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SF1572 (Legislative Session 94 (2025-2026))

Health insurance claims assessment creation provision

AI Generated Summary

Purpose of the Bill

This bill aims to create a health insurance claims assessment in Minnesota. The main goal is to collect funds from health plan companies and third-party administrators based on the claims they pay. The revenue generated will be used to support health care programs like MinnesotaCare and medical assistance.

Main Provisions

  • Claims Expenditure Assessment: A 2% assessment is imposed on claims paid by health plan companies and third-party administrators. This fee applies to various types of health care services and payment scenarios.

  • Responsibility for the Assessment:

    • The health plan company or third-party administrators are responsible for paying this assessment. For group health plans that utilize third-party administrators or excess loss insurers, specific rules dictate which entity is responsible for the payment.
    • If both a third-party administrator and an excess loss insurer are involved, responsibilities are divided according to whether claims are reimbursed by the insurer.

  • Collection Methodology: Health plan companies and administrators can collect this assessment from employers or health plan sponsors, following uniform procedures. The collected amount cannot exceed the assessed fee.

  • Filing and Payment: Companies subject to this assessment must file returns quarterly and make payments to the commissioner of revenue. Electronic payment methods might be required.

  • Record Keeping: Health plan companies and administrators must maintain accurate records. The commissioner can assess additional charges if records are inadequate or incomplete.

  • Penalty for Failure to Pay: Companies that fail to pay the assessment on time may face suspension or revocation of their operating licenses.

  • Use of Revenue: All revenue collected from this assessment will be deposited into the health care access fund and used for health care programs and the administration of this assessment.

Significant Changes to Existing Law

The bill introduces a new section to Minnesota Statutes, specifically targeting health insurance claims and creating a new mechanism to fund state health care programs.

Relevant Terms

  • Health insurance claims
  • Assessment
  • Health plan company
  • Third-party administrator
  • MinnesotaCare
  • Medical assistance
  • Health care provider
  • Managed care
  • Health care access fund

Bill text versions

Actions

DateChamberWhereTypeNameCommittee Name
February 19, 2025SenateFloorActionIntroduction and first reading
February 19, 2025SenateFloorActionReferred toHealth and Human Services
March 12, 2025SenateFloorActionAuthor added
March 19, 2025SenateFloorActionAuthor added

Citations

 
[
  {
    "analysis": {
      "added": [
        "References to county-based purchasing plans and integrated health partnerships included in the definition."
      ],
      "removed": [
        "No definitions were removed."
      ],
      "summary": "Definition of 'Health plan company' as mentioned in the bill aligns with the definition provided in section 62Q.01 subdivision 4.",
      "modified": [
        "Expands scope to include specific types of partnerships and plans."
      ]
    },
    "citation": "62Q.01"
  },
  {
    "analysis": {
      "added": [],
      "removed": [],
      "summary": "Definition of 'Health care provider' as used in the bill corresponds with the definition provided in section 62J.03 subdivision 8.",
      "modified": []
    },
    "citation": "62J.03"
  },
  {
    "analysis": {
      "added": [],
      "removed": [],
      "summary": "Definition of 'Self-insurance plan' follows the meaning given in section 60A.23 subdivision 8.",
      "modified": []
    },
    "citation": "60A.23"
  },
  {
    "analysis": {
      "added": [],
      "removed": [],
      "summary": "Definition of 'Pharmacy benefit manager' in the bill aligns with section 62W.02 subdivision 15.",
      "modified": []
    },
    "citation": "62W.02"
  },
  {
    "analysis": {
      "added": [
        "Integration of county-based purchasing plans into health plan company definitions."
      ],
      "removed": [],
      "summary": "The bill includes county-based purchasing plans authorized under section 256B.692 within its provisions.",
      "modified": []
    },
    "citation": "256B.692"
  },
  {
    "analysis": {
      "added": [
        "Integration of integrated health partnerships into health plan company definitions."
      ],
      "removed": [],
      "summary": "Reference to integrated health partnership authorized under section 256B.0755.",
      "modified": []
    },
    "citation": "256B.0755"
  }
]

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