SF4287

Purpose

This bill aims to ensure that injured paramedics, emergency medical technicians, and other eligible public safety personnel who become disabled in the line of duty can keep their health insurance coverage. It updates procedures and requirements around how health coverage is continued when someone is determined to be duty-disabled or is applying for benefits.

Main Provisions

• Health coverage continuation obligation: The employer must continue health coverage for the duty-disabled person and their dependents if the person is in the line of duty and is or becomes eligible for duty disability benefits.
• Who is covered and when: Applies to peace officers or firefighters (and, by extension for this context, injured paramedics/EMTs) who are determined eligible for a duty disability benefit under related statutes (for example, PERA or MSRS determinations, or plans of relief associations).
• Duration of coverage for pre-enactment recipients: For those already approved for duty disability benefits under certain provisions before enactment, coverage and the employer’s contributions must continue until age 65 or the person would have reached 65 if they had not died.
• Duration of coverage for post-enactment cases: For those applying for or approved for duty disability benefits after enactment (but not yet for a total and permanent duty disability), coverage continues for 60 months (plus applicable dependent coverage) or until age 65, whichever comes first.
• Coverage for specific disability paths: If someone is approved to receive benefits under other disability provisions (e.g., related to 352B.10), the employer must continue health coverage for the same period as above (until age 65, with dependents covered for the same duration).
• Dependent coverage: When coverage is continued, dependents’ coverage is also continued for the same duration, with rules about when dependents stop being covered.
• Waiver option: A covered individual may voluntarily waive health coverage, but cannot receive payment or other consideration from the employer for waiving coverage. Any waiver agreement entered into after enactment is void if it provides compensation for waiving coverage.
• No employer challenge to disability decision after determination: Once a duty disability determination is made, the employer cannot challenge the continuation and payment of health coverage.
• Financial responsibility: The employer must pay the employer’s share of the health coverage contributions for the employee and, if applicable, for dependents, during the continuation period.

Significant Changes to Existing Law

• Broadens or clarifies that health coverage must continue for a broader group of public safety personnel who are duty-disabled or seeking duty disability, with specific duration rules tied to whether the disability is total and permanent or temporary.
• Establishes explicit durations (up to age 65, or 60 months for certain post-enactment cases) for employer-paid health coverage and clarifies that dependents may receive coverage for the same period.
• Tightens the process around disability determinations, including binding effect on the employer and state, required notices, and a defined path for administrative review via the Office of Administrative Hearings.
• Adds a clear prohibition on post-determination challenges by the employer to ongoing health coverage, and clarifies the role of contested case procedures and potential court review.
• Introduces or reinforces waiver rules for health coverage, including a prohibition on compensation for waiving coverage and voiding post-enactment waiver agreements that provide for compensation.

Eligibility and Process Overview

• Who qualifies: Peace officers or firefighters (and related public safety personnel such as injured paramedics/EMTs) who are disabled in the line of duty or who have been determined eligible for a duty disability benefit under applicable statutes.
• How determinations are made: By the respective executive directors of PERA or MSRS (depending on the system), with written notice and reasons provided to the employee and employer.
• Review options: If the determination is made by MSRS, the employee may petition for a review via a contested case before the Office of Administrative Hearings within 60 days.
• Reversal possibility: If additional information is provided before a contested case hearing, the executive director may reverse the determination without a hearing.
• Administrative hearing and finality: If a hearing is held, the judge’s fact-finding decision is final, binding on the executive director, the employee, the employer, and the state; judicial review is available by writ of certiorari to the Minnesota Court of Appeals.
• Standing for review: Only the peace officer or firefighter’s employer and the state may participate in the judicial review of the Office of Administrative Hearings’ decision.

Health Coverage Details

• Continuation obligation: Employers must continue health coverage for the duty-disabled individual and, if applicable, their dependents during the specified continuation period.
• Contributions: The employer remains responsible for the employer’s contribution toward health coverage during the continuation period.
• End of coverage for dependents: Employers are not required to continue dependent coverage once a dependent is no longer a dependent.
• Waiver mechanics: Individuals may waive coverage, but waivers cannot be incentivized by compensation; pre-enactment waivers are not invalidated by the new rules.

Terminology and Concepts Emphasized

• Duty disability benefit
• Public Employees Retirement Association (PERA)
• Minnesota State Retirement System (MSRS)
• Duty disability determinations (including sections like 353.656, 352B.10, 353.656 subdivision 1a, 352B.011 subdivision 7)
• Health coverage / health insurance continuation
• Employer contributions
• Dependents’ coverage
• Age 65 as coverage termination point (if applicable)
• 60 months as a coverage duration
• Waiver of health coverage
• Contested case (Office of Administrative Hearings)
• Written notice with reasons
• Binding determinations
• Writ of certiorari
• Minnesota Court of Appeals

Relevant Terms health coverage, health insurance, duty disability, duty disability benefits, Public Employees Retirement Association, PERA, Minnesota State Retirement System, MSRS, disposition of duty disability, 353.656, 353.656 subdivision 1a, 352B.10, 352B.011 subdivision 7, total and permanent duty disability, 60 months, age 65, dependents, employer contributions, waiver of coverage, void waivers, Office of Administrative Hearings, contested case, writ of certiorari, Minnesota Court of Appeals, binding determination, notice of determination.