§ 256L.15 — Premiums
Plain-Language Summary
Sets MinnesotaCare premium amounts on a sliding scale based on income. Premiums range from $4 to $80 per month per adult. Children under 21 and adults with incomes below 35% of the federal poverty level pay no premiums.
256L.15 PREMIUMS.
§
Subdivision 1.Premium determination for MinnesotaCare.
(a) Families with children and individuals shall pay a premium determined according to subdivision 2.
(b) Members of the military and their families who meet the eligibility criteria for MinnesotaCare upon eligibility approval made within 24 months following the end of the member’s tour of active duty shall have their premiums paid by the commissioner. The effective date of coverage for an individual or family who meets the criteria of this paragraph shall be the first day of the month following the month in which eligibility is approved. This exemption applies for 12 months.
(c) Beginning July 1, 2009, American Indians enrolled in MinnesotaCare and their families shall have their premiums waived by the commissioner in accordance with section 5006 of the American Recovery and Reinvestment Act of 2009, Public Law 111-5. An individual must indicate status as an American Indian, as defined under Code of Federal Regulations, title 42, section 447.50, to qualify for the waiver of premiums. The commissioner shall accept attestation of an individual’s status as an American Indian as verification until the United States Department of Health and Human Services approves an electronic data source for this purpose. §
Subd. 1a.Payment options.
The commissioner may offer the following payment options to an enrollee:
(1) payment by check;
(2) payment by credit card;
(3) payment by recurring automatic checking withdrawal;
(4) payment by onetime electronic transfer of funds;
(5) payment by wage withholding with the consent of the employer and the employee; or
(6) payment by using state tax refund payments.
At application or reapplication, a MinnesotaCare applicant or enrollee may authorize the commissioner to use the Revenue Recapture Act in chapter 270A to collect funds from the applicant’s or enrollee’s refund for the purposes of meeting all or part of the applicant’s or enrollee’s MinnesotaCare premium obligation. The applicant or enrollee may authorize the commissioner to apply for the state working family tax credit on behalf of the applicant or enrollee. The setoff due under this subdivision shall not be subject to the $10 fee under section 270A.07, subdivision 1. §
Subd. 1b.Payments nonrefundable.
Only MinnesotaCare premiums paid for future months of coverage for which a health plan capitation fee has not been paid may be refunded. §
Subd. 2.Sliding fee scale; monthly individual or family income.
(a) The commissioner shall establish a sliding fee scale to determine the percentage of monthly individual or family income that households at different income levels must pay to obtain coverage through the MinnesotaCare program. The sliding fee scale must be based on the enrollee’s monthly individual or family income.
(b) Beginning January 1, 2014, MinnesotaCare enrollees shall pay premiums according to the premium scale specified in paragraph (d).
(c) Paragraph (b) does not apply to:
(1) children 20 years of age or younger; and
(2) individuals with household incomes below 35 percent of the federal poverty guidelines.
(d) The following premium scale is established for each individual in the household who is 21 years of age or older and enrolled in MinnesotaCare:
| Federal Poverty Guideline Greater than or Equal to | Less than | Individual Premium Amount |
|---|---|---|
| 35% | 55% | $4 |
| 55% | 80% | $6 |
| 80% | 90% | $8 |
| 90% | 100% | $10 |
| 100% | 110% | $12 |
| 110% | 120% | $14 |
| 120% | 130% | $15 |
| 130% | 140% | $16 |
| 140% | 150% | $25 |
| 150% | 160% | $37 |
| 160% | 170% | $44 |
| 170% | 180% | $52 |
| 180% | 190% | $61 |
| 190% | 200% | $71 |
| 200% | $80 |
(e) Beginning January 1, 2021, the commissioner shall adjust the premium scale established under paragraph (d) to ensure that premiums do not exceed the amount that an individual would have been required to pay if the individual was enrolled in an applicable benchmark plan in accordance with the Code of Federal Regulations, title 42, section 600.505 (a)(1). §
Subd. 3.
MS 2010 [Repealed, 2008 c 358 art 3 s 14] §
Subd. 4.
[Repealed, 2010 c 200 art 1 s 21]
History:
1995 c 234 art 6 s 20; 1998 c 407 art 5 s 39; 1999 c 245 art 4 s 99-101; 2001 c 203 s 16; 1Sp2001 c 9 art 2 s 65; 2002 c 220 art 15 s 24,25; 2002 c 379 art 1 s 113; 1Sp2003 c 14 art 12 s 83-85; 2005 c 10 art 1 s 57; 1Sp2005 c 4 art 8 s 74-76; 2007 c 147 art 5 s 32-34; 2008 c 286 art 1 s 11; 2008 c 358 art 3 s 11,14; 2009 c 79 art 5 s 68,69; 2009 c 173 art 3 s 20,25; 1Sp2010 c 1 art 24 s 7; 1Sp2011 c 9 art 6 s 82; 2012 c 216 art 13 s 18; 2013 c 108 art 1 s 62,63; 2015 c 71 art 11 s 57,58; 2016 c 189 art 19 s 29; 1Sp2017 c 6 art 4 s 60; 2020 c 115 art 3 s 34; 1Sp2021 c 7 art 1 s 30
History: History: 1995 c 234 art 6 s 20; 1998 c 407 art 5 s 39; 1999 c 245 art 4 s 99-101; 2001 c 203 s 16; 1Sp2001 c 9 art 2 s 65; 2002 c 220 art 15 s 24,25; 2002 c 379 art 1 s 113; 1Sp2003 c 14 art 12 s 83-85; 2005 c 10 art 1 s 57; 1Sp2005 c 4 art 8 s 74-76; 2007 c 147 art 5 s 32-34; 2008 c 286 art 1 s 11; 2008 c 358 art 3 s 11,14; 2009 c 79 art 5 s 68,69; 2009 c 173 art 3 s 20,25; 1Sp2010 c 1 art 24 s 7; 1Sp2011 c 9 art 6 s 82; 2012 c 216 art 13 s 18; 2013 c 108 art 1 s 62,63; 2015 c 71 art 11 s 57,58; 2016 c 189 art 19 s 29; 1Sp2017 c 6 art 4 s 60; 2020 c 115 art 3 s 34; 1Sp2021 c 7 art 1 s 30