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Minnesota Health Insurance Regulations: Coverage, Renewal, and Standard Provisions, Exams of Law

Key regulations pertaining to health insurance in minnesota, covering topics such as coverage for disabled and newborn children, guaranteed renewal provisions, survivor benefits, termination of employment, standard provisions, and medicare supplement plans. It provides specific details on grace periods, reinstatement procedures, notice of claim requirements, and other essential aspects of health insurance policies in the state.

Typology: Exams

2024/2025

Available from 02/25/2025

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MINNESOTA LAWS, RULES, AND
REGULATIONS PERTINENT TO HEALTH
INSURANCE ONLY ALREADY PASSED
Coverage of Disabled Children
Proof of the incapacity and dependency must be furnished to the insurer, HMO, or organization
within ____ _______ of the child reaching the policy's limiting age and annually TWO YEARS
after the limiting age was attained. ✔✔31 days
Coverage of Newborns and Adopted Children
All individual and group health insurance and health maintenance contracts must cover a
newborn infant immediately from the _________ ____ ________ for illness, injury, congenital
malformation, or premature birth. ✔✔moment of birth
Coverage of Newborns and Adopted Children
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MINNESOTA LAWS, RULES, AND

REGULATIONS PERTINENT TO HEALTH

INSURANCE ONLY ALREADY PASSED

Coverage of Disabled Children

Proof of the incapacity and dependency must be furnished to the insurer, HMO, or organization within ____ _______ of the child reaching the policy's limiting age and annually TWO YEARS after the limiting age was attained. ✔✔31 days

Coverage of Newborns and Adopted Children

All individual and group health insurance and health maintenance contracts must cover a newborn infant immediately from the _________ ____ ________ for illness, injury, congenital malformation, or premature birth. ✔✔moment of birth

Coverage of Newborns and Adopted Children

Benefits for individuals age ____ up to the limiting age for dependent coverage are limited to medical and dental treatment that was scheduled or initiated prior to the dependent turning age _____. (blanks are the same number) ✔✔ 19

Guaranteed Renewal

An individual policy or contract issued as a conversion policy prior to ________ ____ _______, will be renewable at the option of the covered person as long as the covered person is not covered under another qualified plan. ✔✔January 1, 2014

Survivors

If the survivor fails to make premium or fee payments within ____ _______ after payment notification, the insurer may terminate coverage without written consent. If the coverage is terminated for non-payment, written notice of cancellation must be mailed to the survivor's last known address at least 30 DAYS before the cancellation. ✔✔90 days

Continuation/Conversion of Benefits

  1. Entire contract

  2. Time limit on certain defenses

  3. Grace period

  4. Reinstatement

  5. Notice of claim

  6. Claim forms

  7. Proof of loss

  8. Time payment of claims

  9. Payment of claims

  10. Physical exam and autopsy

  11. Legal actions

  12. Change of beneficiary ✔✔required provisions

Standard Provisions (Grace period)

Grace period for weekly premium policies. ✔✔seven days

Standard Provisions (Grace period)

Grace period for monthly premium policies. ✔✔10 days

Standard Provisions (Grace period)

Grace period for all other policies. ✔✔31 days

Standard Provisions (Reinstatement)

The insurer may collect no more than _____ ________ of past due premiums with the reinstatement application, and will issue a conditional receipt. ✔✔60 days

Standard Provisions (Reinstatement)

The insured is automatically covered if the insurer has not rejected their reinstatement application within ____ ______. ✔✔45 days

Standard Provisions (Reinstatement)

Standard Provisions (Legal actions)

The insured must wait at least _____ _______ after furnishing written proof of loss to take legal action against the insurer to collect benefits. No legal action can be brought after THREE YEARS from the time written proof of loss is required. ✔✔60 days

Optional Provisions (Cancellation)

The insurer will promptly return the unearned portion of premium paid, calculated on a _____ _______ ________. ✔✔pro rata basis

This act established an insurance safety net for individuals who have been turned down for individual health insurance due to pre-existing conditions. ✔✔Comprehensive Health Insurance Act (CHIA)

Medicare Supplement Plans

The policy must cover preexisting conditions during the first SIX MONTHS of coverage if the insured was not diagnosed or treated for the particular condition during the ____ ______ immediately preceding the effective date of coverage. ✔✔90 days

Medicare Supplement Plans

At the request of the policyholder, benefits and premiums can be suspended for up to _____ ________ while the policyholder is entitled to medical assistance. The policyholder must notify the supplement policy issuer with 90 DAYS after the date the individual becomes entitled to medical assistance. ✔✔24 months

Medicare Supplement Plans

Policyholders have the right to return the Medicare supplement policy within ____ ______ of its delivery if, after reviewing the policy, the insured is not satisfied for any reason. ✔✔30 days