.................... moves to amend H.F. No. 2680, the first engrossment, as follows:
Page 31, after line 33, insert:
"Sec. .... [256L.031] DEFINED CONTRIBUTION PROGRAM.
1.4 Subdivision 1. Defined contributions to enrollees. Beginning January 1,
1.52011, or upon federal approval, whichever is later, the commissioner shall provide
1.6each MinnesotaCare enrollee eligible under section 256L.04 with a monthly defined
1.7contribution to purchase health coverage under a health plan, as defined in section
1.862A.011, subdivision 3. The defined contribution must be paid to a qualified third-party
1.10 Subd. 2. Use of defined contribution. An enrollee may use the monthly defined
1.11contribution only to pay premiums for coverage under a health plan, as defined in section
1.1262A.011, subdivision 3, and to pay any deductibles and cost-sharing required by the health
1.13plan. The defined contribution may be used to pay the enrollee share of premiums, and
1.14deductibles and cost-sharing, for a health plan that is offered by an employer.
1.15 Subd. 3. Determination of defined contribution amount. The commissioner shall
1.16determine the defined contribution for each enrollee using a sliding scale that takes into
1.17account age, health status, and household income. The commissioner shall design the
1.18sliding scale so that the average defined contribution increases with age, poor health status,
1.19and lower household income. The commissioner shall make the defined contribution
1.20sliding scale available to applicants and enrollees by October 1, 2010. The commissioner
1.21shall design the defined contribution sliding scale so that the average per-enrollee cost
1.22for the MinnesotaCare program does not exceed ....... percent of the average per-enrollee
1.23cost that would have been projected if MinnesotaCare had not been converted into a
1.24defined contribution program.
1.25 Subd. 4. Third-party administrator. The commissioner shall contract with a
1.26qualified third-party administrator to administer the defined contributions. The third-party
2.1 (1) collect and process defined contributions for enrollees;
2.2 (2) pay premiums to health plan companies or employers, as applicable, for enrollee
2.3health plan coverage, including any enrollee share of premiums;
2.4 (3) pay enrollee deductibles and cost-sharing, if the defined contributions for an
2.5enrollee exceed the premium cost of the health plan; and
2.6 (4) report premium and other payments made on behalf of each enrollee to the
2.7commissioner, and other information as required by the commissioner.
2.8 Subd. 5. Assistance to enrollees. The commissioner of human services, in
2.9consultation with the commissioner of commerce, shall develop an efficient and
2.10cost-effective method of referring eligible applicants to professional insurance agent
2.11associations. For purposes of this requirement, "professional insurance agent associations"
2.12means the Minnesota Association of Health Underwriters, the National Association of
2.13Independent Financial Advisors (MN), and the Minnesota Independent Insurance Agents
2.14and Brokers. Professional insurance agent associations are authorized to receive an
2.15appropriate per member per month override for each MinnesotaCare enrollee. The agent
2.16or broker shall elect a professional association of choice for each MinnesotaCare enrollee.
2.17Agents and brokers serving MinnesotaCare enrollees shall earn the standard commercial
2.18compensation fees for each policy placed, including MinnesotaCare enrollees receiving
2.19coverage through the Minnesota Comprehensive Health Association.
2.20 Subd. 6. MCHA. Beginning January 1, 2011, or upon federal approval, whichever
2.21is later, MinnesotaCare enrollees who are denied coverage under an individual health plan
2.22by a health plan company are eligible for coverage through a health plan offered by the
2.23Minnesota Comprehensive Health Association, as provided under section 256L.033.
2.24The cost to the Minnesota Comprehensive Health Association related to coverage of
2.25MinnesotaCare enrollees denied coverage under an individual health plan shall be paid
2.26from the health care access fund.
2.27 Subd. 7. Federal approval. The commissioner shall seek all federal waivers and
2.28approvals necessary to implement this section.
Page 32, delete section 21, and insert:
"Sec. .... Minnesota Statutes 2008, section 256L.05, subdivision 3, is amended to read:
Subd. 3. Effective date of coverage.
(a) The effective date of coverage shall be
2.32as provided in the terms of the contract for the health plan under which an enrollee is
is the first day of the month following the month in which eligibility is approved
2.34 and the first premium payment has been received. As provided in section
2.35 coverage for newborns is automatic from the date of birth and must be coordinated with
2.36 other health coverage. The effective date of coverage for eligible newly adoptive children
3.1 added to a family receiving covered health services is the month of placement. The
3.2 effective date of coverage for other new members added to the family is the first day of
3.3 the month following the month in which the change is reported. All eligibility criteria
3.4 must be met by the family at the time the new family member is added. The income of the
3.5 new family member is included with the family's gross income and the adjusted premium
3.6 begins in the month the new family member is added
(b) The initial premium must be received by the last working day of the month for
3.8 coverage to begin the first day of the following month.
3.9 (c) Benefits are not available until the day following discharge if an enrollee is
3.10 hospitalized on the first day of coverage.
3.11 (d) Notwithstanding any other law to the contrary, benefits under sections
3.12 256L.18 are secondary to a plan of insurance or benefit program under which an eligible
3.13 person may have coverage and the commissioner shall use cost avoidance techniques to
3.14 ensure coordination of any other health coverage for eligible persons. The commissioner
3.15 shall identify eligible persons who may have coverage or benefits under other plans of
3.16 insurance or who become eligible for medical assistance.
3.17 (e) The effective date of coverage for single adults and households with no children
3.18 formerly enrolled in general assistance medical care and enrolled in MinnesotaCare
3.19 according to section
256D.03, subdivision 3 , is the first day of the month following the
3.20 last day of general assistance medical care coverage.
3.21EFFECTIVE DATE.This section is effective January 1, 2011, or upon federal
3.22approval, whichever is later.
Page 33, delete sections 23 and 24
Page 33, after line 23, insert:
"Sec. .... Minnesota Statutes 2008, section 256L.07, subdivision 1, is amended to read:
Subdivision 1. General requirements.
Children enrolled in the original
3.27 children's health plan as of September 30, 1992, children who enrolled in the
3.28 MinnesotaCare program after September 30, 1992, pursuant to Laws 1992, chapter 549,
3.29 article 4, section 17, and children who have family gross incomes that are equal to or
3.30 less than 150 percent of the federal poverty guidelines are eligible without meeting
3.31 the requirements of subdivision 2 and the four-month requirement in subdivision 3, as
3.32 long as they maintain continuous coverage in the MinnesotaCare program or medical
3.33 assistance. Children who apply for MinnesotaCare on or after the implementation date
3.34 of the employer-subsidized health coverage program as described in Laws 1998, chapter
3.35 407, article 5, section 45, who have family gross incomes that are equal to or less than 150
4.1 percent of the federal poverty guidelines, must meet the requirements of subdivision 2 to
4.2 be eligible for MinnesotaCare.
Families enrolled in MinnesotaCare under section
256L.04, subdivision 1
income increases above 275 percent of the federal poverty guidelines, are no longer
eligible for the program and shall be disenrolled by the commissioner. Beginning January
1, 2008, individuals enrolled in MinnesotaCare under section
, whose income increases above 200 percent of the federal poverty guidelines or 250
percent of the federal poverty guidelines on or after July 1, 2009, are no longer eligible for
the program and shall be disenrolled by the commissioner. For persons disenrolled under
this subdivision, MinnesotaCare coverage terminates the last day of the calendar month
following the month in which the commissioner determines that the income of a family or
individual exceeds program income limits.
(b) Notwithstanding paragraph (a), children may remain enrolled in MinnesotaCare
if ten percent of their gross individual or gross family income as defined in section
4.15256L.01, subdivision 4
, is less than the annual premium for a policy with a $500
deductible available through the Minnesota Comprehensive Health Association. Children
who are no longer eligible for MinnesotaCare under this clause shall be given a 12-month
notice period from the date that ineligibility is determined before disenrollment. The
premium defined contribution
for children remaining eligible under this clause shall be the
maximum premium minimum contribution
determined under section
, paragraph (b) 256L.031
(c) Notwithstanding paragraphs (a) and (b), parents are not eligible for
MinnesotaCare if gross household income exceeds $57,500 for the 12-month period
4.25EFFECTIVE DATE.This section is effective January 1, 2011, or upon federal
4.26approval, whichever is later.
Page 37, after line 6, insert:
"Sec. .... REPEALER.
4.29Minnesota Statutes 2008, sections 256L.03, subdivisions 1, 1a, 1b, 2, 3, 3a, 4, and
4.306; 256L.05, subdivision 5; 256L.06, subdivision 3; 256L.07, subdivisions 2, 3, 6, and
4.317; 256L.11, subdivisions 2, 2a, 3, 4, 5, 6, and 7; 256L.12; and 256L.15, are repealed,
4.32effective January 1, 2011, or upon federal approval, whichever is later.
4.33Minnesota Statutes 2009 Supplement, sections 256L.03, subdivision 5; and 256L.11,
4.34subdivision 1, are repealed, effective January 1, 2011, or upon federal approval, whichever
Renumber the sections in sequence and correct the internal references
Amend the title accordingly