Title 26.1 — Insurance

The commissioner may require that a corporation possessing a certificate of exemption submit periodically any report the commissioner determines to be desirable or necessary to ascertain compliance with requirements of this chapter. The commissioner, whenever the commissioner det…

Except as prescribed in this chapter, the corporation is otherwise exempt from the provisions of this code and other insurance laws.

Unless otherwise specifically included, this chapter does not apply to recommendations involving: 1. Direct response solicitations if there is no recommendation based on information collected from the consumer pursuant to this chapter; and 2. Contracts used to fund: a. An employe…

This chapter applies to a sale or recommendation of an annuity. This chapter may not be construed to create or imply a private cause of action for a violation of this chapter or to subject a producer to civil liability under the best interest standard of care outlined in section …

1. "Annuity" means an annuity that is an insurance product under state law which is individually solicited, whether the product is classified as an individual or group annuity. 2. "Cash compensation" means a discount, concession, fee, service fee, commission, sales charge, loan, …

1. A producer, if making a recommendation of an annuity, shall act in the best interest of the consumer under the circumstances known at the time the recommendation is made, without placing the producer's or the insurer's financial interest ahead of the consumer's interest. A pro…

1. A producer may not solicit the sale of an annuity product unless the producer has adequate knowledge of the product to recommend the annuity and the producer is in compliance with the insurer's standards for product training. A producer may rely on insurer-provided product-spe…

1. An insurer is responsible for compliance with this chapter. If a violation occurs, either because of the action or inaction of the insurer or the insurer's producer, the commissioner may order: a. An insurer to take reasonably appropriate corrective action for any consumer har…

1. Insurers, general agents, independent agencies, and producers shall maintain or be able to make available to the commissioner a record of the information collected from the consumer, disclosures made to the consumer, including summaries of oral disclosures, and other informati…

For purposes of this chapter: 1. "Applicant" means: a. In the case of an individual Medicare supplement policy or subscriber contract, the person who seeks to contract for insurance benefits. b. In the case of a group Medicare supplement policy or subscriber contract, the propose…

1. The commissioner shall adopt reasonable rules to establish specific standards for provisions of Medicare supplement policies. The standards are in addition to and in accordance with applicable laws of this state, and may include coverage of: a. Terms of renewability. b. Initia…

The commissioner may adopt rules to establish standards for benefits, standard policies and optional benefit riders, claims payments, abusive marketing practices and compensation arrangements, and reporting practices for Medicare supplement policies.

Medicare supplement policies must return benefits to individual policyholders in the aggregate of not less than sixty-five percent of premium received. The commissioner shall adopt rules to establish minimum standards for Medicare supplement policy loss ratios on the basis of inc…

1. To provide for full and fair disclosure in the sale of Medicare supplement policies, no Medicare supplement policy or certificate may be delivered or issued for delivery in this state unless an outline of coverage is delivered to the applicant at the time application is made. …

Medicare supplement policies or certificates must have a notice prominently printed on or attached to the first page of the policy stating in substance that the applicant may return the policy or certificate within thirty days of its delivery and have the premium refunded if, aft…

Every insurer, health care service plan, or other entity providing Medicare supplement insurance or benefits in this state shall provide a copy of any Medicare supplement advertisement within ten days after its first use in this state whether through written, radio, or television…

A policy delivered or issued for delivery to any person in this state in violation of this chapter is valid but must be construed as provided in this chapter. When any provision in a policy subject to this chapter is in conflict with this chapter, the rights, duties, and obligati…

Any person willfully violating any provision of this chapter or order of the commissioner made in accordance with this chapter is guilty of a class A misdemeanor. The commissioner may also suspend or revoke the license of an insurer or insurance producer for any such willful viol…

As used in this chapter and section 26.1-36-37.2, unless the context otherwise requires: 1. "Actuarial certification" means a written statement by a member of the American academy of actuaries, or other individual acceptable to the insurance commissioner, that a small employer ca…

1. This chapter and section 26.1-36-37.2 apply to any health benefit plan that provides coverage to the employees of a small employer in this state if: a. Any portion of the premium or benefits is paid by or on behalf of the small employer; b. An eligible employee or dependent is…

1. A small employer carrier may establish a separate class of business only to reflect substantial differences in expected claims experience or administrative costs resulting from: a. The small employer carrier using more than one type of system for the marketing and sale of heal…

1. This section only applies to a health benefit plan offered by a small employer who employed an average of at least two but not more than twenty-five eligible employees on business days during the preceding calendar year and who employs at least two employees on the first day o…

1. A health benefit plan subject to this chapter and section 26.1-36-37.2 must be renewable with respect to all eligible employees and dependents, at the option of the small employer, except for any of the following: a. The plan sponsor has failed to pay premiums or contributions…

1. a. As a condition of transacting business in this state with small employers, every small employer carrier shall actively offer small employers all health benefit plans it actively markets to small employers in this state. b. (1) Subject to subdivision a of subsection 1, a sma…

Repealed by S.L. 2003, ch. 256, § 3.

Repealed by S.L. 2013, ch. 236, § 6.

Repealed by S.L. 2003, ch. 256, § 3.

Repealed by S.L. 2013, ch. 236, § 6.

1. Each small employer carrier shall actively market health benefit plan coverage to eligible small employers in the state. 2. a. A small employer carrier or producer may not engage in the following activities, directly or indirectly: (1) Encouraging or directing small employers …

The commissioner may adopt rules to require small employer carriers, as a condition of transacting business with small employers in this state after August 1, 1993, to reissue a health benefit plan to any small employer whose health benefit plan has been terminated or has not bee…

This chapter applies to all policies issued or renewed after July 31, 1995. The provisions of chapter 26.1-36 apply when not in conflict with this chapter.

As used in this chapter, the definitions in section 26.1-36.3-01 apply, unless the context otherwise requires. In addition: 1. "Insurer" means any insurance company, nonprofit health service organization, fraternal benefit society, or health maintenance organization that provides…

An insurer may impose a pre-existing condition exclusion only if: 1. The exclusion relates to a condition, regardless of the cause of the condition, for which medical diagnosis, care, or treatment was recommended or received within the six-month period ending on the effective dat…

A group policy may not impose a pre-existing condition exclusion that: 1. Relates to pregnancy as a pre-existing condition. 2. Treats genetic information as a pre-existing condition in the absence of a diagnosis of a condition related to such information.

An insurer shall reduce any time period applicable to a pre-existing condition, for a policy by the aggregate of periods the individual was covered by qualifying previous coverage, if the qualifying previous coverage as defined in section 26.1-36.3-01 is continuous until at least…

1. An insurer issuing policies or certificates under this chapter shall provide for the renewability or continuability of coverage unless: a. The individual or group has failed to pay premiums or contributions in accordance with the terms of the health benefit plan or the insurer…

Premium rates for individual policies are subject to the following: 1. For any class of individuals, the premium rates charged during a rating period to the individuals in that class for the same or similar coverage may not vary by a ratio of more than six to one after August 1, …

Repealed by S.L. 2013, ch. 236, § 6.

An insurer shall accept a personal or business check from an employer as a payment method for premium payment for an employee's individual accident and health insurance policy. This section does not apply to groups as defined under chapter 26.1-36.3.

1. Once each calendar year, any employer with fifty-one or more eligible employees, any employer investigating becoming part of a health plan, including a plan sponsored by an association or a multiple employer welfare arrangement, or any employer upon termination of health insur…

For purposes of this chapter, unless the context otherwise requires, "insurer" means any health insurer, including a group health plan, as defined in section 607(1) of the Employee Retirement Income Security Act of 1974 [Pub. L. 99-272; 100 Stat. 281; 29 U.S.C. 1167(1)], a health…

1. No insurer may deny enrollment of a child under the health coverage of the child's parent on the grounds that: a. The child was born out of wedlock; b. The child is not claimed as a dependent on the parent's federal income tax return; or c. The child does not reside with the p…

If a parent is required by a court or administrative order to provide health coverage for a child and the parent is eligible for family health coverage through an insurer, the insurer shall: 1. Permit the parent to enroll under family coverage any child who is otherwise eligible …

If a child has health coverage through the insurer of a noncustodial parent, the insurer shall: 1. Provide information to the custodial parent as may be necessary for the child to obtain benefits through the health coverage; 2. Permit the custodial parent, the provider of health …

This chapter is adopted pursuant to the requirements of sections 4301 and 13623 of Public Law 103-66 [107 Stat. 312; 29 U.S.C. 1161 et seq. and 42 U.S.C. 1396g-1]. The commissioner may take any action reasonably necessary to enforce this chapter and section 26.1-36-12. Any insure…

As used in this chapter, "self-insurance health plan" has the same meaning as provided under section 54-52.1-01.

The commissioner shall regulate the financial condition, integrity, and equitable administration of a self-insurance health plan established under chapter 54-52.1. All powers granted to the commissioner to regulate insurance companies and insurers under title 26.1 apply to the co…

1. The following policy provisions apply to a self-insurance health plan or to the administrative services only or third-party administrator, and are subject to the jurisdiction of the commissioner: sections 26.1-36-03, 26.1-36-03.1, 26.1-36-05, 26.1-36-10, 26.1-36-12, 26.1-36-12…

The commissioner shall adopt rules to administer this chapter. The rules must establish reserve requirements. The rules may provide certain self-insurance health plans are exempt from all or portions of this chapter.

For purposes of this chapter, unless the context otherwise requires: 1. "Association" means the reinsurance association of North Dakota. 2. "Board" means the board of directors of the reinsurance association of North Dakota. 3. "Earned group health benefit plan premiums" means pr…