1. This section applies to a self-insurance health plan for: a. Health insurance and prescription drug benefits coverage; b. Health insurance benefits coverage, excluding all or part of prescription drug benefits coverage; or c. All or part of prescription drug benefits coverage. 2. Except for prescription drug coverage under subdivision c of subsection 1, a self-insurance health plan established by the board under this section must be provided under an administrative services only (ASO) contract or a third-party administrator (TPA) contract under the uniform group insurance program. The board may not establish a self-insurance health plan unless the board determines the self- insurance health plan best serves the interests of the state and the state's eligible employees. If the board determines it is in the best interest of the plan, individual stop-loss coverage insured by a carrier authorized to do business in this state may be made part of a self-insurance health plan.
54-52.1-04.3. Self-insurance health plan - Reserve fund - Continuing appropriation - Benefits - Insurance commissioner. 1. Pursuant to chapter 26.1-36.6, the board shall establish and maintain under a self-insurance health plan a reserve fund to provide for adverse fluctuations in future charges, claims, costs, or expenses of the uniform group insurance program. Upon the initial changeover from a contract for insurance pursuant to section 54-52.1-04 or a health maintenance organization pursuant to section 54-52.1-04.1 to a self-insurance health plan pursuant to section 54-52.1-04.2, the board must have a plan in place which is reasonably calculated to meet within sixty months of the changeover the
funding requirements of chapter 26.1-36.6. All moneys in the reserve fund, not otherwise appropriated, are appropriated to the board for the payment of claims and other costs of the uniform group insurance program during periods of adverse claims or cost fluctuations. 2. A self-insurance health plan must comply with section 26.1-36.6-03 and must provide the same benefits required of a fully insured plan. 3. The insurance commissioner shall ensure compliance with and enforce the provisions of this section pursuant to chapter 26.1-36.6.