S.F. No. 224 - Modifications to the Purchasing Alliance Stop-Loss Fund (Delete-Everything Amendment)
Author:	Senator Sheila M. Kiscaden
Prepared by:	Katie Cavanor, Senate Counsel (651/296-3801)
Date:	February 17, 2003

Section 1 (256.956, subdivision 1) makes the following modifications to the definition section:

• modifies the definition of "qualifying employer" by clarifying that an employer must have at least one employee but no more than ten employees at the time of initial membership to a qualifying purchasing alliance;

• strikes the exclusion of the city of Duluth in terms of the geographic area of a qualifying purchasing alliance;

• requires the Commissioner of Health to approve any criteria needed in order to receive grants from other public or private entities;

• strikes the enrollment deadline for qualifying purchasing alliances; and

• authorizes the Commissioner of Health to waive the requirement that a qualifying purchasing alliance be organized and operating before May 1, 2001, if this requirement inhibits the commissioner's ability to obtain grants from other entities.

Section 2 (256.956, subdivision 2) authorizes the commissioner to accept grants from public or private entities for the purpose of expanding the stop-loss fund. Any funds obtained must be deposited in the stop-loss fund account and must be distributed in accordance with this section.

Section 3 (256.956, subdivision 3) clarifies that the reimbursement received must be for payments made, less any third-party recoveries. This section also states that claims incurred by a qualifying enrollee are eligible for reimbursement for a two-year period beginning from the date of enrollment. Finally, the section requires a portion of third-party recoveries that are collected by a health plan company within two years of the date of the original claim to be paid back to the stop-loss fund account.

Section 4 (256.956, subdivision 4) modifies the language stating that requests for payments must be made no later than April 1 following the end of the calendar year for which the request is being made by striking "beginning April 1, 2002."

Section 5 (256.956, subdivision 5) requires distribution of the stop-loss funds to occur before June 30 of the following calendar year. The section also permits undistributed funds to carry over to the next biennium.

Section 6 (256.956) extends the sunset for the section until all funds in the stop-loss fund account are distributed or January 1, 2005, whichever is later.

Section 7 specifies that the current appropriations to the account for fiscal years 2004 and 2005 must be used for claim reimbursements for qualifying enrollees who are members of a purchasing alliance that meets the requirements of Minnesota Statutes, chapter 62T; services a geographic area located outstate Minnesota, and is organized and operating by May 1, 2001.

KC:ph

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