HF4333 (Legislative Session 94 (2025-2026))
Supplemental health insurance product established to cover short-term home health and nursing care, and civil penalties provided.
Related bill: SF4390
AI Generated Summary
Purpose
Establishes a new supplemental health insurance product to cover short-term home health and nursing care, and updates related laws. It also revises penalties for violations and expands funding rules for certain nonmedical long-term care supports.
What the bill would do (Main Provisions)
- Create a new insurance product: shortterm home health and nursing care insurance, classified as a fixed indemnity policy. This product is designed to pay predetermined fixed benefits for specified home health and nursing care services.
- Define key policy terms and styles:
- Fixed indemnity policy: pays fixed benefits rather than expenses incurred; may include some policies with mixed expense-incurred and fixed benefits.
- Guaranteed renewable and noncancelable options: protections on renewal, with some rate changes allowed on a class basis if approved by the commissioner.
- Average annualized premium: used for rate filings, reflecting the expected distribution of policyholders by factors like age, sex, coverage amount, etc.
- Freelook period: at least 30 days for insureds to review and cancel for a full refund.
- Qualified insurer: an insurer licensed in Minnesota to offer this product.
- Activities of daily living (ADLs) and cognitive impairment: triggers for benefits under the new product.
- Waiting period: a defined time before coverage becomes effective; cannot be altered if the policy is replaced.
- Coverage rules and limits:
- Benefits trigger when the insured cannot perform at least two ADLs with substantial assistance or has cognitive impairment.
- Maximum benefit period is 360 days for a single policy.
- Policy must include a freelook period and specific renewal/discontinuation protections (e.g., not canceled due to health deterioration; renewal can be denied only for nonpayment, fraud, misrepresentation, loss of insurer authority, or exhaustion of benefits).
- When converting or replacing a policy, the original waiting period cannot be increased.
- Disclosures required:
- Clear notice that this is supplemental health insurance and not long-term care insurance or MN partnership long-term care coverage.
- Clear explanations of the freelook period and all renewability/continuity provisions.
- Regulatory enforcement and penalties:
- Violations of the insurance provisions can trigger fines (up to $200 per offense) and license revocation for violators or nonresident insurers that willfully violate state law.
- Relation to other long-term care laws:
- Clarifies that shortterm home health and nursing care insurance is separate from long-term care insurance (as defined in existing statutes).
- Excludes certain types of policies (e.g., Medicare supplement, major medical, disability income, etc.) from being considered shortterm home health and nursing care insurance.
How it changes existing law
- Amends Minnesota Statutes to:
- Expand and clarify definitions related to long-term care, home health, and shortterm insurance.
- Add the new shortterm home health and nursing care insurance to the list of covered policy forms and adjust how rate information is calculated.
- Update penalties for noncompliance with insurance provisions.
- Aligns the new product with existing long-term care policy exceptions (e.g., certain employer-provided or union-related plans may have different requirements).
- Introduces a framework for approval by the insurance commissioner before the product can be offered.
Section-by-section highlights (conceptual)
- Section 1: Defines terms and sets the framework for fixed indemnity and shortterm home health and nursing care insurance, including renewability concepts and rate-related terminology.
- Section 2: Clarifies long-term care policy definitions and exemptions (who they apply to and who is exempt).
- Section 3: Establishes the actual shortterm home health and nursing care insurance rules, including:
- Eligible services and providers (home health agencies, nursing facilities, plan of care).
- Coverage requirements (ADLs, cognitive impairment, 360-day limit, freelook, renewal rules).
- Disclosures and required policy language.
- Section 4: Adds penalties for violations of insurance provisions and enforcement mechanisms.
- Section 5: Modifies the eligibility and funding structure for the alternative care program (nonmedical assistance recipients), detailing who can receive funding, monthly/annual cost limits, depreciation/adjustments, eligibility extensions, and interaction with medical assistance/elderly waiver programs.
- Other notes: References to various sections of Minnesota law (e.g., 62A.135, 62A.46, 256B.0913) to implement the changes and ensure consistency with existing programs.
Significant changes to existing law
- Creation of a new supplemental insurance product (shortterm home health and nursing care) with explicit definitions, eligibility, and benefit rules.
- Introduction of fixed indemnity concepts into the shortterm care space and explicit protections around renewals, waiting periods, and cancellation.
- New mandatory disclosures for consumers to understand that the product is supplemental and not long-term care insurance.
- New or enhanced penalties for violations of insurance laws.
- Substantial updates to the alternative care funding program for nonmedical assistance recipients, including eligibility criteria, funding limits, service caps, and interactions with MA/elderly waiver programs.
Potential impacts and who it affects
- Consumers: A potential new option to help pay for short-term home health and nursing care needs, with defined benefit limits and protections.
- Insurers: Must develop and obtain approval for the new product, adhere to definitions like fixed indemnity and freelook, and comply with new disclosure and renewability requirements.
- Regulators: Need to approve product forms and oversee enforcement of new penalties and rules.
- Individuals relying on nonmedical alternative care funding: The bill tightens or clarifies eligibility and funding rules, including monthly limits and interactions with MA/elderly waiver programs.
Notes on terminology (for clarity)
- Shortterm home health and nursing care insurance: the new product being created.
- Fixed indemnity policy: a policy that pays a predetermined fixed amount per claim or period.
- Guaranteed renewable / noncancelable: renewal protections and limits on changing coverage or rates.
- Freelook period: a consumer review window (at least 30 days).
- Plan of care, home health agency, nursing facility: defined care providers and formal care plans used to determine eligibility.
- Activities of daily living (ADLs) and cognitive impairment: health status measures triggering benefits.
- Qualified insurer: the entity allowed to offer this new product.
- Alternative care program (nonmedical assistance recipients): state funding program for long-term supports outside medical assistance.
- Elderly waiver and medical assistance (MA): existing programs with which the new funding rules interact.
Relevant terms shortterm home health and nursing care insurance; fixed indemnity policy; guaranteed renewable; noncancelable; average annualized premium; freelook period; qualified insurer; activities of daily living (ADLs); cognitive impairment; plan of care; home health agency; nursing facility; waiting period; disclosures; longterm care policy; alternative care program; nonmedical assistance recipients; elderly waiver; medical assistance (MA); case mix classification; monthly service limit; asset transfer penalty; spenddown; maintenance needs allowance; consumer-directed supports; lead agency.
Bill text versions
- Introduction PDF PDF file
Actions
| Date | Chamber | Where | Type | Name | Committee Name |
|---|---|---|---|---|---|
| March 16, 2026 | House | Action | Introduction and first reading, referred to | Commerce Finance and Policy |
Citations
[
{
"analysis": {
"added": [
"Definition of fixed indemnity policy (includes short-term home health and nursing care insurance under 62A.70)",
"Definitions for guaranteed renewable, noncancelable, and average annualized premium",
"Clarification of rate filing concepts (average annualized premium for pricing)"
],
"removed": [],
"summary": "Amends 62A.135 to add and define short-term fixed indemnity concepts used for a supplemental health insurance product, including the integration of short-term home health and nursing care insurance under 62A.70 and related rate and policy terminology.",
"modified": []
},
"citation": "62A.135",
"subdivision": "1"
},
{
"analysis": {
"added": [
"Long-term care policy definitions and scope clarified in relation to short-term home health and nursing care insurance",
"Exemption language for certain employer-sponsored and labor union arrangements from 62A.46 to 62A.56 until a stated date"
],
"removed": [],
"summary": "Amends long-term care policy provisions; clarifies scope and exemptions related to long-term care policies and the applicability of sections 62A.46 to 62A.56.",
"modified": [
"Clarifies that long-term care policy exclusions apply to short-term home health and nursing care insurance under 62A.70"
]
},
"citation": "62A.46",
"subdivision": "2"
},
{
"analysis": {
"added": [
"Definitions for home health agency, nursing facility, plan of care, insured, and short-term services",
"Definition of short-term home health and nursing care insurance as a policy form that provides home health and/or nursing care services",
"Clarifications around eligibility (e.g., cognitive impairment and ADL criteria)"
],
"removed": [],
"summary": "Establishes short-term home health and nursing care insurance definitions and related terms, including eligibility, services, and duration.",
"modified": []
},
"citation": "62A.70",
"subdivision": ""
},
{
"analysis": {
"added": [
"Penalty provision for violations of sections 60A.06(3) or 62A.01–62A.10 or 62A.70",
"Fine up to $200 per offense",
"Commissioner may revoke licenses for out-of-state or foreign insurers or agents who violate listed provisions"
],
"removed": [],
"summary": "Penalties for violations relating to insurance provisions; authorizes fines and license revocation for noncompliance.",
"modified": []
},
"citation": "72A.13",
"subdivision": "1"
},
{
"analysis": {
"added": [
"Eligibility criteria (citizenship/national status, assessment-determined need for nursing facility-level care, age 65+, MA eligibility timing, asset transfer penalties, etc.)",
"Program-related financial caps (monthly service limits, annual aggregation, and adjustments to limits)",
"Conditions on funding when other coverage exists (MA, waiver obligations, employer/third-party insurance limits)"
],
"removed": [],
"summary": "Elifies eligibility criteria for funding under the alternative care program for nonmedical assistance recipients and outlines related limits and conditions.",
"modified": [
"Details on monthly and annual cost calculations, case-mix adjustments, and eligibility extensions/reassessment procedures"
]
},
"citation": "256B.0913",
"subdivision": "4"
},
{
"analysis": {
"added": [],
"removed": [],
"summary": "References Activities of Daily Living (ADL) meaning as defined in 62S.01, guiding eligibility for short-term care benefits.",
"modified": [
"Links ADL definition to the scope of short-term home health and nursing care insurance"
]
},
"citation": "62S.01",
"subdivision": "2"
},
{
"analysis": {
"added": [],
"removed": [],
"summary": "References cognitive impairment meaning for use in short-term health policy provisions.",
"modified": [
"Links cognitive impairment meaning to the short-term home health and nursing care policy definitions"
]
},
"citation": "62S.01",
"subdivision": "9"
},
{
"analysis": {
"added": [],
"removed": [],
"summary": "Defines home health or related terms for long-term care policy context, referencing 62A.46(10).",
"modified": [
"Cross-references home health agency definition within 62A.46"
]
},
"citation": "62A.46",
"subdivision": "10"
},
{
"analysis": {
"added": [],
"removed": [],
"summary": "Contextual cross-reference within long-term care policy provisions.",
"modified": []
},
"citation": "62A.46",
"subdivision": "3"
},
{
"analysis": {
"added": [],
"removed": [],
"summary": "Contextual cross-reference within long-term care policy provisions.",
"modified": []
},
"citation": "62A.46",
"subdivision": "8"
},
{
"analysis": {
"added": [],
"removed": [],
"summary": "References to chapter 62C (insurer licensing) related to qualified insurers.",
"modified": []
},
"citation": "62C",
"subdivision": ""
},
{
"analysis": {
"added": [],
"removed": [],
"summary": "Cross-reference to penalties under 60A.06; used in the penalties provision for insurance violations.",
"modified": []
},
"citation": "60A.06",
"subdivision": "3"
},
{
"analysis": {
"added": [],
"removed": [],
"summary": "Cross-reference to broad range of insurance provisions applicable to penalties for violations.",
"modified": []
},
"citation": "62A.01 to 62A.10",
"subdivision": ""
},
{
"analysis": {
"added": [],
"removed": [],
"summary": "Reiterates that short-term home health and nursing care insurance is not long-term care insurance, and defines the relationship with 62A.70.",
"modified": []
},
"citation": "62A.70",
"subdivision": ""
},
{
"analysis": {
"added": [
"Exemption for associations from certain long-term care policy requirements"
],
"removed": [],
"summary": "Exemption clause for associations from 62A.46–62A.56 until July 1, 1988.",
"modified": []
},
"citation": "62A.31",
"subdivision": "1"
},
{
"analysis": {
"added": [],
"removed": [],
"summary": "Defines Medicare supplement policies in the context of short-term coverage, cross-referencing Medicare-related standards.",
"modified": []
},
"citation": "62A.3099",
"subdivision": "18"
},
{
"analysis": {
"added": [],
"removed": [],
"summary": "Reference to community assessment for eligibility determinations under the alternative care program.",
"modified": []
},
"citation": "256B.0911",
"subdivision": ""
},
{
"analysis": {
"added": [],
"removed": [],
"summary": "Exemplifies asset-related limits (home equity) for alternative care funding eligibility.",
"modified": []
},
"citation": "256B.056",
"subdivision": ""
},
{
"analysis": {
"added": [],
"removed": [],
"summary": "Asset transfer penalties or related penalties tied to medical assistance eligibility considerations.",
"modified": []
},
"citation": "256B.0595",
"subdivision": ""
},
{
"analysis": {
"added": [],
"removed": [],
"summary": "Foundational definitions for the alternative care program, including case-mix and service limit constructs.",
"modified": []
},
"citation": "256S.01",
"subdivision": ""
},
{
"analysis": {
"added": [],
"removed": [],
"summary": "Describes monthly service limits and related program mechanics for alternative care.",
"modified": []
},
"citation": "256S.04",
"subdivision": ""
},
{
"analysis": {
"added": [],
"removed": [],
"summary": "Annual adjustments to monthly service limits under the alternative care program.",
"modified": []
},
"citation": "256S.05",
"subdivision": ""
},
{
"analysis": {
"added": [],
"removed": [],
"summary": "Case-mix classification framework and related monthly cost limits for alternative care services.",
"modified": []
},
"citation": "256S.18",
"subdivision": ""
}
]Progress through the legislative process
In Committee