reglab/statecodes huggingface dataset:
2023 Minnesota Statutes › Chapters 59A - 79A — Insurance › Chapter 62A — Accident And Health Insurance › Section 62A.4524 — Officer's And Employee's Fidelity Bond.

62A.4524 OFFICER'S AND EMPLOYEE'S FIDELITY BOND.
(a) A prepaid limited health service organization shall maintain in force a fidelity bond in its own name on its officers and employees in an amount not less than $20,000,000 or in any other amount prescribed by the commissioner. Except as otherwise provided by this paragraph, the bond must be issued by an insurance company that is licensed to do business in this state or, if the fidelity bond required by this paragraph is not available from an insurance company that holds a certificate of authority in this state, a fidelity bond procured by a licensed surplus lines agent resident in this state in compliance with sections 60A.195 to 60A.2095 satisfies the requirements of this paragraph.
(b) In lieu of the bond specified in paragraph (a), a prepaid limited health service organization may deposit with the commissioner cash or securities or other investments of the types set forth in section 62A.4521. Such a deposit must be maintained by the commissioner in the amount and subject to the same conditions required for a bond under this paragraph.
History:
2005 c 17 art 2 s 15
2023 Minnesota Statutes › Chapters 59A - 79A — Insurance › Chapter 62A — Accident And Health Insurance › Section 62A.4525 — Reports.

62A.4525 REPORTS.
(a) Every prepaid limited health service organization shall file with the commissioner annually, on or before April 1, a report verified by at least two principal officers covering the preceding calendar year.
(b) The report must be on forms prescribed by the commissioner and must include:
(1) a financial statement of the organization, including its balance sheet, income statement, and statement of changes in financial position for the preceding year, certified by an independent public accountant, or a consolidated audited financial statement of its parent company certified by an independent public accountant, attached to which must be consolidating financial statements of the prepaid limited health service organization;
(2) the number of subscribers at the beginning of the year, the number of subscribers at the end of the year, and the number of enrollments terminated during the year; and
(3) such other information relating to the performance of the organization as is necessary to enable the commissioner to carry out the commissioner's duties under sections 62A.451 to 62A.4528.
(c) The commissioner may require more frequent reports containing information necessary to enable the commissioner to carry out the commissioner's duties under sections 62A.451 to 62A.4528.
(d) The commissioner may suspend the organization's certificate of authority pending the proper filing of the required report by the organization.
History:
2005 c 17 art 2 s 16
2023 Minnesota Statutes › Chapters 59A - 79A — Insurance › Chapter 62A — Accident And Health Insurance › Section 62A.4527 — Penalties.

62A.4527 PENALTIES.
In lieu of any penalty specified elsewhere in sections 62A.451 to 62A.4528, or when no penalty is specifically provided, whenever a prepaid limited health service organization or other person, corporation, partnership, or entity subject to those sections has been found, pursuant to chapter 14, to have violated any provision of sections 62A.451 to 62A.4528, the commissioner may:
(1) issue and cause to be served upon the organization, person, or entity charged with the violation a copy of the findings and an order requiring the organization, person, or entity to cease and desist from engaging in the act or practice that constitutes the violation; and
(2) impose a monetary penalty of not more than $1,000 for each violation, but not to exceed an aggregate penalty of $10,000.
History:
2005 c 17 art 2 s 18
2023 Minnesota Statutes › Chapters 59A - 79A — Insurance › Chapter 62A — Accident And Health Insurance › Section 62A.4528 — Rehabilitation, Conservation, Or Liquidation.

62A.4528 REHABILITATION, CONSERVATION, OR LIQUIDATION.
(a) Any rehabilitation, conservation, or liquidation of a prepaid limited health service organization must be deemed to be the rehabilitation, conservation, or liquidation of an insurance company and must be conducted under chapter 60B.
(b) A prepaid limited health service organization is not subject to the laws and rules governing insurance insolvency guaranty funds, nor shall any insurance insolvency guaranty fund provide protection to individuals entitled to receive limited health services from a prepaid limited health service organization.
History:
2005 c 17 art 2 s 19
2023 Minnesota Statutes › Chapters 59A - 79A — Insurance › Chapter 62A — Accident And Health Insurance › Section 62A.49 — Home Care Services Coverage.

62A.49 HOME CARE SERVICES COVERAGE.
Subdivision 1.
Generally.
Section 62A.48 does not prohibit the sale of policies, certificates, subscriber contracts, or other evidences of coverage that provide home care services only. Home care services only policies may be sold, provided that they meet the requirements set forth in sections 62A.46 to 62A.56, except that they do not have to meet those conditions that relate to long-term care in nursing facilities. Disclosures and representations regarding these policies must be adjusted accordingly to remove references to coverage for nursing home care.
Subd. 2.
Provider networks and managed care.
Home health care services issued pursuant to this section may be provided through a limited provider network and may employ managed care practices. If these methods are used, they must be adequately disclosed within the policy and any advertisements or representations regarding coverage. Policies may not be sold in areas where there are not sufficient providers to meet the needs of the policyholders located in that area.
Subd. 3.
Prohibited limitations.
A long-term care insurance policy or certificate shall not, if it provides benefits for home health care or community care services, limit or exclude benefits by:
(1) requiring that the insured would need care in a skilled nursing facility if home health care services were not provided;
(2) requiring that the insured first or simultaneously receive nursing or therapeutic services in a home, community, or institutional setting before home health care services are covered;
(3) limiting eligible services to services provided by a registered nurse or licensed practical nurse;
(4) requiring that a nurse or therapist provide services covered by the policy that can be provided by a home health aide or other licensed or certified home care worker acting within the scope of licensure or certification;
(5) excluding coverage for personal care services provided by a home health aide;
(6) requiring that the provision of home health care services be at a level of certification or licensure greater than that required by the eligible service;
(7) requiring that the insured have an acute condition before home health care services are covered;
(8) limiting benefits to services provided by Medicare-certified agencies or providers;
(9) excluding coverage for adult day care services; or
(10) excluding coverage based upon location or type of residence in which the home health care services would be provided.
History:
1994 c 485 s 32; 1996 c 446 art 1 s 38; 1Sp2003 c 14 art 2 s 4
2023 Minnesota Statutes › Chapters 59A - 79A — Insurance › Chapter 62A — Accident And Health Insurance › Section 62A.52 — Review Of Plan Of Care.

62A.52 REVIEW OF PLAN OF CARE.
The insurer may review an insured's plan of care at reasonable intervals, but not more frequently than once every 30 days.
History:
1986 c 397 s 6
2023 Minnesota Statutes › Chapters 59A - 79A — Insurance › Chapter 62A — Accident And Health Insurance › Section 62A.54 — Prohibited Practices.

62A.54 PROHIBITED PRACTICES.
Unless otherwise provided for in sections 62A.46 to 62A.56, the solicitation or sale of long-term care policies is subject to the requirements and penalties applicable to the sale of Medicare supplement insurance policies as set forth in sections 62A.3099 to 62A.44.
It is misconduct for any agent or company to make any misstatements concerning eligibility or coverage under the medical assistance program, or about how long-term care costs will or will not be financed if a person does not have long-term care insurance. Any agent or company providing information on the medical assistance program shall also provide information about how to contact the county human services department or the state Department of Human Services.
History:
1986 c 397 s 7; 1988 c 689 art 2 s 10; 1992 c 564 art 1 s 33; 2005 c 17 art 1 s 14
2023 Minnesota Statutes › Chapters 59A - 79A — Insurance › Chapter 62A — Accident And Health Insurance › Section 62A.56 — Rulemaking.

62A.56 RULEMAKING.
Subdivision 1.
Permissive.
The commissioner may adopt rules pursuant to chapter 14 to carry out the purposes of sections 62A.46 to 62A.56. The rules may:
(1) establish additional disclosure requirements for long-term care policies designed to adequately inform the prospective insured of the need and extent of coverage offered;
(2) prescribe uniform policy forms in order to give the purchaser of long-term care policies a reasonable opportunity to compare the cost of insuring with various insurers; and
(3) establish other reasonable minimum standards as needed to further the purposes of sections 62A.46 to 62A.56.
Subd. 2.
Mandatory.
The commissioner shall adopt rules under chapter 14 establishing general standards to ensure that assessments used in the prescribing of long-term care are reliable, valid, and clinically appropriate.
History:
1986 c 397 s 8; 1990 c 551 s 8
2023 Minnesota Statutes › Chapters 59A - 79A — Insurance › Chapter 62A — Accident And Health Insurance › Section 62A.60 — Retroactive Denial Of Expenses.

62A.60 RETROACTIVE DENIAL OF EXPENSES.
In cases where the subscriber or insured is liable for costs beyond applicable co-payments or deductibles, no insurer may retroactively deny payment to a person who is covered when the services are provided for health care services that are otherwise covered, if the insurer or its representative failed to provide prior or concurrent review or authorization for the expenses when required to do so under the policy, plan, or certificate. If prior or concurrent review or authorization was provided by the insurer or its representative, and the preexisting condition limitation provision, the general exclusion provision and any other coinsurance, or other policy requirements have been met, the insurer may not deny payment for the authorized service or time period except in cases where fraud or substantive misrepresentation occurred.
History:
1989 c 330 s 20; 1996 c 446 art 1 s 39
2023 Minnesota Statutes › Chapters 59A - 79A — Insurance › Chapter 62A — Accident And Health Insurance › Section 62A.61 — Disclosure Of Methods Used By Health Carriers To Determine Usual And Customary Fees.

62A.61 DISCLOSURE OF METHODS USED BY HEALTH CARRIERS TO DETERMINE USUAL AND CUSTOMARY FEES.
(a) A health carrier that bases reimbursement to health care providers upon a usual and customary fee must maintain in its office a copy of a description of the methodology used to calculate fees including at least the following:
(1) the frequency of the determination of usual and customary fees;
(2) a general description of the methodology used to determine usual and customary fees; and
(3) the percentile of usual and customary fees that determines the maximum allowable reimbursement.
(b) A health carrier must provide a copy of the information described in paragraph (a) to the commissioner of health or the commissioner of commerce, upon request.
(c) The commissioner of health or the commissioner of commerce, as appropriate, may use to enforce this section any enforcement powers otherwise available to the commissioner with respect to the health carrier. The commissioner of health or commerce, as appropriate, may require health carriers to provide the information required under this section and may use any powers granted under other laws relating to the regulation of health carriers to enforce compliance.
(d) For purposes of this section, "health carrier" has the meaning given in section 62A.011.
(e) "Usual and customary" means the normal charge, in the absence of insurance, of the provider for a service or article, but not more than the prevailing charge in the area for like service or article. A "like service" is the same nature and duration, requires the same skill, and is performed by a provider of similar training and experience. A "like article" is one that is identically or substantially equivalent. "Area" means the municipality or, in the case of a large city, a subdivision of the city, in which the service or article is actually provided or a greater area as is necessary to obtain a representative cross-section of charges for like service or article.
History:
1993 c 345 art 8 s 3; 1997 c 225 art 2 s 5; 1999 c 177 s 40
2023 Minnesota Statutes › Chapters 59A - 79A — Insurance › Chapter 62A — Accident And Health Insurance › Section 62A.616 — Coverage For Nursing Home Care For Terminally Ill And Other Services.

62A.616 COVERAGE FOR NURSING HOME CARE FOR TERMINALLY ILL AND OTHER SERVICES.
An insurer may offer a health plan that covers nursing home care for the terminally ill, personal care attendants, and hospice care. For the purposes of this section, "terminally ill" means a diagnosis certified by a physician that a person has less than six months to live.
History:
1995 c 258 s 36
2023 Minnesota Statutes › Chapters 59A - 79A — Insurance › Chapter 62A — Accident And Health Insurance › Section 62A.63 — Definitions.

62A.63 DEFINITIONS.
Subdivision 1.
Application.
For purposes of section 62A.64, the terms defined in this section have the meanings given them.
Subd. 2.
Health care provider.
"Health care provider" means a person, hospital, or health care facility, organization, or corporation that is licensed, certified, or otherwise authorized by the laws of this state to provide health care.
Subd. 3.
Insurer.
"Insurer" means a health insurer regulated under this chapter, service plan corporation as defined under section 62C.02, subdivision 6, and health maintenance organization as defined under section 62D.02, subdivision 4.
History:
1991 c 109 s 1
2023 Minnesota Statutes › Chapters 59A - 79A — Insurance › Chapter 62A — Accident And Health Insurance › Section 62A.64 — Health Insurance; Prohibited Agreements.

62A.64 HEALTH INSURANCE; PROHIBITED AGREEMENTS.
An agreement between an insurer and a health care provider may not:
(1) prohibit, or grant the insurer an option to prohibit, the provider from contracting with other insurers or payors to provide services at a lower price than the payment specified in the contract;
(2) require, or grant the insurer an option to require, the provider to accept a lower payment in the event the provider agrees to provide services to any other insurer or payor at a lower price; or
(3) require, or grant the insurer an option of, termination or renegotiation of the existing contract in the event the provider agrees to provide services to any other insurer or payor at a lower price.
History:
1991 c 109 s 2
2023 Minnesota Statutes › Chapters 59A - 79A — Insurance › Chapter 62B — Credit Insurance › Section 62B.01 — Scope.

62B.01 SCOPE.
All life insurance, accident and health insurance, and involuntary unemployment insurance in connection with loan or other credit transactions are subject to sections 62B.01 to 62B.14, except life, accidental death, and disability insurance written in connection with first real estate mortgage loans. Insurance is not subject to sections 62B.01 to 62B.14 where its issuance is an isolated transaction on the part of the insurer not related to an agreement or a plan for insuring debtors of the creditor. Credit life, credit accident and health, and credit involuntary unemployment insurance provided at no additional cost to the borrower are not subject to sections 62B.01 to 62B.14.
History:
Ex1967 c 2 s 1; 1989 c 330 s 21; 1993 c 343 s 8; 2002 c 307 art 2 s 2
2023 Minnesota Statutes › Chapters 59A - 79A — Insurance › Chapter 62B — Credit Insurance › Section 62B.02 — Definitions.

62B.02 DEFINITIONS.
Subdivision 1.
Scope.
For the purpose of sections 62B.01 to 62B.14 the following terms have the meanings given to them in this section.
Subd. 2.
Credit life insurance.
"Credit life insurance" means insurance on the life of a debtor pursuant to or in connection with a specific loan or other credit transaction.
Subd. 3.
Credit accident and health insurance.
"Credit accident and health insurance" means insurance on a debtor to provide indemnity for payments becoming due on a specific loan or other credit transaction while the debtor is disabled as defined in the policy.
Subd. 3a.
Credit involuntary unemployment insurance.
"Credit involuntary unemployment insurance" means insurance on a debtor in connection with a specified loan or other credit transaction to provide payment to a creditor in the event of involuntary unemployment of the debtor for the installment payments or other periodic payments becoming due while the debtor is involuntarily unemployed.
Subd. 4.
Creditor.
"Creditor" means the lender of money or vendor or lessor of goods, services, or property, rights or privileges, for which payment is arranged through a credit transaction, or successor to the right, title or interest of a lender, vendor, or lessor, and an affiliate, associate or subsidiary of them, director, officer or employee of them or any other person in any way associated with them.
Subd. 5.
Debtor.
"Debtor" means a borrower of money or a purchaser or lessee of goods, services, property, rights or privileges for which payment is arranged through a credit transaction.
Subd. 6.
Indebtedness.
"Indebtedness" means the total amount payable by a debtor to a creditor in connection with a loan or other credit transaction.
Subd. 7.
Commissioner.
"Commissioner" means the commissioner of commerce.
History:
Ex1967 c 2 s 2; 1983 c 289 s 114 subd 1; 1984 c 655 art 1 s 92; 1993 c 343 s 9
2023 Minnesota Statutes › Chapters 59A - 79A — Insurance › Chapter 62B — Credit Insurance › Section 62B.03 — Forms Of Credit Life Insurance, Credit Accident And Health Insurance, And Credit Involuntary Unemployment Insurance.

62B.03 FORMS OF CREDIT LIFE INSURANCE, CREDIT ACCIDENT AND HEALTH INSURANCE, AND CREDIT INVOLUNTARY UNEMPLOYMENT INSURANCE.
Credit life insurance, credit accident and health insurance, and credit involuntary unemployment insurance shall be issued only in the following forms:
(1) individual policies of life insurance issued to debtors on the term plan;
(2) individual policies of accident and health insurance issued to debtors on a term plan or disability benefit provisions in individual policies of credit life insurance;
(3) individual policies of involuntary unemployment insurance issued to debtors on the term plan;
(4) group policies of life insurance issued to creditors providing insurance upon the lives of debtors on the term plan;
(5) group policies of accident and health insurance issued to creditors on a term plan insuring debtors or disability benefit provisions in group credit life insurance policies to provide such coverage;
(6) group policies of involuntary unemployment insurance issued to creditors on a term plan insuring debtors.
History:
Ex1967 c 2 s 3; 1993 c 343 s 10
2023 Minnesota Statutes › Chapters 59A - 79A — Insurance › Chapter 62B — Credit Insurance › Section 62B.05 — Term Of Credit Insurance.

62B.05 TERM OF CREDIT INSURANCE.
The term of any credit life insurance, credit accident and health insurance, or credit involuntary unemployment insurance shall, subject to acceptance by the insurer, commence on the date when the debtor becomes obligated to the creditor, except that, where a group policy provides coverage with respect to existing obligations, the insurance on a debtor with respect to the indebtedness shall commence on the effective date of the policy. Where evidence of insurability is required and the evidence is furnished more than 30 days after the date when the debtor becomes obligated to the creditor, the term of the insurance may commence on the date on which the insurance company determines the evidence to be satisfactory, and in that event there shall be an appropriate refund or adjustment of any charge to the debtor for insurance. The term of the insurance shall not extend more than 15 days beyond the scheduled maturity date of the indebtedness except when extended without additional cost to the debtor.
If an indebtedness is prepaid in full before its scheduled maturity, except by performance of the insurer's obligation under the policy, the insurance shall be deemed canceled and a refund shall be paid or credited as provided in section 62B.08. Upon prepayment in full, the creditor shall make the refund of unearned premium, unless the credit insurance was originated by a third party, in which case the creditor shall promptly notify the third party who shall make the refund.
History:
Ex1967 c 2 s 5; 1977 c 382 s 4; 1978 c 641 s 1; 1Sp1985 c 10 s 61; 1986 c 455 s 87; 1993 c 343 s 12
2023 Minnesota Statutes › Chapters 59A - 79A — Insurance › Chapter 62B — Credit Insurance › Section 62B.09 — Issuance Of Policies.

62B.09 ISSUANCE OF POLICIES.
Subdivision 1.
Regulation.
Policies of credit life insurance and credit accident and health insurance shall be delivered or issued for delivery in this state only by an insurer authorized to do an insurance business in this state and shall be issued only through holders of licenses or authorizations issued by the commissioner.
Subd. 2.
Characterization of premiums.
The premiums for individual policies of credit life or credit accident and health insurance issued to debtors or the cost to debtors under group policies of credit life or credit accident and health insurance issued to creditors, whether or not written by or through any lender or other creditor, its affiliate, associate or subsidiary or a director, officer or employee of any of them, shall not be deemed interest or charges nor consideration or any amount whatsoever for any examination, service, brokerage, commission, compensation for services, incidental expenses or other thing or otherwise, in addition to or in excess of permitted interest or charges in connection with the loan or credit transaction. Any gain, participation or advantage to any lender or other creditor, its affiliate, associates or subsidiary or to a director, officer or employee of any of them arising out of such premium or cost by way of commission, dividend or otherwise, shall not be deemed interest or charges nor consideration or any amount whatsoever for any examination, service, brokerage, commission, compensation for services, incidental expenses or other thing or otherwise, in addition to or in excess of permitted interest or charges in connection with the loan or credit transaction.
Subd. 3.
Creditor's authority.
Any creditor doing business in the state of Minnesota may, in the same office or place of business where such creditor transacts business, take applications or enrollments for credit life insurance, credit accident and health insurance, or credit involuntary unemployment insurance upon a borrower or purchaser or one of them if there are two or more in connection with the making of a loan or sale.
History:
Ex1967 c 2 s 9; 1993 c 343 s 23
2023 Minnesota Statutes › Chapters 59A - 79A — Insurance › Chapter 62B — Credit Insurance › Section 62B.10 — Claims.

62B.10 CLAIMS.
Subdivision 1.
Handling.
All claims shall be promptly reported to the insurer or its designated claim representative, and the insurer shall maintain adequate claim files. Claims shall be settled as soon as possible and in accordance with the terms of the insurance contract.
Subd. 2.
Payment.
All claims shall be paid either by draft drawn upon the insurer or by check of the insurer to the order of the claimant to whom payment of the claim is due pursuant to the policy provisions, or upon direction of the claimant to one specified.
Subd. 3.
Settlement or adjustment.
No plan or arrangement shall be used whereby any person, firm or corporation other than the insurer or its designated claim representative shall be authorized to settle or adjust claims. The creditors shall not be designated as claim representative for the insurer in adjusting claims; provided, that a group policyholder may, by arrangement with the group insurer, draw drafts or checks in payment of claims due to the group policyholder subject to audit and review by the insurer.
History:
Ex1967 c 2 s 10
2023 Minnesota Statutes › Chapters 59A - 79A — Insurance › Chapter 62B — Credit Insurance › Section 62B.11 — Existing Insurance; Choice Of Insurer.

62B.11 EXISTING INSURANCE; CHOICE OF INSURER.
When credit life insurance, credit accident and health insurance, or credit involuntary unemployment insurance is required as additional security for any indebtedness, the debtor shall, upon request to the creditor, have the option of furnishing the required amount of insurance through existing policies of insurance owned or controlled by the debtor or of procuring and furnishing the required coverage through any insurer authorized to transact an insurance business within this state.
History:
Ex1967 c 2 s 11; 1986 c 444; 1993 c 343 s 24
2023 Minnesota Statutes › Chapters 59A - 79A — Insurance › Chapter 62B — Credit Insurance › Section 62B.12 — Rulemaking.

62B.12 RULEMAKING.
The commissioner may, after notice and hearing, issue rules the commissioner deems appropriate for the supervision of sections 62B.01 to 62B.14. The commissioner shall promulgate rules to establish rates for credit involuntary unemployment insurance prior to its issuance, and to enact the other provisions of Laws 1993, chapter 343, and the commissioner shall report by February 15, 1994, to the house of representatives Committee on Financial Institutions and Insurance and to the senate Commerce and Consumer Protection Committee on the rules or status of the rulemaking, including the expected loss ratio. The commissioner is not obligated to promulgate a rule unless and until four or more insurers who plan to write credit involuntary unemployment insurance in Minnesota agree to pay for the cost of the promulgation of any rules authorized by this section. Companies selling credit involuntary unemployment insurance shall be assessed by the department to pay the costs of rulemaking.
Moneys collected pursuant to this provision must be deposited in the state treasury and credited to a special account and are appropriated to the commissioner for the rulemaking purposes authorized by this section.
For the purposes of this chapter, any insurer authorized to offer the coverage specified by section 60A.06, subdivision 1, clause (1) or (4), shall be authorized to sell credit involuntary unemployment insurance pursuant to this chapter.
History:
Ex1967 c 2 s 12; 1985 c 248 s 70; 1986 c 444; 1993 c 343 s 25; 1994 c 425 s 11
2023 Minnesota Statutes › Chapters 59A - 79A — Insurance › Chapter 62B — Credit Insurance › Section 62B.13 — Judicial Review.

62B.13 JUDICIAL REVIEW.
Any party to the proceeding affected by an order of the commissioner shall be entitled to judicial review in accordance with chapter 14.
History:
Ex1967 c 2 s 13; 1982 c 424 s 130
2023 Minnesota Statutes › Chapters 59A - 79A — Insurance › Chapter 62B — Credit Insurance › Section 62B.14 — Penalties.

62B.14 PENALTIES.
In addition to any other penalty provided by law, any person, firm or corporation which violates an order of the commissioner after it has become final, and while it is in effect, shall, upon proof thereof to the satisfaction of the court, forfeit and pay to the state a sum not to exceed $250 which may be recovered in a civil action, except that if the violation is found to be willful, the amount of the penalty shall be a sum not to exceed $1,000. The commissioner may revoke or suspend the license or certificate of authority of the person, firm or corporation guilty of such violation. Such order for suspension or revocation shall be upon notice and hearing, and shall be subject to judicial review as provided in section 62B.13.
History:
Ex1967 c 2 s 14; 1986 c 444
2023 Minnesota Statutes › Chapters 59A - 79A — Insurance › Chapter 62C — Nonprofit Health Service Plan Corporations › Section 62C.01 — Nonprofit Health Service Plan Corporations Act.

62C.01 NONPROFIT HEALTH SERVICE PLAN CORPORATIONS ACT.
Subdivision 1.
Citation.
Sections 62C.01 to 62C.23 may be cited as the "Nonprofit Health Service Plan Corporations Act."
Subd. 2.
Purpose.
It is the purpose and intent of Laws 1971, chapter 568 to promote a wider, more economical and timely availability of hospital, medical-surgical, dental, and other health services for the people of Minnesota, through nonprofit, prepaid health service plans, and thereby advance public health and the art and science of medical and health care within the state, while reasonably regulating the formation, continuation, operation, and termination of such service plans by establishment and enforcement of reasonable and practical standards of administration, investments, surplus and reserves.
Subd. 3.
Scope.
Every foreign or domestic nonprofit corporation organized for the purpose of establishing or operating a health service plan in Minnesota whereby health services are provided to subscribers to the plan under a contract with the corporation shall be subject to and governed by Laws 1971, chapter 568, and shall not be subject to the laws of this state relating to insurance, except the gross premiums tax provisions contained in chapter 297I and as otherwise specifically provided. Laws 1971, chapter 568 shall apply to all health service plan corporations incorporated after August 1, 1971, and to all existing health service plan corporations, except as otherwise provided. Nothing in sections 62C.01 to 62C.23 shall apply to prepaid group practice plans. A prepaid group practice plan is any plan or arrangement other than a service plan, whereby health services are rendered to certain patients by providers who devote their professional effort primarily to members or patients of the plan, and whereby the recipients of health services pay for the services on a regular, periodic basis, not on a fee for service basis.
History:
1971 c 568 s 1; 1992 c 549 art 9 s 3; 2000 c 394 art 2 s 13
2023 Minnesota Statutes › Chapters 59A - 79A — Insurance › Chapter 62C — Nonprofit Health Service Plan Corporations › Section 62C.02 — Definitions.

62C.02 DEFINITIONS.
Subdivision 1.
Scope.
For the purposes of sections 62C.01 to 62C.23 the terms defined in this section have the meanings given them.
Subd. 2.
Commissioner.
"Commissioner" means the commissioner of commerce or a person duly designated to act in the commissioner's place.
Subd. 3.
Health service.
"Health service" means any service or class of services, supply, drug, or equipment provided to an individual for diagnosis, relief, or treatment of an injury, ailment, or bodily condition.
Subd. 4.
Subscriber.
"Subscriber" means a person covered under a subscriber contract for health services to the extent therein described.
Subd. 5.
Provider.
"Provider" means an institution, organization, or person that furnishes health services either directly or pursuant to a prescription or directive from a person licensed by the state to make such a prescription or directive.
Subd. 6.
Service plan corporation.
"Service plan corporation" means a foreign or domestic nonprofit corporation which contracts for health service or payment therefor for subscribers pursuant to a service plan, in exchange for periodic prepayments by or on behalf of subscribers. An "existing corporation" means a service plan association or corporation legally in existence on August 1, 1971, and authorized to do business in this state on that date.
Subd. 7.
Service plan.
"Service plan" means any program or other method whereby a service plan corporation, for a consideration, contracts for provision of health service to subscribers by providers who have entered service agreements with the service plan corporation or which provides for reimbursement to the subscriber for health service provided by providers who have not entered service agreements with the service plan corporation.
Subd. 8.
Service agreement.
"Service agreement" means an agreement, contract or other arrangement between a service plan corporation and a provider under which the provider agrees that when health services are provided for a subscriber the provider shall not make a direct charge against the subscriber for those services or parts of services which are covered by the subscriber's contract, but shall look to the service plan corporation for the payment for covered services, to the extent they are covered.
Subd. 9.
Subscriber contract.
"Subscriber contract" means a contract, agreement, or other arrangement between a service plan corporation and its subscriber under the terms and conditions of which health service or reimbursement therefor is provided to the subscriber.
Subd. 10.
Participating provider.
"Participating provider" means a provider who is party to a service agreement with a service plan corporation.
History:
1971 c 568 s 2; 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 62C — Nonprofit Health Service Plan Corporations › Section 62C.03 — Service Plan Corporations Authorized.

62C.03 SERVICE PLAN CORPORATIONS AUTHORIZED.
Subdivision 1.
General authority.
A service plan corporation may be organized to establish, maintain and operate a service plan providing health services in their entirety or in part, according to the subscriber contract. No subscriber's contract shall provide for payment of cash indemnification by the corporation to the subscriber or the subscriber's estate for death, illness, or other injury, except as provided by Laws 1971, chapter 568 as it relates to nonparticipating providers. In the event that the subscriber compensates the provider for services received the subscriber is subrogated to the provider's right against the service plan.
Subd. 2.
Contracting authority.
A service plan corporation may enter other contracts, arrangements, or agreements as provided in Laws 1971, chapter 568, to carry out the intent and purpose of Laws 1971, chapter 568.
Subd. 3.
Health services by nonparticipating providers.
A service plan corporation may provide for health services by nonparticipating providers in cases of emergency or expediency, or when selected in accordance with the subscriber's contract. When health service is provided out of state, the provider must be duly licensed, registered, and authorized to provide the service where provided.
History:
1971 c 568 s 3; 1986 c 444
2023 Minnesota Statutes › Chapters 59A - 79A — Insurance › Chapter 62C — Nonprofit Health Service Plan Corporations › Section 62C.04 — Organization.

62C.04 ORGANIZATION.
Subdivision 1.
Incorporated as nonprofit.
Except as otherwise expressly provided, a service plan corporation organized after August 1, 1971 shall be incorporated under and subject to chapter 317A, as it may be amended, and in addition shall have, to the extent provided in its articles of incorporation, all powers and duties provided by Laws 1971, chapter 568 for service plan corporations. A service plan corporation may be incorporated by not less than three legal residents of this state.
Subd. 2.
Existing corporations.
An existing corporation shall be deemed a service plan corporation under Laws 1971, chapter 568, subject to all of its terms and conditions, shall receive a certificate of authority from the commissioner, and shall not be required to obtain new licenses for its agents and representatives. However, any existing service plan corporation shall, within 30 days after the first annual meeting of the corporation following August 1, 1971, amend its articles and bylaws to the extent necessary to conform to and be governed by Laws 1971, chapter 568 and chapter 317A and file said articles and bylaws for approval and filing in accordance with Laws 1971, chapter 568. If any service plan corporation fails to meet these requirements the commissioner may suspend without a hearing its certificate of authority until the requirements of Laws 1971, chapter 568 have been fully met.
Subd. 3.
Regulation of name.
No service plan corporation shall include within its name the words "insurance," "casualty," "surety," "mutual," "indemnity," or any other words descriptive of the insurance, casualty, or surety business. No service plan corporation shall have a name, mark or symbol which is the same as, or deceptively similar to, the name of any other domestic corporation.
Subd. 4.
Combination of health services.
A service plan corporation may be organized to provide for a combination of health services and an existing corporation may so provide by amendment of its articles of incorporation, or by merger, consolidation, or joint operating arrangements with another service plan corporation. All such actions taken shall be subject to the provisions of chapter 317A, and to the approval of the commissioner for protection of the public and subscribers. If the commissioner denies approval an appeal may be made to the Ramsey County District Court for review de novo of all matters relevant to the proposed combination.
History:
1971 c 568 s 4; 1989 c 304 s 137
2023 Minnesota Statutes › Chapters 59A - 79A — Insurance › Chapter 62C — Nonprofit Health Service Plan Corporations › Section 62C.05 — Articles Of Incorporation; Bylaws.

62C.05 ARTICLES OF INCORPORATION; BYLAWS.
Subdivision 1.
Required conformance.
The articles of incorporation and bylaws of any service plan corporation and any amendments thereto shall conform to the requirements of Laws 1971, chapter 568 and chapter 317A.
Subd. 2.
Specified statements in articles.
In addition to meeting the requirements of chapter 317A, the articles of incorporation of a service plan corporation shall clearly state its purposes in strict conformity with Laws 1971, chapter 568 and that subscribers' contracts shall not restrict the subscribers' freedom in selecting a provider in a particular class of providers.
History:
1971 c 568 s 5; 1989 c 304 s 137
2023 Minnesota Statutes › Chapters 59A - 79A — Insurance › Chapter 62C — Nonprofit Health Service Plan Corporations › Section 62C.06 — Approval Of Articles And Bylaws.

62C.06 APPROVAL OF ARTICLES AND BYLAWS.
Subdivision 1.
Commissioner's review and approval.
Proposed articles, bylaws or amendments thereto must be approved by the commissioner. The proposed articles, bylaws or amendments shall be submitted to the commissioner in triplicate. One copy shall be promptly returned endorsed by the commissioner to show the date of receipt. Failure of the commissioner to approve or disapprove by an order transmitted to the corporation within 30 days of receipt and stating the reasons for any disapproval, shall be deemed approval.
Subd. 2.
Filing.
Upon approval, the corporation shall file the articles or amendment with the secretary of state, together with a copy of the order or an affidavit of an officer of the corporation that no order has been issued and that more than 30 days have expired since submission of the proposed articles or amendment. When the filing fees and charges have been paid as required by law, and the secretary of state determines that the articles or amendments are in acceptable form, the secretary of state shall record them and take any other action provided for by chapter 317A.
Subd. 3.
Certificate of incorporation.
The existence of a service plan corporation hereafter organized shall begin upon issuance of a certificate of incorporation by the secretary of state. Within 14 days after issuance of the certificate, the corporation shall cause to be published once in a qualified newspaper in the county in which it has its registered office, a notice stating the name of the corporation, the date of incorporation, the general nature of its business, the address of its registered office, and the names and addresses of the incorporators and directors. Proof of publication shall be filed with the secretary of state within ten days after publication. If a corporation fails to comply with this subdivision, it shall forfeit $50 to the state.
Subd. 4.
[Repealed, 1984 c 618 s 61]
History:
1971 c 568 s 6; 1976 c 181 s 2; 1986 c 444; 1989 c 304 s 137
2023 Minnesota Statutes › Chapters 59A - 79A — Insurance › Chapter 62C — Nonprofit Health Service Plan Corporations › Section 62C.07 — Directors; Management.

62C.07 DIRECTORS; MANAGEMENT.
Subdivision 1.
Authority and composition.
The articles of incorporation or the bylaws of a service plan corporation shall provide that the authority and responsibility for election of officers and proper and lawful operation of the corporation shall be in a board of not less than 12 directors with powers and authority as necessary for or instrumental to complete execution of the purposes of the corporation as provided by law, its articles and bylaws. The number of directors shall be fixed by the articles or bylaws.
Subd. 2.
Selection.
The directors shall be selected in accordance with the bylaws and at least one-third shall be individuals who are not practicing or engaged in providing health services, and who before their retirement did not practice or engage in providing health services, are not spouses of such persons, and are not employed by or directors of a provider.
History:
1971 c 568 s 7
2023 Minnesota Statutes › Chapters 59A - 79A — Insurance › Chapter 62C — Nonprofit Health Service Plan Corporations › Section 62C.08 — Certificate Of Authority.

62C.08 CERTIFICATE OF AUTHORITY.
Subdivision 1.
Requirement.
No service plan corporation shall enter into subscriber contracts or solicit applications therefor, until it has secured a certificate of authority from the commissioner. Application for a certificate of authority shall be made upon forms prescribed by the commissioner.
Subd. 2.
Granting.
The commissioner may grant a certificate of authority after determining that the applicant is in compliance with Laws 1971, chapter 568 with regard to the applicant's stated purpose, its articles and bylaws and its financial condition, that it has met the filing requirements of Laws 1971, chapter 568 relating to subscribers' contracts and service agreements and that the service plan corporation has knowledgeable, responsible management.
Subd. 3.
Foreign service plan corporation.
A foreign service plan corporation applying for a certificate of authority in this state shall be deemed to be a corporation which is organized under Laws 1971, chapter 568, and such foreign corporation shall be required to meet the same requirements as an existing domestic corporation provided that no foreign corporation shall be denied a certificate of authority because its corporate powers exceed those which are permitted by the laws of this state, although its activities in this state may not exceed the powers of a domestic service plan corporation.
Subd. 4.
Exception.
No certificate of authority shall be required for a foreign service plan corporation whose activities in this state are limited to servicing members of covered groups whose contracts have been issued in another state, or for a foreign service plan corporation whose activities in this state are conducted pursuant to a contract or agreement with a licensed domestic service plan corporation if such contract or agreement is authorized by section 62C.13.
History:
1971 c 568 s 8; 1986 c 444
2023 Minnesota Statutes › Chapters 59A - 79A — Insurance › Chapter 62C — Nonprofit Health Service Plan Corporations › Section 62C.09 — Financial Requirements.

62C.09 FINANCIAL REQUIREMENTS.
Subdivision 1.
Generally.
The commissioner shall not issue a certificate of authority to any service plan corporation hereafter organized unless the corporation has met all legal requirements and, if organized on a capital stock basis unless the corporation has paid up capital stock of not less than $200,000 and an initial surplus of not less than $200,000, or, if organized on a membership basis, unless the corporation has an initial surplus of not less than $400,000.
Subd. 2.
Reserve requirements.
A service plan corporation in existence on August 1, 1971, or hereafter formed shall establish and maintain reserves for claims in process, incomplete and unreported claims, retroactive cost adjustments to providers, allowances for subscription charges received from subscribers but not yet earned and all other accrued liabilities in accordance with section 60A.12 as it relates to accident and health insurance companies.
Subd. 3.
[Repealed, 2004 c 285 art 3 s 11]
Subd. 4.
[Repealed, 2004 c 285 art 3 s 11]
Subd. 5.
Risk-based capital requirement.
A service plan corporation is subject to regulation of its financial solvency under sections 60A.50 to 60A.592.
History:
1971 c 568 s 9; 1977 c 261 s 1; 1977 c 405 s 1; 2004 c 285 art 3 s 2
2023 Minnesota Statutes › Chapters 59A - 79A — Insurance › Chapter 62C — Nonprofit Health Service Plan Corporations › Section 62C.10 — Investment.

62C.10 INVESTMENT.
Funds of a corporation subject to this chapter shall be invested only in securities and property designated by law for investment by domestic life insurance companies. Notwithstanding any limitations set forth in chapter 61A, an organization which has received a certificate of authority from the commissioner to operate under this chapter may invest up to 20 percent of its admitted assets in corporations whose business is the arrangement for, management of, or provision of health care services, including dental and related managed care and administrative services. Any amounts so invested shall, for purposes of section 62C.09, be added to the minimum and maximum reserve requirements as calculated for a service plan corporation.
History:
1971 c 568 s 10; 1993 c 70 s 1; 1994 c 425 s 12
2023 Minnesota Statutes › Chapters 59A - 79A — Insurance › Chapter 62C — Nonprofit Health Service Plan Corporations › Section 62C.11 — Financial Statements And Examinations.

62C.11 FINANCIAL STATEMENTS AND EXAMINATIONS.
Subdivision 1.
Annual filing.
A service plan corporation shall annually on or before the last day of March, file with the commissioner a financial statement, in such form as the commissioner shall prescribe, verified by not less than two of its principal officers, showing the financial condition of the corporation as of December 31 of the preceding year.
Subd. 2.
Periodic examinations.
The commissioner shall examine a service plan corporation to ascertain its financial condition, its ability to fulfill its obligations, and its compliance with Laws 1971, chapter 568, as often as the commissioner deems expedient for protection of the public, but not less than once each three years. The commissioner shall have access at all reasonable times to all books and records of the corporation, and may summon the officers and employees and examine them under oath as to any matter pertinent to Laws 1971, chapter 568.
Subd. 3.
Initial examinations.
The commissioner shall visit and examine any service plan corporation formed after August 1, 1971 within the first six months after it begins doing business, and thereafter once during each of the next three years. Thereafter the commissioner shall visit and examine the corporation at least once every three years.
Subd. 4.
Examination and audit expenses.
Any examination or audit conducted by or at the request of the commissioner shall be at the expense of the service plan corporation.
Subd. 5.
Failure to examine; notification to governor.
The commissioner shall notify the governor whenever examinations required by this section have not been made and inform the governor of the reasons therefor.
History:
1971 c 568 s 11; 1986 c 444; 2000 c 483 s 12