Minn. R. agency 120, ch. 2740, MINNESOTA COMPREHENSIVE HEALTH ASSOCIATION, pt. 2740.2100

Current through Register Vol. 49, No. 18, October 28, 2024

Part 2740.2100 - DEFINITIONS

Subpart 1.Accident and health insurance business.

"Accident and health insurance business" means the issuance or renewal of any accident and health insurance policy as defined in Minnesota Statutes, section 62E.02, subdivision 11.

A. An insurer is engaged in accident and health insurance business during the period in which any policy or contract which has been issued or renewed remains in effect.

B. Such business shall not include the issuance or renewal of policies or contracts providing coverage that is:

(1) limited to disability or income protection coverage for a specified period of time;

(2) limited to automobile insurance that provides coverage for medical payments as defined and authorized under Minnesota Statutes, section 60A.06, subdivision 1, clause (12);

(3) supplemental to liability insurance, as defined and authorized in Minnesota Statutes, section 60A.06, subdivision 1, clause (13);

(4) limited to policies or contracts issued prior to July 1, 1976 under which there is no unilateral right of the insurer or fraternal to cancel, nonrenew, amend, or change the terms, conditions, or premium rate of the policy or contract in any way; provided that all policies and contracts designed solely to provide payments on a per diem, fixed indemnity or nonexpense incurred basis issued prior to June 3, 1977 under which there is no unilateral right of the insurer or fraternal to cancel, nonrenew, amend, or change the terms, conditions, or premium rate of the policy or contract in any way, are also excluded;

(5) designed solely to provide payment on a per diem, fixed indemnity, or nonexpense incurred basis, except that all policies and contracts designed solely to provide payments on a hospital indemnity basis issued or renewed by an insurer on or after June 3, 1977 are included to the extent that such coverage is issued to an applicant who is not covered by a qualified plan or a health maintenance plan at the time of issue;

(6) limited to credit accident and health insurance, meaning insurance on a debtor to provide indemnity for payments becoming due on a specific loan or other credit transaction while the debtor is disabled as defined in the policy, as authorized by Minnesota Statutes, chapter 62B;

(7) designed solely to provide dental or vision care;

(8) limited to blanket accident and sickness insurance as defined in Minnesota Statutes, section 62A.11; or

(9) limited to accident-only coverage issued by an insurance agent and that provides reasonable benefits in relation to the cost of covered services.

Subp. 2.Health maintenance organization business.

"Health maintenance organization business" means the operation of a nonprofit corporation licensed and operated as provided in Minnesota Statutes, chapter 62D.

Subp. 3.Licensed or authorized to do business.

"Licensed or authorized to do business" means:

A. licensed by the commissioner to conduct business under Minnesota Statutes, chapter 62A or 62C, or by the commissioner of health under Minnesota Statutes, chapter 62D; or

B. authorized by the secretary of state to carry on any business in the state of Minnesota or otherwise doing business in this state and acting as an insurer, self-insurer, fraternal, or health maintenance organization.

Subp. 4.Self-insurance business.

"Self-insurance business" means the provision, directly or indirectly, of a plan of health coverage by a self-insurer. "Self-insurance business" does not include the direct provision of health care services to employees at no charge to them by an employer engaged in the business of providing health care services to the public, nor does it include provision of benefits that, if provided by an insurer doing accident and health insurance business, would be excluded under subpart 1, item B. "Directly or indirectly" for the purposes of parts 2740.2100 to 2740.5500 means that the self-insurer funds the plan of health coverage in any amount or collects any employee contributions which are used to pay for the plan of health coverage.

Minn. R. agency 120, ch. 2740, MINNESOTA COMPREHENSIVE HEALTH ASSOCIATION, pt. 2740.2100

10 SR 474

Statutory Authority: MS s 62E.09