HF3055

HF3055 (Legislative Session 94 (2025-2026))

Insurers allowed to provide explanation of benefits electronically.

Related bill: SF3297

AI Generated Summary

Purpose of the Bill

The bill aims to update existing statutes to allow insurers in Minnesota to provide explanations of benefits (EOB) documents electronically. This is intended to modernize the communication process between insurers and patients, giving patients the option to receive their EOBs in a digital format.

Main Provisions

Electronic Availability: Insurers, termed as "group purchasers," are permitted to provide explanations of benefits electronically.
Patient Choice: Patients must be given the option to select their preferred format—paper, electronic, or both—for receiving EOBs.
Default Delivery: If a patient doesn’t make a choice, they will continue to receive a paper version of the EOB by default.
Data Consistency: Both the paper and electronic versions of the EOB must contain the same data elements and definitions.
Consultation Requirement: Before mandating paper documents for dental services, the commissioner, in consultation with relevant dental authorities, must determine the necessity.

Significant Changes to Existing Law

The bill amends the current law by adding the electronic transmission option for EOBs, which were previously required to be distributed in paper form only.
It introduces new specifications for how EOBs can be delivered, emphasizing the patient's right to choose the form of communication.
The law removes the blanket requirement for insurers to use only paper documents, thereby modernizing the process.

Relevant Terms

Explanation of Benefits (EOB)
Electronic EOB
Paper EOB
Group Purchasers
Health Care Providers
Minnesota Uniform Health Care Reimbursement Documents
Administrative Uniformity Committee
Health Plan Company

Bill text versions

Introduction PDF file

Actions

Date	Chamber	Where	Type	Name	Committee Name
April 01, 2025	House	Floor	Action	Introduction and first reading, referred to	Health Finance and Policy

Citations

[
  {
    "analysis": {
      "added": [
        "The inclusion of electronic equivalents for explanation of benefits documents."
      ],
      "removed": [
        ""
      ],
      "summary": "The bill revises section 62J.51 subdivision 19a to clarify the definition of a uniform explanation of benefits document.",
      "modified": [
        "Details regarding group purchasers claim adjudication."
      ]
    },
    "citation": "62J.51",
    "subdivision": "subdivision 19a"
  },
  {
    "analysis": {
      "added": [
        "Details about electronic versions of uniform explanation of benefits being permissible."
      ],
      "removed": [
        ""
      ],
      "summary": "Amendments to section 62J.581 set standards for uniform health care reimbursement documents.",
      "modified": [
        "Clarification on the usage of paper vs. electronic documents."
      ]
    },
    "citation": "62J.581",
    "subdivision": ""
  },
  {
    "analysis": {
      "added": [
        ""
      ],
      "removed": [
        ""
      ],
      "summary": "The bill references section 62J.536, subdivision 1, paragraph b in context with claim payment advice transaction standards.",
      "modified": [
        ""
      ]
    },
    "citation": "62J.536",
    "subdivision": "subdivision 1, paragraph b"
  },
  {
    "analysis": {
      "added": [
        ""
      ],
      "removed": [
        ""
      ],
      "summary": "The requirements of this bill exclude health plan companies complying with section 62A.01, subdivisions 2 and 3.",
      "modified": [
        "Exclusion criteria for health plan companies."
      ]
    },
    "citation": "62A.01",
    "subdivision": "subdivisions 2 and 3"
  },
  {
    "analysis": {
      "added": [
        ""
      ],
      "removed": [
        ""
      ],
      "summary": "Sectional reference encompasses the scope of uniform claim payment and benefits document formats.",
      "modified": [
        "Clarification regarding applicability to all health care services."
      ]
    },
    "citation": "62J.50 to 62J.61",
    "subdivision": ""
  },
  {
    "analysis": {
      "added": [
        ""
      ],
      "removed": [
        ""
      ],
      "summary": "Federal regulations are cited regarding exceptions to document requirements for non-covered group purchasers.",
      "modified": [
        ""
      ]
    },
    "citation": "42 U.S.C. § 1320d to 1320d-8",
    "subdivision": ""
  }
]