SF3784
High-deductible health plans enrolled patients prompt payment alternative mechanism provision
Legislative Session 94 (2025-2026)
Related bill: HF3734
AI Generated Summary
Purpose
- Establishes an alternative mechanism to promote prompt payment of emergency room and ambulance charges for patients enrolled in very high deductible health plans (VHDHPs). It also creates a licensing and regulatory framework for vendors and entities that administer self-insurance and insurance plans, with specific rules related to VHDHPs.
Main provisions
Licensing and regulation of vendors of risk management services
- Any vendor of risk management services or entity administering a self-insurance or insurance plan must be licensed by the state commissioner to operate in Minnesota.
- Applicants must describe the type of activities and services they plan to offer. Licenses can include restrictions on the services allowed.
- Initial license fee: $1,500, plus $1,500 for each three-year renewal (licenses last three years).
- The bill creates a framework for ongoing regulation of these entities to ensure they are solvent and run fairly and honestly when handling claims and benefits.
Definitions and scope
- Defines terms such as: administering a self-insurance or insurance plan; employer; entity; self-insurance or insurance plan; vendor of risk management services.
- Specifies which groups are not covered by this licensing framework (e.g., certain existing insurers, HMOs, employers directly operating their own self-insurance, and certain other specified arrangements).
Financial controls and bonding
- Instead of requiring an unlimited parent-company guarantee, the commissioner may accept a surety bond equal to 120% of the total claims handled by the applicant in the prior year.
- If the annual claims exceed the bond amount, the administrator must notify the commissioner and the bond may need to be increased.
Compliance related to very high deductible health plans (VHDHP)
- An entity that administers an insurance plan that includes a VHDHP must comply with a specific provision (section 62Q.025 subdivision 3).
- If the entity is acting under certain responsibilities or contracts connected to a VHDHP, it must ensure that the health plan company or the administering entity provides for compliance with 62Q.025 subdivision 3.
- The entity cannot enter into contracts or provide services for a VHDHP unless the terms require compliance with 62Q.025 subdivision 3.
Rulemaking authority
- The commissioner can adopt rules to carry out these provisions.
- Rules can cover reporting requirements, standards for financing and administration, bonding requirements, and other reasonable requirements to support the bill’s goals.
- Rules may also set standards to ensure fair handling of claims and timely payment of benefits.
Significant changes to existing law
- Adds a new licensing and regulatory regime for vendors of risk management services and entities that administer self-insurance or insurance plans, introducing explicit licensing, bonding, and regulatory oversight.
- Requires licensing and a bond framework based on prior-year claims, tightening financial accountability for these entities.
- Introduces a dedicated compliance and contracting requirement for any plan that includes a very high deductible health plan (VHDHP), tying administration and contracts to specific Minnesota statute (62Q.025) to ensure proper handling of VHDHP-related obligations.
- Expands rulemaking authority for the commissioner to create detailed standards for administration, reporting, financing, and bonding of these plans and services.
Potential impact and goals
- Aims to improve prompt payment and fair administration of ER and ambulance charges for individuals with VHDHPs.
- Seeks to protect patients by ensuring that entities handling self-insurance and other employee benefit plans are financially sound and properly regulated.
- Creates clearer requirements for accountability and compliance when VHDHPs are involved in an insured or self-insured plan.
Relevant Terms - very high deductible health plan (VHDHP) - VHDHP (as defined in 62Q.01) - vendor of risk management services - self-insurance - self-insurance plan - insurance plan - administering a self-insurance or insurance plan - employer - entity - license - commissioner - bond / surety bond - claims - risk management - trade practice requirements (72A.19 to 72A.30) - health plan company - 62Q.01 - 62Q.025 subdivision 3 - Section 60A.23 subdivision 8 - rulemaking (Sections 14.001 to 14.69)
Bill text versions
- Introduction PDF PDF file
Actions
| Date | Chamber | Where | Type | Name | Committee Name |
|---|---|---|---|---|---|
| February 23, 2026 | Senate | Action | Introduction and first reading | ||
| February 23, 2026 | Senate | Action | Referred to | Commerce and Consumer Protection |
Citations
[
{
"analysis": {
"added": [
"Licensing and regulation framework for vendors of risk management services and entities administering self-insurance plans.",
"License issuance details, including initial and renewal fees and a three-year license term.",
"Surety bond requirements tied to the amount of claims handled (120 percent of prior-year claims).",
"Regulatory structure for contract filings, oversight, and bonding to ensure financial integrity.",
"Rulemaking authority to adopt standards, guidelines, and reporting requirements (pursuant to sections 14.001 to 14.69).",
"Provisions linking compliance with very high deductible health plan (VHDHP) requirements to 62Q.025."
],
"removed": [
""
],
"summary": "Amends Minnesota Statutes 2024, section 60A.23, subdivision 8 to regulate vendors of risk management services and entities administering self-insurance or insurance plans. Establishes a licensing framework, regulatory oversight, and related provisions.",
"modified": [
"Expands the scope of regulation to include administrators of self-insurance plans and vendors of risk management services, with associated licensing and financial integrity requirements."
]
},
"citation": "60A.23",
"subdivision": "8"
},
{
"analysis": {
"added": [
"Definition framework for very high deductible health plans (VHDHP) referenced in the bill."
],
"removed": [
""
],
"summary": "References section 62Q.01, which contains definitions relevant to health plans (including VHDHP) and related provisions. The bill notes a subdivision for VHDHP within 62Q.01.",
"modified": [
"Uses 62Q.01 as the definitional basis for VHDHP in relation to risk management and self-insurance provisions."
]
},
"citation": "62Q.01",
"subdivision": ""
},
{
"analysis": {
"added": [
"Reference to 60A.06, subdivision 1 (and related clauses) to define entities affected by risk management and self-insurance provisions."
],
"removed": [
""
],
"summary": "Cross-references to Minnesota Statutes 60A.06, subdivision 1, within the bill, including related clauses that define types of entities (e.g., employers, service plan entities, HMO) involved in risk management and self-insurance contexts.",
"modified": [
"Clarifies the definitions and applicability of existing definitions in the context of risk management services and self-insured plans."
]
},
"citation": "60A.06",
"subdivision": "1"
},
{
"analysis": {
"added": [
"Reference to HMO definitions to determine applicability of provisions to entities defined as HMOs."
],
"removed": [
""
],
"summary": "Cites 62D.02, subdivision 4, defining health maintenance organizations (HMOs) for purposes of the bill's risk management and self-insurance provisions.",
"modified": [
"Maintains alignment between the bill's definitions and existing HMO definitions under 62D.02(4)."
]
},
"citation": "62D.02",
"subdivision": "4"
},
{
"analysis": {
"added": [
"Reference to employer definition to anchor who may be affected by vendor licensing and risk management requirements."
],
"removed": [
""
],
"summary": "Cites 62E.02, subdivision 2, which defines ‘Employer’ for purposes of the risk management and self-insurance framework.",
"modified": [
"Links employer definition to the bill’s expanded regulatory regime for self-insurance and risk management services."
]
},
"citation": "62E.02",
"subdivision": "2"
},
{
"analysis": {
"added": [
"Reference to service plan corporations as defined for regulatory purposes in risk management contexts."
],
"removed": [
""
],
"summary": "Cites 62C.02, subdivision 6, which defines a service plan corporation, used in the bill to categorize entities administering insurance or self-insurance.",
"modified": [
"Ensures alignment with the bill’s regulatory framework for entities administering self-insurance plans."
]
},
"citation": "62C.02",
"subdivision": "6"
},
{
"analysis": {
"added": [
"Reference to workers’ compensation liability provisions as context for contract restrictions."
],
"removed": [
""
],
"summary": "Cites 79A.03, subdivision 6, concerning workers’ compensation liabilities, referenced in the bill’s prohibition on certain post-2001 contracts.",
"modified": [
"Incorporates existing workers’ compensation-related subsections into the regulatory framework for risk management services."
]
},
"citation": "79A.03",
"subdivision": "6"
},
{
"analysis": {
"added": [
"Trade practice requirements from 72A.19 to 72A.30 apply to vendors of risk management services and entities administering self-insurance plans."
],
"removed": [
""
],
"summary": "Cites sections in the 72A chapter (72A.19 through 72A.30) regarding trade practices applicable to vendors of risk management services and insurers.",
"modified": [
"References to 72A trade practices codify regulatory expectations for vendor conduct in the risk management realm."
]
},
"citation": "72A.19 to 72A.30",
"subdivision": ""
},
{
"analysis": {
"added": [
"Grant of rulemaking authority to the commissioner to implement and enforce the new risk management regulations."
],
"removed": [
""
],
"summary": "Rulemaking authority cited to permit the Department to adopt rules under sections 14.001 to 14.69.",
"modified": [
"Explicitly ties the regulator’s rulemaking power to the broad Administrative Procedure Act sections 14.001 to 14.69."
]
},
"citation": "14.001 to 14.69",
"subdivision": ""
}
]Progress through the legislative process
In Committee