1.1    .................... moves to amend S.F. No. 276, as amended to insert the language
1.2of H.F. 464, as follows:
1.3Delete everything after the enacting clause and insert:

1.4    "Section 1. Minnesota Statutes 2006, section 43A.316, subdivision 1, is amended to
1.5read:
1.6    Subdivision 1. Intent. The legislature finds that the creation of a statewide program
1.7using best practices and innovative benefit design and administration to provide public
1.8employees, school districts employees, and other eligible persons with life insurance and
1.9hospital, medical, and dental benefit coverage through provider organizations would result
1.10in a greater utilization more efficient use of government resources and would advance the
1.11health and welfare of the citizens of the state.

1.12    Sec. 2. Minnesota Statutes 2006, section 43A.316, subdivision 2, is amended to read:
1.13    Subd. 2. Definitions. For the purpose of this section, the terms defined in this
1.14subdivision have the meaning given them.
1.15    (a) Commissioner. "Commissioner" means the commissioner of employee relations.
1.16    (b) Employee. "Employee" means:
1.17    (1) a person who is a public employee within the definition of section 179A.03,
1.18subdivision 14 , who is insurance eligible and is employed by an eligible employer;
1.19    (2) an elected public official of an eligible employer who is insurance eligible;
1.20    (3) a person employed by a labor organization or employee association certified as
1.21an exclusive representative of employees of an eligible employer or by another public
1.22employer approved by the commissioner, so long as the plan meets the requirements of a
1.23governmental plan under United States Code, title 29, section 1002(32); or
1.24    (4) a person employed by a county or municipal hospital.
1.25    (c) Eligible employer. "Eligible employer" means:
2.1    (1) a public employer within the definition of section 179A.03, subdivision 15, that
2.2is a town, county, city, school district as defined in section 120A.05, service cooperative
2.3as defined in section 123A.21, intermediate district as defined in section 136D.01,
2.4Cooperative Center for Vocational Education as defined in section 123A.22, regional
2.5management information center as defined in section 123A.23, or an education unit
2.6organized under the joint powers action, section 471.59; or
2.7    (2) an exclusive representative of employees, as defined in paragraph (b);
2.8    (3) a county or municipal hospital; or
2.9    (4) another public employer approved by the commissioner.
2.10    (d) Exclusive representative. "Exclusive representative" means an exclusive
2.11representative as defined in section 179A.03, subdivision 8.
2.12    (e) Labor-Management Committee. "Labor-Management Committee" means the
2.13committee established by subdivision 4.
2.14    (f) Program. "Program" means the statewide public employees insurance buyers
2.15group program created by subdivision 3.

2.16    Sec. 3. Minnesota Statutes 2006, section 43A.316, subdivision 3, is amended to read:
2.17    Subd. 3. Public employee insurance buyers group program. The commissioner
2.18shall be the administrator of the public employee insurance buyers group program and
2.19may determine its funding arrangements. The commissioner shall model the program
2.20after the plan established in section 43A.18, subdivision 2, but may modify that plan,
2.21in consultation with the Labor-Management Committee. The commissioner, or the
2.22commissioner's designated representatives, shall be consulted in discussions or studies
2.23by state agencies related to improving statewide health care quality, outcomes, and costs.
2.24The commissioner may:
2.25    (1) Develop and administer separately rated programs within the public buyers
2.26group program, including a separately rated and administered program for employees of
2.27public school districts. Separate programs within the public buyers group program may be
2.28pilot or demonstration programs, or permanent programs.
2.29    (2) Develop, implement, and administer demonstration or pilot programs to help
2.30explore methods for improving the effectiveness and value of the public buyers group
2.31program.
2.32    (3) Conduct evaluations and studies to determine the effectiveness and impact of
2.33pilot, demonstration, or other programs as part of the public buyers group program.
2.34    (4) Develop, adopt, modify, and implement strategies to control health care costs
2.35and to improve health care outcomes, including, but not limited to, health care cost and
2.36quality measurement and reporting strategies, pay-for-performance strategies, value-based
3.1purchasing strategies, and other demonstrated or emerging best practices in health care
3.2purchasing.
3.3    (5) In consultation with the labor management committee described in subdivision
3.45, develop, adopt, modify and administer innovative health benefit designs, including
3.5possible tiered arrangements, high-deductible plans with health care savings accounts,
3.6special provider networks, limited benefit plans, incentive programs for healthy behaviors
3.7and health improvement, and other health benefit designs.
3.8    (6) Temporarily suspend or limit new entrant groups into the public buyers group
3.9program if necessary to maintain the quality, effectiveness, and viability of the program.
3.10    (7) Participate as part of broader community, regional, or national alliances or
3.11initiatives, including joint public-private sector efforts, improve health care purchasing,
3.12and health care costs, quality, and outcomes.
3.13    (8) Develop, implement, and administer a Web site and related capabilities to
3.14provide members and the public with information and a means to make inquiries to the
3.15public buyers group program. The Web site may include information on the program's
3.16goals and its performance in reaching the goals.

3.17    Sec. 4. Minnesota Statutes 2006, section 43A.316, is amended by adding a subdivision
3.18to read:
3.19    Subd. 3a. Health improvement programs. The commissioner is authorized to plan,
3.20develop, purchase, administer, and evaluate disease management and other programs,
3.21strategies, and incentives to improve the health and health outcomes of members.

3.22    Sec. 5. Minnesota Statutes 2006, section 43A.316, subdivision 4, is amended to read:
3.23    Subd. 4. Labor-Management Committee. The Labor-Management Committee
3.24consists of ten members appointed by the commissioner governor. The Labor-Management
3.25Committee must comprise five members who represent employees, including at least
3.26one retired employee, and five members who represent eligible employers. Committee
3.27members are eligible for expense reimbursement in the same manner and amount as
3.28authorized by the commissioner's plan adopted under section 43A.18, subdivision 2. The
3.29commissioner shall consult with the labor-management committee in major decisions that
3.30affect the program. The committee shall study issues relating to the insurance program
3.31including, but not limited to, flexible benefits, utilization review, quality assessment, and
3.32cost efficiency. The committee continues to exist while the program remains in operation.

3.33    Sec. 6. Minnesota Statutes 2006, section 43A.316, subdivision 5, is amended to read:
3.34    Subd. 5. Public employee participation. (a) Participation in the program is subject
3.35to the conditions in this subdivision.
4.1    (b) Each exclusive representative for an eligible employer determines whether the
4.2employees it represents will participate in the program. The exclusive representative shall
4.3give the employer notice of intent to participate at least 30 days before the expiration date
4.4of the collective bargaining agreement preceding the collective bargaining agreement that
4.5covers the date of entry into the program. The exclusive representative and the eligible
4.6employer shall give notice to the commissioner of the determination to participate in the
4.7program at least 30 days before entry into the program. Entry into the program is governed
4.8by a schedule established by the commissioner.
4.9    (c) Employees not represented by exclusive representatives may become members
4.10of the program upon a determination of an eligible employer to include these employees
4.11in the program. Either all or none of the employer's unrepresented employees must
4.12participate. The eligible employer shall give at least 30 days' notice to the commissioner
4.13before entering the program. Entry into the program is governed by a schedule established
4.14by the commissioner.
4.15    (d) Participation in the program is for a two-year three-year term. Participation is
4.16automatically renewed for an additional two-year term unless the exclusive representative,
4.17or the employer for unrepresented employees, gives the commissioner notice of
4.18withdrawal at least 30 days before expiration of the participation period. A group that
4.19withdraws must wait two years before rejoining. An exclusive representative, or employer
4.20for unrepresented employees, may also withdraw if premiums increase 50 percent or more
4.21from one insurance year to the next. The commissioner may modify the participation
4.22requirement as part of a demonstration or pilot effort. Any modifications must be clearly
4.23communicated to all employers who are members of the public buyers group program, and
4.24incorporated in any information about the program, at least 60 days prior to the change
4.25becoming effective. The modifications must apply on an equal basis to all current and
4.26prospective employers enrolled in the program.
4.27    (e) The commissioner, in consultation with the Labor-Management Committee and
4.28other experts, may explore mutual gain-sharing arrangements, discounts, incentives,
4.29or penalties for public employers based on the length of their continuous membership
4.30in the public buyers group program and other factors. Any incentives for long-term
4.31membership in the program must be consistent with the program's goals; maintaining the
4.32overall integrity and viability of the program; other applicable laws, rules, and policies;
4.33and available to all groups on equal terms. The terms of any incentives for long-term
4.34participation in the program must be clearly communicated to all employers who are
4.35members of the public buyers group program, and incorporated in any information about
4.36the program. Any administration of, or changes to the incentives, must be communicated
5.1at least 180 days prior to each employer's renewal date before the change may become
5.2effective. The commissioner, in consultation with the Labor-Management Committee,
5.3shall report to the legislature and the governor by January 15, 2008, and annually
5.4thereafter, on the adequacy of the participation requirement and any special incentives
5.5based on the length of participation, in helping maintain the stability and effectiveness of
5.6the public buyers group program.
5.7    (e) (f) The exclusive representative shall give the employer notice of intent to
5.8withdraw to the commissioner at least 30 days before the expiration date of a collective
5.9bargaining agreement that includes the date on which the term of participation expires.
5.10    (f) (g) Each participating eligible employer shall notify the commissioner of
5.11names of individuals who will be participating within two weeks of the commissioner
5.12receiving notice of the parties' intent to participate. The employer shall also submit other
5.13information as required by the commissioner for administration of the program.

5.14    Sec. 7. Minnesota Statutes 2006, section 43A.316, is amended by adding a subdivision
5.15to read:
5.16    Subd. 5a. Participating employer rights to data. Employers participating in
5.17the public buyers group program shall not be refused or impeded by the program in
5.18their efforts to obtain the utilization or claims data needed by the employer to seek
5.19alternative bids for insurance coverage. The ability of participating employers to secure
5.20their data for the purposes of seeking alternative bids for coverage exists regardless of
5.21any other program participation requirements or incentives for long-term participation
5.22in the program. Participating employers will not be charged for the report generated to
5.23satisfy this subdivision.

5.24    Sec. 8. Minnesota Statutes 2006, section 43A.316, is amended by adding a subdivision
5.25to read:
5.26    Subd. 5b. School districts. School districts eligible for the public buyers group
5.27program must request bids for insurance coverage through the public buyers group
5.28program at least once every four years. This subdivision does not require school districts
5.29eligible for the program to purchase coverage through the program. Other public
5.30employers are encouraged to seek bids from the public buyers group program at least
5.31once every four years.

5.32    Sec. 9. Minnesota Statutes 2006, section 43A.316, is amended by adding a subdivision
5.33to read:
5.34    Subd. 9a. Report. The commissioner shall report biennially to the governor and
5.35legislature on March 1 of each odd-numbered year. The report will include information on
6.1membership, finances, operations, effectiveness, and impact of the public buyers group
6.2program. The report may include discussion of changes and innovations, particularly with
6.3respect to improving health care costs, quality, and outcomes, and any issues or challenges
6.4faced by the program and how they might be addressed. The report will be posted on a
6.5Web site maintained by or for the public buyers group program, and must be available
6.6to the public.

6.7    Sec. 10. Minnesota Statutes 2006, section 43A.316, subdivision 10, is amended to read:
6.8    Subd. 10. Exemption. The public employee insurance buyers group program
6.9and, where applicable, the employers participating in it are exempt from chapters 60A,
6.1062A, 62C, 62D, 62E, and 62H, section 471.617, subdivisions 2 and 3, and the bidding
6.11requirements of section 471.6161. Nothing in this statute or other statutes shall limit the
6.12commissioner's ability to develop and test innovative health insurance benefit designs for
6.13the public buyers group program.

6.14    Sec. 11. APPROPRIATION.
6.15    Notwithstanding Minnesota Statutes, section 295.581, $60,000 in fiscal year
6.162008 and $2,260,000 in fiscal year 2009 are appropriated to the commissioner of
6.17employee relations for onetime administrative costs for marketing, communication, plan
6.18administration, and the development of a data warehouse to support the Public Buyers
6.19Group.

6.20    Sec. 12. REVISOR'S INSTRUCTION.
6.21    The revisor of statutes shall change the headnote for Minnesota Statutes, section
6.2243A.316, to read "PUBLIC BUYERS GROUP PROGRAM.""
6.23Amend the title accordingly