Subdivision 1. Definition. For purposes of this section:
(1) "continuous coverage" has the meaning given in section 62L.02, subdivision 9;
(2) "guaranteed issue" means:
(i) for individual health plans, that a health plan company shall not decline an application by an individual for any individual health plan offered by that health plan company, including coverage for a dependent of the individual to whom the health plan has been or would be issued; and
(ii) for group health plans, that a health plan company shall not decline an application by a group for any group health plan offered by that health plan company and shall not decline to cover under the group health plan any person eligible for coverage under the group's eligibility requirements, including persons who become eligible after initial issuance of the group health plan; and
(3) "large employer" means an entity that would be a small employer, as defined in section 62L.02, subdivision 26, except that the entity has more than 50 current employees, based upon the method provided in that subdivision for determining the number of current employees.
Subd. 2. [Repealed, 1995 c 234 art 4 s 4]
Subd. 3. [Repealed, 1995 c 234 art 4 s 4]
Subd. 4. [Repealed, 1995 c 234 art 4 s 4]
Subd. 5. [Repealed, 1995 c 234 art 4 s 4]
Subd. 6. [Repealed, 1995 c 234 art 4 s 4]
Subd. 7. Portability of coverage. Effective July 1, 1994, no health plan company shall offer, sell, issue, or renew any group health plan that does not, with respect to individuals who maintain continuous coverage and who qualify under the group's eligibility requirements:
(1) make coverage available on a guaranteed issue basis;
(2) give full credit for previous continuous coverage against any applicable preexisting condition limitation or preexisting condition exclusion; and
(3) with respect to a group health plan offered, sold, issued, or renewed to a large employer, impose preexisting condition limitations or preexisting condition exclusions except to the extent that would be permitted under chapter 62L if the group sponsor were a small employer as defined in section 62L.02, subdivision 26.
To the extent that this subdivision conflicts with chapter 62L, chapter 62L governs, regardless of whether the group sponsor is a small employer as defined in section 62L.02, except that for group health plans issued to groups that are not small employers, this subdivision's requirement that the individual have maintained continuous coverage applies. An individual who has maintained continuous coverage, but would be considered a late entrant under chapter 62L, may be treated as a late entrant in the same manner under this subdivision as permitted under chapter 62L.
Subd. 8. [Repealed, 1995 c 234 art 4 s 4]
Subd. 9. [Repealed, 1995 c 234 art 4 s 4]
Subd. 10. Guaranteed issue. No health plan company shall offer, sell, or issue any health plan that does not make coverage available on a guaranteed issue basis in accordance with the Affordable Care Act.
1994 c 625 art 6 s 3; art 8 s 72; 1995 c 96 s 2; 1995 c 234 art 4 s 2; 1997 c 175 art 3 s 1,2; 1997 c 225 art 2 s 63; 2013 c 84 art 1 s 70; 2016 c 158 art 1 s 21
Structure Minnesota Statutes
Chapters 59A - 79A — Insurance
Chapter 62Q — Health Plan Companies
Section 62Q.02 — Applicability Of Chapter.
Section 62Q.021 — Federal Act; Compliance Required.
Section 62Q.025 — High Deductible Health Plans.
Section 62Q.03 — Process For Risk Adjustment System.
Section 62Q.075 — Local Public Accountability And Collaboration Plan.
Section 62Q.096 — Credentialing Of Providers.
Section 62Q.097 — Requirements For Timely Provider Credentialing.
Section 62Q.101 — Evaluation Of Provider Performance.
Section 62Q.1055 — Chemical Dependency.
Section 62Q.106 — Dispute Resolution By Commissioner.
Section 62Q.107 — Prohibited Provision; Judicial Review.
Section 62Q.12 — Denial Of Access.
Section 62Q.121 — Licensure Of Medical Directors.
Section 62Q.135 — Contracting For Chemical Dependency Services.
Section 62Q.137 — Chemical Dependency Treatment; Coverage.
Section 62Q.14 — Restrictions On Enrollee Services.
Section 62Q.145 — Abortion And Scope Of Practice.
Section 62Q.16 — Midmonth Termination Prohibited.
Section 62Q.165 — Universal Coverage.
Section 62Q.17 — Voluntary Purchasing Pools.
Section 62Q.18 — Portability Of Coverage.
Section 62Q.181 — Written Certification Of Coverage.
Section 62Q.184 — Step Therapy Override.
Section 62Q.1841 — Prohibition On Use Of Step Therapy For Metastatic Cancer.
Section 62Q.185 — Guaranteed Renewability; Large Employer Group.
Section 62Q.186 — Prohibition On Rescissions Of Health Plans.
Section 62Q.188 — Flexible Benefits Plans.
Section 62Q.19 — Essential Community Providers.
Section 62Q.22 — Health Care Services Prepaid Option.
Section 62Q.23 — General Services.
Section 62Q.32 — Local Ombudsperson.
Section 62Q.33 — Local Government Public Health Functions.
Section 62Q.37 — Audits Conducted By Independent Organization.
Section 62Q.43 — Geographic Access.
Section 62Q.45 — Coverage For Out-of-area Primary Care.
Section 62Q.46 — Preventive Items And Services.
Section 62Q.47 — Alcoholism, Mental Health, And Chemical Dependency Services.
Section 62Q.471 — Exclusion For Suicide Attempts Prohibited.
Section 62Q.472 — Screening And Testing For Opioids.
Section 62Q.48 — Cost-sharing In Prescription Insulin Drugs.
Section 62Q.49 — Enrollee Cost Sharing; Negotiated Provider Payments.
Section 62Q.50 — Prostate Cancer Screening.
Section 62Q.51 — Point-of-service Option.
Section 62Q.52 — Direct Access To Obstetric And Gynecologic Services.
Section 62Q.521 — Postnatal Care.
Section 62Q.525 — Coverage For Off-label Drug Use.
Section 62Q.526 — Coverage For Participation In Approved Clinical Trials.
Section 62Q.527 — Nonformulary Antipsychotic Drugs; Required Coverage.
Section 62Q.528 — Drug Coverage In Emergency Situations.
Section 62Q.529 — Coverage For Drugs Prescribed And Dispensed By Pharmacies.
Section 62Q.53 — Mental Health Coverage; Medically Necessary Care.
Section 62Q.535 — Coverage For Court-ordered Mental Health Services.
Section 62Q.54 — Referrals For Residents Of Health Care Facilities.
Section 62Q.545 — Coverage Of Home Care Nursing.
Section 62Q.55 — Emergency Services.
Section 62Q.556 — Unauthorized Provider Services.
Section 62Q.56 — Continuity Of Care.
Section 62Q.57 — Designation Of Primary Care Provider.
Section 62Q.58 — Access To Specialty Care.
Section 62Q.645 — Efficiency Reports And Distribution Of Information.
Section 62Q.65 — Access To Provider Discounts.
Section 62Q.66 — Durable Medical Equipment Coverage.
Section 62Q.67 — Disclosure Of Covered Durable Medical Equipment.
Section 62Q.675 — Hearing Aids; Persons 18 Or Younger.
Section 62Q.676 — Medication Therapy Management.
Section 62Q.677 — Lifetime And Annual Limits.
Section 62Q.678 — Dependent Child Notice.
Section 62Q.69 — Complaint Resolution.
Section 62Q.70 — Appeal Of The Complaint Decision.
Section 62Q.71 — Notice To Enrollees.
Section 62Q.72 — Record Keeping; Reporting.
Section 62Q.73 — External Review Of Adverse Determinations.
Section 62Q.731 — Appeal From Adverse Determination.
Section 62Q.733 — Definitions.
Section 62Q.735 — Provider Contracting Procedures.
Section 62Q.736 — Payment Rates.
Section 62Q.737 — Service Code Changes.
Section 62Q.739 — Unilateral Terms Prohibited.
Section 62Q.74 — Network Shadow Contracting.
Section 62Q.746 — Access To Certain Information Regarding Providers.
Section 62Q.75 — Prompt Payment Required.
Section 62Q.751 — Collecting Deductibles And Coinsurance.
Section 62Q.77 — Terms Of Coverage Disclosure.
Section 62Q.78 — Dental Benefit Plan Requirements.
Section 62Q.80 — Community-based Health Care Coverage Program.
Section 62Q.81 — Essential Health Benefit Package Requirements.