North Dakota Code 26.1-36.3-02 – Applicability and scope
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:
Terms Used In North Dakota Code 26.1-36.3-02
- Dependent: A person dependent for support upon another.
- Obligation: An order placed, contract awarded, service received, or similar transaction during a given period that will require payments during the same or a future period.
- Organization: includes a foreign or domestic association, business trust, corporation, enterprise, estate, joint venture, limited liability company, limited liability partnership, limited partnership, partnership, trust, or any legal or commercial entity. See North Dakota Code 1-01-49
- Person: means an individual, organization, government, political subdivision, or government agency or instrumentality. See North Dakota Code 1-01-49
- State: when applied to the different parts of the United States, includes the District of Columbia and the territories. See North Dakota Code 1-01-49
- United States: includes the District of Columbia and the territories. See North Dakota Code 1-01-49
- written: include "typewriting" and "typewritten" and "printing" and "printed" except in the case of signatures and when the words are used by way of contrast to typewriting and printing. See North Dakota Code 1-01-37
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 reimbursed, whether through wage adjustments or otherwise, by or on behalf of the small employer for any portion of the premium; or
c. The health benefit plan is treated by the employer or any of the eligible employees or dependents as part of a plan or program for the purposes of section 106, 125, or 162 of the United States Internal Revenue Code.
2. a. Except as provided in subdivision b, carriers that are affiliated companies or that are eligible to file a consolidated tax return must be treated as one carrier and any restrictions or limitations imposed by this chapter and section 26.1-36-37.2 apply as if all health benefit plans delivered or issued for delivery to small employers in this state by the affiliated carriers were issued by one carrier.
b. An affiliated carrier that is a health maintenance organization having a certificate of authority may be considered to be a separate carrier for the purposes of this chapter and section 26.1-36-37.2.
c. Unless otherwise authorized by the commissioner, a small employer carrier may not enter into one or more ceding arrangements with respect to health benefit plans delivered or issued for delivery to small employers in this state if the arrangements would result in less than fifty percent of the insurance obligation or risk for the health benefit plans being retained by the ceding carrier.
3. a. A Taft Hartley trust, or a carrier with the written authorization of that trust, may make a written request to the commissioner for a waiver from the application of any of the provisions of subsection 1 of section 26.1-36.3-04 with respect to a health benefit plan provided to the trust.
b. The commissioner may grant the waiver if the commissioner finds that application of subsection 1 of section 26.1-36.3-04, with respect to the trust:
(1) Would have a substantial adverse effect on the participants and beneficiaries of that trust; and
(2) Would require significant modifications to one or more collective bargaining arrangements under which the trust is established or maintained.
c. A waiver granted under this section does not apply to a person who participates in the trust as an associate member of an employee organization.