Subdivision 1. Scope of coverage. This section applies to:
(1) a health plan as defined in section 62A.011; and
(2) a policy, contract, or certificate issued by a community integrated service network licensed under chapter 62N.
Subd. 2. Required coverage. Every health plan included in subdivision 1 that provides dependent coverage must define "dependent" no more restrictively than the definition provided in section 62L.02, subdivision 11.
Subd. 3. No additional restrictions permitted. Any health plan included in subdivision 1 that provides dependent coverage of children shall make that coverage available to children until the child attains 26 years of age. A health carrier must not place restrictions on this coverage and must comply with the following requirements:
(1) with respect to a child who has not attained 26 years of age, a health carrier shall not define dependent for purposes of eligibility for dependent coverage of children other than the terms of a relationship between a child and the enrollee or spouse of the enrollee;
(2) a health carrier must not deny or restrict coverage for a child who has not attained 26 years of age based on (i) the presence or absence of the child's financial dependency upon the participant, primary subscriber, or any other person; (ii) residency with the participant and in the individual market the primary subscriber, or with any other person; (iii) marital status; (iv) student status; (v) employment; or (vi) any combination of those factors; and
(3) a health carrier must not deny or restrict coverage of a child based on eligibility for other coverage, except as provided in subdivision 5.
Subd. 4. Grandchildren. Nothing in this section requires a health carrier to make coverage available for a grandchild, unless the grandparent becomes the legal guardian or adoptive parent of that grandchild or unless the grandchild meets the requirements of section 62A.042. For grandchildren included under a grandparent's policy pursuant to section 62A.042, coverage for the grandchild may terminate if the grandchild does not continue to reside with the covered grandparent continuously from birth, if the grandchild does not remain financially dependent upon the covered grandparent, or when the grandchild reaches age 25, except as provided in section 62A.14 or if coverage is continued under section 62A.20.
Subd. 5. Terms of coverage of dependents. The terms of coverage in a health plan offered by a health carrier providing dependent coverage of children cannot vary based on age except for children who are 26 years of age or older.
Subd. 6. Opportunity to enroll. A health carrier must comply with all provisions of the Affordable Care Act in regards to providing an opportunity to enroll in coverage to any child whose coverage ended, or was not eligible for coverage under a group health plan or individual health plan because, under the terms of the coverage, the availability of dependent coverage of a child ended before age 26.
Subd. 7. Grandfathered plan coverage. (a) For plan years beginning before January 1, 2014, a group health plan that is a grandfathered plan and makes available dependent coverage of children may exclude an adult child who has not attained 26 years of age from coverage only if the adult child is eligible to enroll in an eligible employer-sponsored health benefit plan, as defined in section 5000A(f)(2) of the Internal Revenue Code, other than the group health plan of a parent.
(b) For plan years beginning on or after January 1, 2014, a group health plan that is a grandfathered plan must comply with all requirements of this section.
Subd. 8. Compliance. This section does not require compliance with any provision of the Affordable Care Act before the effective date provided for that provision in the Affordable Care Act.
Subd. 9. Enforcement. The commissioner shall enforce this section.
1992 c 549 art 3 s 9; 2001 c 215 s 12; 2013 c 84 art 1 s 23
Structure Minnesota Statutes
Chapters 59A - 79A — Insurance
Chapter 62A — Accident And Health Insurance
Section 62A.011 — Definitions.
Section 62A.02 — Policy Forms.
Section 62A.021 — Health Care Policy Rates.
Section 62A.023 — Notice Of Rate Change.
Section 62A.024 — Explanations Of Rate Increases; Attribution To Statutory Changes.
Section 62A.03 — General Provisions Of Policy.
Section 62A.04 — Standard Provisions.
Section 62A.041 — Maternity Benefits.
Section 62A.0411 — Maternity Care.
Section 62A.042 — Family Coverage; Coverage Of Newborn Infants.
Section 62A.043 — Dental And Podiatric Coverage.
Section 62A.044 — Payments To Governmental Institutions.
Section 62A.045 — Payments On Behalf Of Enrollees In Government Health Programs.
Section 62A.046 — Coordination Of Benefits.
Section 62A.047 — Children's Health Supervision Services And Prenatal Care Services.
Section 62A.048 — Dependent Coverage.
Section 62A.049 — Limitation On Preauthorizations; Emergencies.
Section 62A.05 — Construction Of Provisions.
Section 62A.06 — Statements In Application.
Section 62A.07 — Rights Of Insurer, When Not Waived.
Section 62A.08 — Coverage Of Policy, Continuance In Force.
Section 62A.081 — Payments To Facilities Operated By State Or Local Government.
Section 62A.082 — Nondiscrimination In Access To Transplants.
Section 62A.095 — Subrogation Clauses Regulated.
Section 62A.096 — Notice To Insurer Of Subrogation Claim Required.
Section 62A.10 — Group Insurance.
Section 62A.105 — Coverages; Transfers To Substantially Similar Products.
Section 62A.11 — Blanket Accident And Sickness Insurance.
Section 62A.13 — Commercial Traveler Insurance Companies.
Section 62A.135 — Fixed Indemnity Policies; Minimum Loss Ratios.
Section 62A.136 — Hearing, Dental, And Vision Plan Coverage.
Section 62A.14 — Disabled Children.
Section 62A.141 — Coverage For Disabled Dependents.
Section 62A.145 — Survivor; Definition.
Section 62A.146 — Continuation Of Benefits To Survivors.
Section 62A.147 — Disabled Employees' Benefits; Definitions.
Section 62A.148 — Group Insurance; Provision Of Benefits For Disabled Employees.
Section 62A.149 — Benefits For Alcoholics And Drug Dependents.
Section 62A.15 — Coverage Of Certain Licensed Health Professional Services.
Section 62A.151 — Health Insurance Benefits For Emotionally Disabled Children.
Section 62A.152 — Benefits For Ambulatory Mental Health Services.
Section 62A.153 — Outpatient Medical And Surgical Services.
Section 62A.154 — Benefits For Des Related Conditions.
Section 62A.155 — Coverage For Services Provided To Ventilator-dependent Persons.
Section 62A.16 — Scope Of Certain Continuation And Conversion Requirements.
Section 62A.17 — Termination Of Or Layoff From Employment; Continuation And Conversion Rights.
Section 62A.18 — Prohibition Against Disability Offsets.
Section 62A.19 — Prohibition Against Nondiagnostic X-rays.
Section 62A.20 — Continuation Coverage Of Current Spouse And Children.
Section 62A.21 — Continuation And Conversion Privileges For Insured Former Spouses And Children.
Section 62A.22 — Refusal To Provide Coverage Because Of Option Under Workers' Compensation.
Section 62A.23 — Group Disability Income Coverage; Termination Without Prejudice; Definitions.
Section 62A.24 — Continuation Of Benefits.
Section 62A.25 — Reconstructive Surgery.
Section 62A.26 — Coverage For Phenylketonuria Treatment.
Section 62A.265 — Coverage For Lyme Disease.
Section 62A.27 — Coverage Of Adopted Children.
Section 62A.28 — Coverage For Scalp Hair Prostheses.
Section 62A.285 — Prohibited Underwriting; Breast Implants.
Section 62A.29 — Surety Bond Or Security For Certain Health Benefit Plans.
Section 62A.30 — Coverage For Diagnostic Procedures For Cancer.
Section 62A.302 — Coverage Of Dependents.
Section 62A.3021 — Coverage Of Dependents By Plans Other Than Health Plans.
Section 62A.303 — Prohibition; Severing Of Groups.
Section 62A.304 — Coverage For Port-wine Stain Elimination.
Section 62A.305 — Fibrocystic Condition; Termination Or Reduction Of Coverage.
Section 62A.306 — Use Of Gender Prohibited.
Section 62A.307 — Prescription Drugs; Equal Treatment Of Prescribers.
Section 62A.3075 — Cancer Chemotherapy Treatment Coverage.
Section 62A.308 — Hospitalization And Anesthesia For Dental Procedures.
Section 62A.3091 — Nondiscriminate Coverage Of Tests.
Section 62A.3092 — Equal Treatment Of Surgical First Assisting Services.
Section 62A.3093 — Coverage For Diabetes.
Section 62A.3094 — Coverage For Autism Spectrum Disorders.
Section 62A.3095 — Prescription Eye Drops Coverage.
Section 62A.3099 — Definitions.
Section 62A.31 — Medicare Supplement Benefits; Minimum Standards.
Section 62A.315 — Extended Basic Medicare Supplement Plan; Coverage.
Section 62A.316 — Basic Medicare Supplement Plan; Coverage.
Section 62A.3161 — Medicare Supplement Plan With 50 Percent Coverage.
Section 62A.3162 — Medicare Supplement Plan With 75 Percent Coverage.
Section 62A.3163 — Medicare Supplement Plan With 50 Percent Part A Deductible Coverage.
Section 62A.3164 — Medicare Supplement Plan With $20 And $50 Co-payment Medicare Part B Coverage.
Section 62A.3165 — Medicare Supplement Plan With High Deductible Coverage.
Section 62A.317 — Standards For Claims Payment.
Section 62A.318 — Medicare Select Policies And Certificates.
Section 62A.36 — Loss Ratio Standards.
Section 62A.37 — Government Certifications, Approvals, And Endorsements.
Section 62A.38 — Notice Of Free Examination.
Section 62A.40 — Replacement Regulated.
Section 62A.42 — Rulemaking Authority.
Section 62A.421 — Demonstration Projects.
Section 62A.43 — Limitations On Sales.
Section 62A.436 — Commissions.
Section 62A.44 — Applications.
Section 62A.451 — Definitions.
Section 62A.4511 — Certificate Of Authority Required.
Section 62A.4512 — Application For Certificate Of Authority.
Section 62A.4513 — Issuance Of Certificate Of Authority; Denial.
Section 62A.4514 — Filing Requirements For Authorized Entities.
Section 62A.4515 — Material Modifications.
Section 62A.4516 — Evidence Of Coverage.
Section 62A.4517 — Construction With Other Laws.
Section 62A.4518 — Nonduplication Of Coverage.
Section 62A.4519 — Complaint System.
Section 62A.4520 — Examination Of Organization.
Section 62A.4521 — Investments.
Section 62A.4523 — Protection Against Insolvency; Deposit.
Section 62A.4524 — Officer's And Employee's Fidelity Bond.
Section 62A.4526 — Suspension Or Revocation Of Certificate Of Authority.
Section 62A.4528 — Rehabilitation, Conservation, Or Liquidation.
Section 62A.48 — Long-term Care Policies.
Section 62A.49 — Home Care Services Coverage.
Section 62A.50 — Disclosures And Representations.
Section 62A.52 — Review Of Plan Of Care.
Section 62A.54 — Prohibited Practices.
Section 62A.60 — Retroactive Denial Of Expenses.
Section 62A.616 — Coverage For Nursing Home Care For Terminally Ill And Other Services.
Section 62A.62 — Demonstration Project.
Section 62A.64 — Health Insurance; Prohibited Agreements.
Section 62A.65 — Individual Market Regulation.
Section 62A.673 — Coverage Of Services Provided Through Telehealth.