope of coverage.
This section applies to all policies of accident and health insurance, health maintenance contracts regulated under chapter 62D, health benefit certificates offered through a fraternal benefit society regulated under chapter 64B, and group subscriber contracts offered by nonprofit health service plan corporations regulated under chapter 62C, but does not apply to policies designed primarily to provide coverage payable on a per diem, fixed indemnity or nonexpense incurred basis, or policies that provide only accident coverage.
Subd. 2.
Required coverage.
Every policy, plan, certificate, or contract referred to in subdivision 1 issued or renewed after August 1, 1985, must provide coverage for special dietary treatment for phenylketonuria when recommended by a physician.
History:
1985 c 49 s 41; 1Sp1985 c 9 art 2 s 1; 1992 c 564 art 1 s 54
2023 Minnesota Statutes › Chapters 59A - 79A — Insurance › Chapter 62A — Accident And Health Insurance › Section 62A.265 — Coverage For Lyme Disease.

62A.265 COVERAGE FOR LYME DISEASE.
Subdivision 1.
Required coverage.
Every health plan, including a plan providing the coverage specified in section 62A.011, subdivision 3, clause (10), must cover treatment for diagnosed Lyme disease.
Subd. 2.
Special restrictions prohibited.
No health plan included in subdivision 1 may impose a special deductible, co-payment, waiting period, or other special restriction on treatment for Lyme disease that the health plan does not apply to nonpreventive treatment in general.
History:
1996 c 465 art 5 s 2
2023 Minnesota Statutes › Chapters 59A - 79A — Insurance › Chapter 62A — Accident And Health Insurance › Section 62A.27 — Coverage Of Adopted Children.

62A.27 COVERAGE OF ADOPTED CHILDREN.
(a) A health plan that provides coverage to a Minnesota resident must cover adopted children of the insured, subscriber, participant, or enrollee on the same basis as other dependents. Consequently, the plan shall not contain any provision concerning preexisting condition limitations, insurability, eligibility, or health underwriting approval concerning children placed for adoption with the participant.
(b) The coverage required by this section is effective from the date of placement for adoption. For purposes of this section, placement for adoption means the assumption and retention by a person of a legal obligation for total or partial support of a child in anticipation of adoption of the child. The child's placement with a person terminates upon the termination of the legal obligation for total or partial support.
(c) For the purpose of this section, health plan includes:
(1) coverage offered by community integrated service networks;
(2) coverage that is designed solely to provide dental or vision care; and
(3) any plan under the federal Employee Retirement Income Security Act of 1974 (ERISA), United States Code, title 29, sections 1001 to 1461.
(d) No policy or contract covered by this section may require notification to a health carrier as a condition for this dependent coverage. However, if the policy or contract mandates an additional premium for each dependent, the health carrier is entitled to all premiums that would have been collected had the health carrier been aware of the additional dependent. The health carrier may withhold payment of any health benefits for the new dependent until it has been compensated with the applicable premium which would have been owed if the health carrier had been informed of the additional dependent immediately.
History:
1983 c 56 s 1; 1985 c 49 s 41; 1987 c 337 s 53; 1988 c 656 s 4; 1995 c 207 art 10 s 4; 1997 c 225 art 2 s 62; 2003 c 2 art 1 s 7; 2006 c 255 s 11
2023 Minnesota Statutes › Chapters 59A - 79A — Insurance › Chapter 62A — Accident And Health Insurance › Section 62A.28 — Coverage For Scalp Hair Prostheses.

62A.28 COVERAGE FOR SCALP HAIR PROSTHESES.
Subdivision 1.
Scope of coverage.
This section applies to all policies of accident and health insurance, health maintenance contracts regulated under chapter 62D, health benefit certificates offered through a fraternal benefit society regulated under chapter 64B, and group subscriber contracts offered by nonprofit health service plan corporations regulated under chapter 62C. This section does not apply to policies designed primarily to provide coverage payable on a per diem, fixed indemnity or nonexpense incurred basis, or policies that provide only accident coverage.
Subd. 2.
Required coverage.
Every policy, plan, certificate, or contract referred to in subdivision 1 issued or renewed after August 1, 1987, must provide coverage for scalp hair prostheses worn for hair loss suffered as a result of alopecia areata.
The coverage required by this section is subject to the co-payment, coinsurance, deductible, and other enrollee cost-sharing requirements that apply to similar types of items under the policy, plan, certificate, or contract and may be limited to one prosthesis per benefit year.
History:
1987 c 202 s 1; 1992 c 564 art 1 s 54; 2004 c 288 art 7 s 1; 2013 c 84 art 1 s 22
2023 Minnesota Statutes › Chapters 59A - 79A — Insurance › Chapter 62A — Accident And Health Insurance › Section 62A.285 — Prohibited Underwriting; Breast Implants.

62A.285 PROHIBITED UNDERWRITING; BREAST IMPLANTS.
Subdivision 1.
Scope of coverage.
This section applies to all policies of accident and health insurance regulated under this chapter, subscriber contracts offered by nonprofit health service plan corporations regulated under chapter 62C, health maintenance contracts regulated under chapter 62D, and health benefit certificates offered through a fraternal benefit society regulated under chapter 64B. This section does not apply to policies, plans, certificates, or contracts payable on a fixed indemnity or non-expense-incurred basis, or policies, plans, certificates, or contracts that provide only accident coverage.
Subd. 2.
Required coverage.
No policy, plan, certificate, or contract referred to in subdivision 1 shall be issued or renewed to provide coverage to a Minnesota resident if it provides an exclusion, reduction, or other limitation as to coverage, deductible, coinsurance, or co-payment applicable solely to conditions caused by breast implants.
Subd. 3.
Refusal to issue or renew.
No issuer of a policy, plan, certificate, or contract referred to in subdivision 1 shall refuse to issue or renew at standard premium rates a policy, plan, certificate, or contract referred to in subdivision 1 solely because the prospective insured or enrollee has breast implants.
Subd. 4.
[Repealed, 2000 c 483 s 55]
History:
1992 c 564 art 4 s 8
2023 Minnesota Statutes › Chapters 59A - 79A — Insurance › Chapter 62A — Accident And Health Insurance › Section 62A.3021 — Coverage Of Dependents By Plans Other Than Health Plans.

62A.3021 COVERAGE OF DEPENDENTS BY PLANS OTHER THAN HEALTH PLANS.
Subdivision 1.
Scope of coverage.
This section applies to coverage described in section 62A.011, subdivision 3, clauses (4), (6), (7), (8), (9), and (10).
Subd. 2.
Dependent.
"Dependent" means an eligible employee's spouse, unmarried child who is under the age of 25, dependent child of any age who is disabled and who meets the eligibility criteria in section 62A.14, subdivision 2, or any other person whom state or federal law requires to be treated as a dependent for purposes of health plans. For the purpose of this definition, a child includes a child for whom the employee or the employee's spouse has been appointed legal guardian and an adoptive child as provided in section 62A.27. A child also includes grandchildren as provided in section 62A.042 with continued eligibility of grandchildren as provided in section 62A.302, subdivision 4.
History:
2013 c 84 art 1 s 24