MN SF4096

Adds "preventive items and services" to the definition of comprehensive health maintenance services and creates a new statutory definition of "service area" as commissioner-approved geographic locations (cities, counties, townships) where HMOs may sell products

Requires HMOs to directly allocate administrative expenses to specific business lines or products, with remaining expenses allocated per Advisory Group on Administrative Expenses recommendations; investment income must be allocated based on cumulative net income by business line

Mandates HMOs publish up-to-date, accurate provider directories showing which providers accept new patients, along with location, contact information, specialty, and affiliations; hard copies must be provided upon request

Requires health carriers to reprocess claims as in-network if a provider's status changed from in-network to out-of-network after the change took effect but before the website was updated, unless the enrollee was notified beforehand

Repeals section 62D.181 (MCHA alternative coverage for HMO insolvency) and section 62D.08, subdivision 7 (administrative expenses reporting requirements now moved to quarterly financial statements section)