Minnesota Statutes Chapter 62Q, Secs. 62Q.01 onward: Health Plan Companies

What this document is

Minnesota Statutes Chapter 62Q - Health Plan Companies (Secs. 62Q.01 onward) is a state statute published by Minnesota Office of the Revisor of Statutes (revisor.mn.gov). It is one of the Minnesota documents that insurance license exam questions are written from, including minnesota life & health practice questions. This page summarizes it and points to the official version, which is the text to rely on.

Sections cited in practice questions

Each practice answer shows the exact passage it comes from. These are sections of this document that questions cite, with a short excerpt from the source text.

• Minn. Stat. Chapter 62Q § 62Q.43, subd. 2 (Geographic Access: Access Requirement)

  “Every closed-panel health plan must allow enrollees under the age of 26 years to change their designated clinic or primary care provider at least once per month, as long as the clinic or provider is part of the health plan company's statewide clinic or provider network. A health plan company shall...”

• Minn. Stat. Chapter 62Q § 62Q.01, subd. 2 (Commissioner)

  “"Commissioner" means the commissioner of health for purposes of regulating health maintenance organizations, and community integrated service networks, or the commissioner of commerce for purposes of regulating all other health plan companies.”

• Minn. Stat. Chapter 62Q § 62Q.73, subd. 8 (External Review of Adverse Determinations: Effects of External Review)

  “A decision rendered under this section shall be nonbinding on the enrollee and binding on the health plan company. The health plan company may seek judicial review of the decision on the grounds that the decision was arbitrary and capricious or involved an abuse of discretion.”

• Minn. Stat. Chapter 62Q § 62Q.68, subd. 3 (Complainant)

  “"Complainant" means an enrollee, applicant, or former enrollee, or anyone acting on behalf of an enrollee, applicant, or former enrollee, who submits a complaint.”

• Minn. Stat. § 62Q.43, subd. 2 (Geographic Access; Access requirement)

  “Every closed-panel health plan must allow enrollees under the age of 26 years to change their designated clinic or primary care provider at least once per month, as long as the clinic or provider is part of the health plan company's statewide clinic or provider network. A health plan company shall...”

• Minn. Stat. § 62Q.56, subd. 3 (Continuity of Care; Disclosure)

  “Information regarding an enrollee's rights under this section must be included in member contracts or certificates of coverage and must be provided by a health plan company upon request of an enrollee or prospective enrollee.”

• Minn. Stat. § 62Q.56, subd. 1b (Change in Health Care Provider; Termination for Cause)

  “If the contract termination was for cause, enrollees must be notified of the change and transferred to participating providers in a timely manner so that health care services remain available and accessible to the affected enrollees. The health plan company is not required to refer an enrollee back...”

• Minn. Stat. § 62Q.73, subd. 8 (Effects of External Review)

  “A decision rendered under this section shall be nonbinding on the enrollee and binding on the health plan company. The health plan company may seek judicial review of the decision on the grounds that the decision was arbitrary and capricious or involved an abuse of discretion.”

• Minn. Stat. § 62Q.70, subd. 1 (Appeal of the Complaint Decision; Establishment)

  “The person or persons with authority to resolve or recommend the resolution of the internal appeal must not be solely the same person or persons who made the complaint decision under section 62Q.69 .”

• Minn. Stat. § 62Q.58, subd. 4 (Access to Specialty Care; Referral)

  “If an enrollee receives services from a nonparticipating specialist because a participating specialist is not available, services must be provided at no additional cost to the enrollee beyond what the enrollee would otherwise pay for services received from a participating specialist.”

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