SF4390 (Legislative Session 94 (2025-2026))
Supplemental health insurance product establishment to cover short-term home health and nursing care
AI Generated Summary
Purpose
This bill aims to create and regulate a new supplemental health insurance product that covers short-term home health and nursing care. It defines how this product would work, who could offer it, what benefits it would provide, and how it would interact with existing state health and long-term care programs. It also adds civil penalties for violations and makes related amendments to several Minnesota statutes.
What the bill would do (Main provisions)
- Create a new short-term home health and nursing care insurance product
- This product is a fixed indemnity policy, defined to pay a predetermined fixed benefit for specified services, and it is included in the framework for fixed indemnity policies (and specifically noted as included under short-term home health and nursing care insurance).
- It is intended to cover short-term home health services and short-term nursing care services, not long-term care or other types of policies.
- Definitions and key terms
- Defines fixed indemnity policy, guaranteed renewable, noncancelable, average annualized premium, activities of daily living (ADLs), cognitive impairment, freelook period (at least 30 days), home health agency, nursing facility, and plan of care.
- Clarifies what counts as short-term home health and nursing care insurance, including the services and providers involved, and what does not count (e.g., long-term care policies, Medicare supplement policies, etc.).
- Policy requirements and limits
- Benefits must be provided if the insured has cognitive impairment or cannot perform at least two ADLs with substantial assistance.
- Coverage is limited to no more than 360 days.
- A freelook period, required disclosures, and renewability/continuity provisions must be provided to the insured.
- The policy cannot be canceled due to deterioration in health status or use of benefits.
- Waiting periods and conversion/replacement provisions must be handled in a way that does not impose new waiting periods if a policy is converted or replaced.
- Coverage cannot be denied or altered except for nonpayment of premium, fraud or misrepresentation, the insurer losing its authority to transact business in Minnesota, or exhaustion of the maximum benefit period.
- Regulatory oversight and filing
- The offering, issuing, delivering, and renewal of this insurance must be done by a qualified insurer and approved by the Minnesota commissioner as required by law.
- Disclosures to consumers
- Requires clear written disclosures, including that this is supplemental health insurance (not long-term care insurance and not part of Minnesota’s long-term care partnership program), explanations of the freelook period, and explanations of renewability and continuity provisions.
- Civil penalties and licensing
- Establishes penalties for violations of the related insurance provisions (fines up to $200 per offense) and gives the commissioner authority to revoke the license of insurers that willfully violate the provisions.
- Interaction with public programs (Alternative Care and MA)
- Adds and details how alternative care funding (for nonmedical assistance recipients) works with any potential coverage, including eligibility criteria (citizenship, age 65+, likely MA eligibility within 135 days, etc.), income/assets considerations, and limits.
- Includes specific monthly cost limits and rules about how coverage and costs are calculated, including case mix classifications and exceptions for certain program participants.
- States that short-term home health and nursing care insurance under 62A.70 does not count as health or third-party insurance for these purposes.
- Sets rules about eligibility, disenrollment, and continued eligibility if funding continues with payment arrangements, including consequences for nonpayment and the process for extending eligibility.
- Addresses exceptions and exclusions related to medical assistance, elderly waivers, nursing homes, certified boarding homes, and other facilities, as well as how funds interact with waivers and spenddowns.
- Scope and limitations
- Emphasizes that this product is supplemental to existing coverage and not a substitute for long-term care insurance or other state/federal health programs.
- Maintains protections around eligibility and funding that tie into current elderly and disability programs, and clarifies when the alternative care program can or cannot fund services.
Significant changes to existing law
- Adds a new qualified-insurer–only market segment for short-term home health and nursing care insurance, with a defined 360-day coverage limit and fixed-indemnity benefits.
- Codifies specific definitions and requirements for short-term home health and nursing care insurance, including freelook, renewability, and clear consumer disclosures.
- Integrates a regulatory framework for this new product under the insurance statutes (and references to related sections), including rate and filing concepts like average annualized premium.
- Creates penalties for violations of the new provisions and empowers the state insurance commissioner to revoke licenses for willful violations.
- Modifies and clarifies the relationship between this new product and existing long-term care and medical assistance programs, particularly the elderly waiver and the alternative care program, including eligibility rules, funding limits, and how services are billed and funded.
- Sets up detailed criteria for who may receive alternative care funding and under what circumstances, including cost limits, assets, and income considerations, and excludes certain situations and facilities from funding.
- The text provided ends mid-section, with further amendments possibly following, but the included sections establish these core elements and interactions.
Relevant Terms - short-term home health and nursing care insurance - fixed indemnity policy - guaranteed renewable - noncancelable - activities of daily living (ADLs) - cognitive impairment - freelook period - home health agency - nursing facility - plan of care - qualified insurer - average annualized premium - long-term care policy - Minnesota Statutes sections 62A.135, 62A.46, 72A.13, 256B.0913 - 62A.70 (short-term home health and nursing care insurance) - alternative care program - elderly waiver (MA-related considerations) - medical assistance (MA) - case mix classification (A) - monthly service limit - asset transfer penalty, spenddown, maintenance needs allowance - eligibility and funding for nonmedical assistance recipients - allegations of violations and penalties (fines, license revocation)
Bill text versions
- Introduction PDF PDF file
Actions
| Date | Chamber | Where | Type | Name | Committee Name |
|---|---|---|---|---|---|
| March 12, 2026 | Senate | Action | Introduction and first reading | ||
| March 12, 2026 | Senate | Action | Referred to | Commerce and Consumer Protection |
Citations
[
{
"analysis": {
"added": [
"Definition of fixed indemnity policy expanded to explicitly include short-term home health and nursing care insurance under 62A.70."
],
"removed": [],
"summary": "Amends 62A.135 subdivision 1 to define fixed indemnity policy and to clarify that fixed indemnity policies may include short-term home health and nursing care insurance via section 62A.70.",
"modified": [
"Subd.1 definitions updated to accommodate inclusion of short-term home health and nursing care insurance."
]
},
"citation": "62A.135",
"subdivision": "subdivision 1"
},
{
"analysis": {
"added": [
"Long-term care policy defined (including that it provides prescribed long-term care benefits).",
"Clarification that long-term care policy does not include short-term home health and nursing care insurance under 62A.70."
],
"removed": [],
"summary": "Amends 62A.46 subdivision 2 to define long-term care policy and to clarify alignment with short-term coverage.",
"modified": [
"62A.46 Subd.2 updated to explicitly distinguish long-term care policies from short-term home health and nursing care insurance."
]
},
"citation": "62A.46",
"subdivision": "subdivision 2"
},
{
"analysis": {
"added": [],
"removed": [],
"summary": "Cross-references to the range of sections governing long-term care policy; situates the long-term care framework relative to the new short-term product.",
"modified": [
"References to 62A.46 through 62A.56 updated to reflect changes affecting long-term care policy definitions and scope."
]
},
"citation": "62A.46 to 62A.56",
"subdivision": ""
},
{
"analysis": {
"added": [],
"removed": [],
"summary": "Exemptions for associations from the requirements of 62A.30 to 62A.44; maintains exemption status until a specified date.",
"modified": [
"Maintain exemptions for associations under 62A.30–62A.44; clarifies continued inapplicability of certain provisions until July 1, 1988."
]
},
"citation": "62A.30 to 62A.44",
"subdivision": ""
},
{
"analysis": {
"added": [],
"removed": [],
"summary": "Reference to exemptions under 62A.31 subdivision 1 clause c affecting applicability of other sections.",
"modified": [
"Clarifies that exemptions described in 62A.31, subdivision 1, clause c apply and affect the subject provisions referenced (62A.46–62A.56)."
]
},
"citation": "62A.31",
"subdivision": "subdivision 1"
},
{
"analysis": {
"added": [
"Affirmation that short-term health and nursing care insurance requires approval as necessary under 62A.02 and 62A.135."
],
"removed": [],
"summary": "Requires commissioner approval for short-term health insurance under the framework referenced in 62A.02 and 62A.135.",
"modified": [
"Cross-reference to 62A.02 clarified in Sec.3."
]
},
"citation": "62A.02",
"subdivision": ""
},
{
"analysis": {
"added": [
"Penalty framework referencing violations of 60A.06, 62A.01–62A.10, and 62A.70; fine up to $200 per offense and possible license revocation for violators."
],
"removed": [],
"summary": "Penalties provision for violations of specified insurance-related sections; cross-references to other statutes.",
"modified": [
"Sec.4 changes establish penalties for noncompliance with listed provisions and cross-referenced statutes."
]
},
"citation": "72A.13",
"subdivision": "subdivision 1"
},
{
"analysis": {
"added": [
"Eligibility criteria for funding under the alternative care program now codified with specific conditions (citizenship, age, disability status, etc.).",
"Detailed asset and income-related limitations and program rules incorporated."
],
"removed": [],
"summary": "Modifies eligibility for alternative care funding under the nonmedical assistance framework.",
"modified": [
"Subdivision 4 updated to reflect the current eligibility and funding requirements for alternative care services."
]
},
"citation": "256B.0913",
"subdivision": "subdivision 4"
},
{
"analysis": {
"added": [
"Reference to 256B.0911 subdivision 2 establishing criteria used to compare community-based services versus nursing facility needs."
],
"removed": [],
"summary": "Defines eligibility determinants used for alternative care funding when comparing to nursing facility needs.",
"modified": [
"Cross-reference clarified for use in the alternative care program."
]
},
"citation": "256B.0911",
"subdivision": "subdivision 2"
},
{
"analysis": {
"added": [
"Explicit mention of asset transfer penalty under 256B.0595 as a condition in funding eligibility."
],
"removed": [],
"summary": "Asset transfer penalty referenced in determining eligibility for alternative care funding.",
"modified": [
"Contextual cross-reference to asset transfer penalties clarified."
]
},
"citation": "256B.0595",
"subdivision": ""
},
{
"analysis": {
"added": [
"References to equity interest in the home exceeding 500,000 affecting eligibility (256B.056)."
],
"removed": [],
"summary": "Equity in home limits as part of eligibility considerations for long-term care funding.",
"modified": [
"Integrated with alternative care eligibility criteria."
]
},
"citation": "256B.056",
"subdivision": ""
},
{
"analysis": {
"added": [
"Clarification of nursing facility-level criteria for eligibility in alternative care scenarios."
],
"removed": [],
"summary": "Reiterates eligibility determinants under 256B.0911 subdivision 2 for nursing facility-level care in the context of alternative care.",
"modified": [
"Cross-reference reinforced in Sec.5."
]
},
"citation": "256B.0911",
"subdivision": "subdivision 2"
},
{
"analysis": {
"added": [
"Monthly service limit defined for participants in the alternative care program and adjusted via reassessment and annual updates."
],
"removed": [],
"summary": "Sets monthly limit framework for alternative care services under 256S.18.",
"modified": [
"Linkage to the monthly limit described in 256S.18 strengthened."
]
},
"citation": "256S.18",
"subdivision": ""
},
{
"analysis": {
"added": [
"Monthly service limit referenced for alternative care funding; applies to new and reassessed participants."
],
"removed": [],
"summary": "Defines monthly service limits for alternative care funding under 256S.04.",
"modified": [
"Cross-reference included to ensure alignment with 256S.18 limits."
]
},
"citation": "256S.04",
"subdivision": ""
},
{
"analysis": {
"added": [
"Maintenance needs allowance referenced for eligibility determinations."
],
"removed": [],
"summary": "Incorporates maintenance needs allowance in determining eligibility for alternative care funding under 256S.05.",
"modified": [
"Alignment of income and resource tests with 256S.05."
]
},
"citation": "256S.05",
"subdivision": ""
},
{
"analysis": {
"added": [
"ADL-related definitions emphasized (section 62S.01, subdivision 2)."
],
"removed": [],
"summary": "Defines Activities of Daily Living (ADL) and related terms used in short-term coverage definitions.",
"modified": [
"Cross-reference updated to support short-term home health and nursing care insurance definitions."
]
},
"citation": "62S.01",
"subdivision": "subdivision 2"
},
{
"analysis": {
"added": [
"Cognitive impairment definition cited (62S.01, subdivision 9)."
],
"removed": [],
"summary": "Cognitive impairment definition referenced for short-term coverage eligibility.",
"modified": [
"Contextual alignment with 62S.01 subdivisions for eligibility criteria."
]
},
"citation": "62S.01",
"subdivision": "subdivision 9"
},
{
"analysis": {
"added": [
"Additional ADL-related criteria referenced (62S.01, subdivision 18)."
],
"removed": [],
"summary": "Additional ADL-related criteria referenced for short-term coverage.",
"modified": [
"Consistency with short-term home health and nursing care definitions."
]
},
"citation": "62S.01",
"subdivision": "subdivision 18"
},
{
"analysis": {
"added": [
"Defines terms used in this chapter for short-term home health and nursing care insurance."
],
"removed": [],
"summary": "Establishes definitions for short-term home health and nursing care insurance within 62A.70.",
"modified": [
"Sec.3 updates introduce 62A.70 definitions as part of the regulatory framework."
]
},
"citation": "62A.70",
"subdivision": "subdivision 1"
},
{
"analysis": {
"added": [
"Qualification and approval process for short-term products by a qualified insurer."
],
"removed": [],
"summary": "Approval framework for short-term home health and nursing care insurance.",
"modified": [
"Subd.2 codifies the approval process necessary under the statute."
]
},
"citation": "62A.70",
"subdivision": "subdivision 2"
},
{
"analysis": {
"added": [
"Policy must provide benefits for specified cognitive impairment and ADL requirements, with cap of 360 days, freelook period, and renewability provisions."
],
"removed": [],
"summary": "Policy requirements for short-term home health and nursing care insurance.",
"modified": [
"Subd.3 enumerates benefit triggers, duration limits, and renewal protections."
]
},
"citation": "62A.70",
"subdivision": "subdivision 3"
},
{
"analysis": {
"added": [
"Disclosures include that the policy is supplemental health insurance, not long-term care insurance, and not a Minnesota partnership product; freelook and renewal explanations."
],
"removed": [],
"summary": "Disclosures required for short-term home health and nursing care insurance.",
"modified": [
"Subd.4 codifies required consumer disclosures."
]
},
"citation": "62A.70",
"subdivision": "subdivision 4"
}
]Progress through the legislative process
In Committee