Minn. R. agency 144, ch. 4685, OPEN ENROLLMENT, pt. 4685.3200

Current through Register Vol. 49, No. 25, December 16, 2024

Part 4685.3200 - WAIVER

Subpart 1.Application to the commissioner.

The requirements of Minnesota Statutes, section 62D.10 may be waived or the imposition of necessary underwriting restrictions may be authorized upon a written application to the commissioner stating the grounds for the request.

Subp. 2.Compliance.

The commissioner shall determine whether or not compliance with the requirement for open enrollment would:

A. contravene the maximum enrollment limitation of 500,000 enrollees imposed by the act;

B. prevent a health plan from competing effectively with other health plans or with commercial health insurers for the enrollment of new members or for the retention of current members;

C. result in a health plan incurring unreasonably high expenses in relation to the value of the benefits or services it provides;

D. jeopardize the availability or adequacy of a health plan's working capital and any required surpluses or reserves; or

E. endanger the ability of a health plan to meet its current and future obligations to enrollees.

Subp. 3.Considerations.

In making this determination the commissioner of health shall:

A. consider information supplied by a health plan in its application for the waiver or underwriting restrictions;

B. be permitted access to all health plan records pertinent to such application;

C. consider prevailing practices and standards relating to the financing and delivery of health care service in the community; and

D. consider any comments submitted by the commissioner of commerce or any interested party.

Minn. R. agency 144, ch. 4685, OPEN ENROLLMENT, pt. 4685.3200

L 1983 c 289 s 114 subd 1; L 1984 c 655 art 1 s 92

Statutory Authority: MS s 62D.10