North Dakota (ND)
Individual Health Insurance Regulations

Learn more about North Dakota Individual Health Insurance

Applications for individual health insurance in North Dakota may be medically underwritten. This allows the insurance company to ask eligibility and medical questions that they may use to determine their risk in offering you coverage. Based on your application, you may either be approved for standard coverage or denied coverage completely. For those that are not eligible due to pre-existing conditions, the Comprehensive Health Association of North Dakota provides guaranteed issue coverage. Each insurance carrier selling individual health insurance in North Dakota must offer a standard and a basic plan that has identical benefits that are regulated by the state. These are the same standardized plans that are offered to small groups. North Dakota is one of the few states that does not permit the insurance companies to place an elimination riders on individual health plans. This means that they must accept you as you are, or not at all. If you have a pre-existing condition, there may be a 12 month exclusionary period on this condition unless you have prior creditable coverage that can be applied to that exclusion period. Insurance carriers are allowed to charge higher rates based on your health status and other risk factors. Your individual health insurance policy may only be cancelled for non-payment of premium or fraud and may not be cancelled solely based on an illness or high claims payments.

Request North Dakota Individual Health Insurance Quotes from any of our multiple providers.

North Dakota (BD)
Small Group Health Insurance Regulations

Any person that goes to work for a company that offers group health insurance may not be denied acceptance on the plan based on their health status. This is referred to as nondiscrimination. The employee must be eligible for coverage under the employer's guidelines, who may elect to not offer coverage to all employees, require a minimum number hours of work per week or place a waiting period from your date of hire. If you are enrolling in an HMO plan, the insurance company may require a waiting period of 2 months before you start receiving benefits. You are not required to pay a premium during this affiliation period. Group health insurance regulations in North Dakota apply to companies with 2-50 employees. Rating restrictions only apply to companies with 25 or fewer employees. For any new member that does not have prior creditable coverage, the insurance company may place a 12 month exclusionary period on pre-existing medical conditions. They are permitted to review medical records and health history for up to 6 months prior to the start date of your coverage. Rates charged to small groups can be higher if the group has employees that are considered a claims risk, but the highest rate allowed may not be more than 35% greater than the standard rate charged to healthy groups.

Small business owners can request quotes for North Dakota group health insurance from any of our listed providers.

North Dakota COBRA and Continuation Coverage

Federal COBRA laws apply to any company that has 20 or more employees. Under federal COBRA, an employee may remain on the group health plan for 18 months following the termination date of their group coverage as an active and eligible employee. North Dakota has a mini-COBRA law that applies to smaller groups and allows an employee to remain on the group plan for 39 weeks if they were covered under the group plan as an active employee for at least 3 months. You must accept your mini-COBRA options within 10 days of the termination of your group coverage or receipt of notification, whichever comes later. Conversion plans are available to persons losing their group coverage. Once you have exhausted your COBRA coverage, or if you are not eligible for standard issued individual health insurance, you may apply for coverage under the Comprehensive Health Association of North Dakota, which is the states high-risk pool.