Chapter 62K — Title

62K.01 Title This chapter is officially called the 'Minnesota Health Plan Market Rules.' It sets the rules that health insurance … 62K.02 Purpose and Scope This section explains the purpose and scope of the health plan market rules. The rules apply to individual and small … 62K.03 Definitions This section defines key terms used throughout the chapter, including 'health carrier,' 'health plan,' 'enrollee,' … 62K.04 Market Rules; Violation Health carriers selling individual or small group plans in Minnesota must follow all the rules in this chapter. Breaking … 62K.05 Federal Act; Compliance Required Health carriers in Minnesota must follow all parts of the federal Affordable Care Act (ACA) that apply in this state. … 62K.06 Metal Level Mandatory Offerings Health carriers that sell bronze or catastrophic level plans must also offer silver and gold level plans in the same … 62K.07 Information Disclosures Health carriers must report detailed information to the state, including claims payment practices, enrollment data, … 62K.075 Provider Network Notifications Health carriers must list their provider networks on their websites and update them at least once a month. If a doctor's … 62K.08 Marketing Standards Health carriers must follow all state and federal marketing rules when advertising individual and small group health … 62K.09 Accreditation Standards Health carriers offering individual or small group plans must be accredited by a recognized organization like URAC or … 62K.10 Geographic Accessibility; Provider Network Adequacy Health carriers must have enough doctors, specialists, and other providers in their networks so that enrollees can get … 62K.105 Network Adequacy Complaints The Commissioner of Health must have an easy process for enrollees to file complaints if their health carrier does not … 62K.11 Balance Billing Prohibited In-network providers cannot charge you more than what your health plan allows, plus your copay, deductible, or … 62K.12 Quality Assurance and Improvement Health carriers must have a written quality improvement program that evaluates the care provided to enrollees, checks … 62K.13 Service Area Requirements Health carriers must offer their plans across at least an entire county. They cannot draw service areas to avoid areas … 62K.14 Limited-scope Pediatric Dental Plans Children's dental plans must be offered on a guaranteed basis, cannot exclude pre-existing conditions, and must ensure … 62K.15 Annual Open Enrollment Periods; Special Enrollment Periods Health carriers can only enroll new individual plan members during the annual open enrollment period or during special …