Title 26.1, Insurance

In addition to any other powers granted by law, a health service corporation writing hospital service contracts may: 1. Enter into contracts for the rendering of hospital service to any of its subscribers with hospitals maintained and operated by the state or any of its political…

A health service corporation writing medical service contracts may: 1. Enter into contracts with subscribers whereby each subscriber, subscriber member, officer, or employee is entitled to certain specified health services as provided in the subscriber's contract. 2. Enter into c…

A health service corporation writing optometric service contracts may: 1. Enter into contracts with subscribers whereby each subscriber, subscriber member, officer, or employee is entitled to certain specified health services as provided in the subscriber's contract. 2. Enter int…

A health service corporation writing health service contracts other than hospital service, medical service, and optometric service contracts may: 1. Enter into contracts with subscribers whereby each subscriber, subscriber member, officer, or employee is entitled to certain speci…

This chapter does not authorize a health service corporation to engage in the practice of medicine, dentistry, optometry, or any other profession for which a license or registration is required.

A health service corporation writing hospital service contracts or medical service contracts may not commence business and enter into any contracts with subscribers, nor secure any application therefor, unless the corporation has a contributed surplus of not less than one hundred…

Every nonprofit health service corporation is a charitable and benevolent organization and is exempt from taxation by the state or any political subdivision thereof, except that the tax imposed by section 26.1-03-17 is applicable to a corporation subject to this chapter and the r…

Unless in conflict with this chapter, chapter 10-33 applies to the incorporation, operation, and control of any nonprofit health service corporation.

1. Except as provided in this section, every physician, oral surgeon, dentist, or practitioner licensed and registered in this state has the right to contract with any health service corporation for furnishing general or special medical care, dental care, or optometric care, as t…

A medical service plan may provide for medical services to subscribers by physicians and oral surgeons not participating under the plan, subject to the approval of the board of directors of the health service corporation. A dental service plan may provide for dental services to s…

Contracts between a health service corporation and health service providers at all times are subject to the approval of the commissioner. Contracts between health service corporations and subscribers for health service are subject to the applicable provisions of chapter 26.1-36 a…

The issuance of a health service contract by a health service corporation to a subscriber does not create the relationship of hospital and patient, physician and patient, dentist and patient, practitioner and patient, or any other similar relationship between the corporation and …

All dental or optometric care rendered to a subscriber under the subscriber's contract must be in accordance with the accepted standards of dental or optometric practice prevailing in the community in which the service is rendered. All service must be rendered by dentists and pra…

Every subscriber under a dental or optometric service plan must receive a copy of the contract. The contract must clearly state the care, appliances, materials, and supplies to be provided under the contract and the rate charged the subscriber. Every subscriber must have, at all …

A health service corporation may contract with state, federal, or other governmental agencies, private agencies, corporations, associations, groups, or individuals to provide health services for needy or other persons. A health service corporation may receive from these entities …

The sales representatives of any health service corporation are subject to the laws pertaining to insurance producers as defined in chapter 26.1-26. The license for a sales representative must be issued on a form prescribed by the commissioner, and the fee for a license or renewa…

Chapter 26.1-04 applies to health service corporations and contracts with hospitals, doctors of medicine and oral surgeons, dentists, practitioners, health service providers, and subscribers, except to the extent that the commissioner determines that the nature of health service …

Rates must cover reasonably anticipated claims, cover reasonable costs of operation and overhead expenses, and maintain contingency reserves at a proper level of not less than the sum of incurred claims and operating and overhead expenses for at least two months, but not more tha…

1. Each health service corporation shall file with the commissioner every manual of classifications, rates, rating formulas, rating systems, and rules applicable thereto, and any modification of the foregoing which it proposes to use. Each filing must state the proposed effective…

1. If the commissioner finds that a rate filing does not meet the requirements of this chapter, the commissioner shall disapprove the rate filing pursuant to section 26.1-30-21. 2. If at any time subsequent to the applicable waiting period or extension thereof the commissioner fi…

Each health service corporation, within a reasonable time after receiving a written request therefor, shall furnish to any subscriber with whom it has a contract and who is affected by a rate made by it, or to the authorized representative of the subscriber, all pertinent informa…

A subscriber under a health service contract or a health service corporation may not willfully withhold information from, or give false or misleading information to, the commissioner or any statistical agency designated by the commissioner, when the information given or withheld …

The funds of any health service corporation may be invested only in those investments authorized to be made by domestic insurance companies of this state. Investments made prior to July 1, 1983, are subject to the requirements for authorized investments prior to July 1, 1983, and…

Every health service corporation shall transmit to the commissioner, not later than March first of each year, a statement of its condition and business for the year ending on the preceding December thirty-first. The statement must be in the form and must contain the information p…

The commissioner, or any deputy or examiner designated by the commissioner, has the right, at all reasonable times, to free access to all books and records of a health service corporation, and may summon and examine, under oath, the officers and employees of the corporation in al…

Any involuntary liquidation and dissolution of a health service corporation is governed by chapter 26.1-07. Any voluntary liquidation and dissolution is governed by chapter 10-33. Any merger or consolidation of a health service corporation is subject to the approval of the commis…

1. Any nonprofit health service corporation organized under chapter 26.1-17, having admitted assets in excess of all liabilities at least equal to the original surplus required of a mutual insurance company by section 26.1-12-10, without reincorporation, and upon adoption of a re…

1. Any health service corporation aggrieved by any order or decision of the commissioner made without a hearing, within thirty days after notice of the order to the corporation, may make written request to the commissioner for a hearing thereon. The commissioner shall hear the pa…