Subdivision 1. Definition. "Association" means the Minnesota Comprehensive Health Association created in section 62E.10.
Subd. 2. Eligible individuals. An individual is eligible for alternative coverage under this section if:
(1) the individual had individual health coverage through a health maintenance organization or community integrated service network, the coverage is no longer available due to the insolvency of the health maintenance organization or community integrated service network, and the individual has not obtained alternative coverage; or
(2) the individual had group health coverage through a health maintenance organization or community integrated service network, the coverage is no longer available due to the insolvency of the health maintenance organization or community integrated service network, and the individual has not obtained alternative coverage.
Subd. 3. Application and issuance. If a health maintenance organization or community integrated service network will be liquidated, individuals eligible for alternative coverage under subdivision 2 may apply to the association to obtain alternative coverage. Upon receiving an application and evidence that the applicant was enrolled in the health maintenance organization or community integrated service network at the time of an order for liquidation, the association shall issue policies to eligible individuals, without the limitation on preexisting conditions described in section 62E.14, subdivision 3.
Subd. 4. Coverage. Alternative coverage issued under this section must be at least a number two qualified plan, as described in section 62E.06, subdivision 2, or for individuals over age 65, a basic Medicare supplement plan, as described in section 62A.316.
Subd. 5. Premium. The premium for alternative coverage issued under this section must not exceed 80 percent of the premium for the comparable coverage offered by the association.
Subd. 6. Duration. The duration of alternative coverage issued under this section is:
(1) for individuals eligible under subdivision 2, clause (1), 90 days; and
(2) for individuals eligible under subdivision 2, clause (2), 90 days or the length of time remaining in the group contract with the insolvent health maintenance organization or community integrated service network, whichever is greater.
Subd. 7. Replacement coverage; limitations. The association is not obligated to offer replacement coverage under this chapter at the end of the periods specified in subdivision 6. Any continuation obligation arising under this chapter or chapter 62A will cease at the end of the periods specified in subdivision 6.
Subd. 8. Claims expenses exceeding premiums. Claims expenses resulting from the operation of this section which exceed premiums received shall be borne by contributing members of the association in accordance with section 62E.11, subdivision 5.
Subd. 9. Coordination of policies. If an insolvent health maintenance organization or community integrated service network has insolvency insurance coverage at the time of an order for liquidation, the association may coordinate the benefits of the policy issued under this section with those of the insolvency insurance policy available to the enrollees. The premium level for the combined association policy and the insolvency insurance policy may not exceed those described in subdivision 5.
1988 c 612 s 24; 1989 c 258 s 11; 1995 c 234 art 1 s 6-9; 1997 c 225 art 2 s 62; 2013 c 84 art 1 s 36
Structure Minnesota Statutes
Chapters 59A - 79A — Insurance
Chapter 62D — Health Maintenance Organizations
Section 62D.01 — Citation And Purpose.
Section 62D.03 — Establishment Of Health Maintenance Organizations.
Section 62D.04 — Issuance Of Certificate Authority.
Section 62D.041 — Protection In The Event Of Insolvency.
Section 62D.042 — Initial Net Worth Requirement.
Section 62D.044 — Admitted Assets.
Section 62D.045 — Investment Restrictions.
Section 62D.05 — Powers Of Health Maintenance Organizations.
Section 62D.06 — Governing Body.
Section 62D.07 — Evidence Of Coverage; Required Terms.
Section 62D.08 — Annual Report.
Section 62D.09 — Information To Enrollees.
Section 62D.095 — Enrollee Cost Sharing.
Section 62D.10 — Provisions Applicable To All Health Plans.
Section 62D.101 — Continuation And Conversion Privileges For Former Spouses And Children.
Section 62D.102 — Family Therapy.
Section 62D.103 — Second Opinion Related To Substance Use Disorder And Mental Health.
Section 62D.104 — Required Out-of-area Conversion.
Section 62D.105 — Coverage Of Current Spouse, Former Spouse, And Children.
Section 62D.107 — Equal Access To Acupuncture Services.
Section 62D.109 — Services Associated With Clinical Trials.
Section 62D.11 — Complaint System.
Section 62D.115 — Quality Of Care Complaints.
Section 62D.12 — Prohibited Practices.
Section 62D.121 — Required Replacement Coverage.
Section 62D.123 — Provider Contracts.
Section 62D.124 — Geographic Accessibility.
Section 62D.13 — Powers Of Insurers And Nonprofit Health Service Plans.
Section 62D.14 — Examinations.
Section 62D.145 — Disclosure Of Information Held By Health Maintenance Organizations.
Section 62D.15 — Suspension Or Revocation Of Certificate Of Authority.
Section 62D.16 — Denial, Suspension, And Revocation; Administrative Procedures.
Section 62D.17 — Penalties And Enforcement.
Section 62D.18 — Rehabilitation Or Liquidation Of Health Maintenance Organization.
Section 62D.181 — Insolvency; Mcha Alternative Coverage.
Section 62D.182 — Liabilities.
Section 62D.19 — Unreasonable Expenses.
Section 62D.211 — Renewal Fee.
Section 62D.22 — Statutory Construction And Relationship To Other Laws.
Section 62D.23 — Filings And Reports As Public Documents.
Section 62D.24 — Commissioner Of Health's Authority To Contract.