Managed Care Systems
For Consumers
- Enrollee External Appeals and Complaints
- Mental Health Parity
- The No Surprises Act
- Provider Network Adequacy
- HMO Quality Audits and HEDIS Measures
- FAQs
For HMOs, CBPs, and Providers
- Essential Community Providers
- HMO Licensure
- Health Plan Reporting Requirements
- Network Adequacy Filing Requirements
About Minnesota HMOs
Related Sites
Health Plan Reporting Requirements
Health Maintenance Organizations (HMOs), County Based Purchasers (CBPs), and other health plans are all required to report information to the Minnesota Department of Health.
- HMOs are required to complete annual supplemental reporting, annual Quality Work Plans, update licensure documents and complete Collaboration Plans every four years.
- CPBs are required to complete annual supplemental reporting and update licensure documents.
- All health plans are required to complete annual No Surprises Act reporting
- All health plans that offer coverage in the individual and small group markets are required to have provider networks approved.
- Submit all documents through the Managed Care Systems Portal unless otherwise stated.
HMO Annual Supplemental Reporting
Under Minnesota Statue §62D.08 Subd. 2. Annual reporting is required from every health maintenance organization (HMO). Currently, there are four reports that are required each year:
Reports Due April 1st
- Statement of Revenue, Expenses, and Net Income
- Reallocation of Expenses and Investment Income
- Complaint Category Report
Reports Due July 1st
- Enrollment Report
Submit all documents through the Managed Care Systems Portal.
Forms and Templates
NEW! For 2025 reporting, the Statement of Revenue, Expenses and Net Income Template has now been combined with the Reallocation of Expenses and Investment Income Template.
- Statement of Revenue, Expenses and Net Income & Reallocation of Expenses and Investment Income Template 2025 (Excel)
- Complaint Category Reporting (Excel)
- Enrollment Template 2025 (Excel) (Minnesota Supplement Report #6 Enrollment Demographics)
- Enrollment Attestation (Word) [only file if no enrollment in Minnesota]
Provider Reporting
Provider reporting is accomplished through annual network adequacy review, see Provider Network Reporting for more information.
Please send an email to health.healthplan@state.mn.us if you have any questions regarding HMO annual reporting forms.
HMO and CBP Licensure Updates
Under Minnesota Statutes, section 62D.08, subd. 1, HMOs and CBPs are required to provide notice of changes to certain licensure documents for approval.
Updates to licensure documents, except those related to SERFF filing, can be submitted in the Managed Care Systems Portal.
Additional Health Plan Company Reporting: No Surprises Act and Contraceptive Coverage Exemption.
In 2023, the Minnesota legislature made two changes which require additional reporting to the Minnesota Department of Health (MDH) and Minnesota Department of Commerce (DOC). These include reporting summary data on No Surprises Act (NSA) claims and complaints and the number of organizations granted an accommodation for Contraceptive Coverage.
All health plan companies with fully-insured commercial coverage are required to complete reporting by April 1st of each year. Reporting instructions were sent via email, and can also be accessed below.