This text of North Dakota § 26.1-18.1-16 (Regulation of health maintenance organization producers) is published on Counsel Stack Legal Research, covering North Dakota primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.
1.The commissioner may adopt rules necessary to provide for the licensing of health
maintenance organization producers. The rules must establish:
a.The requirements for licensure of resident health maintenance organization
producers.
b.The conditions for entering into reciprocal agreements with other jurisdictions for
the licensure of nonresident health maintenance organization producers.
c.Any examination, prelicensing, or continuing education requirements.
d.The requirements for registering and terminating the appointment of health
maintenance organization producers.
e.Any requirements for registering any assumed names or office locations in which
a health maintenance organization producer does business.
f.The conditions for health maintenance organization producer license renewal
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1. The commissioner may adopt rules necessary to provide for the licensing of health
maintenance organization producers. The rules must establish:
a. The requirements for licensure of resident health maintenance organization
producers.
b. The conditions for entering into reciprocal agreements with other jurisdictions for
the licensure of nonresident health maintenance organization producers.
c. Any examination, prelicensing, or continuing education requirements.
d. The requirements for registering and terminating the appointment of health
maintenance organization producers.
e. Any requirements for registering any assumed names or office locations in which
a health maintenance organization producer does business.
f. The conditions for health maintenance organization producer license renewal.
g. The grounds for denial, refusal, suspension, or revocation of a health
maintenance organization producer's license.
h. Any required fees for the licensing activities of health maintenance organization
producers.
i. Any other requirement or procedure and any form as may be reasonably
necessary to provide for the effective administration of the licensing of health
maintenance organization producers under this section.
2. None of the following may be required to hold a health maintenance organization
producer license:
a. Any regular salaried officer or employee of a health maintenance organization
who devotes substantially all of the person's time to activities other than the
taking or transmitting of applications or membership fees or premiums for health
maintenance organization membership, or who receives no commission or other
compensation directly dependent upon the business obtained and who does not
solicit or accept from the public applications for health maintenance organization
membership;
b. Employers or their officers or employees or the trustees of any employee benefit
plan to the extent that the employers, officers, employees, or trustees are
engaged in the administration or operation of any program of employee benefits
involving the use of health maintenance organization memberships, provided that
the employers, officers, employees, or trustees are not in any manner
compensated directly or indirectly by the health maintenance organization issuing
the health maintenance organization memberships;
c. Banks or their officers and employees to the extent that the banks, officers, and
employees collect and remit charges by charging same against accounts of
depositors on the orders of the depositor; or
d. Any person or the employee of any person who has contracted to provide
administrative, management, or health care services to a health maintenance
organization and who is compensated for those services by the payment of an
amount calculated as a percentage of the revenues, net income, or profit of the
health maintenance organization, if that method of compensation is the sole basis
for subjecting that person or the employee of the person to this chapter.
3. The commissioner may by rule exempt certain classes of persons from the
requirement of obtaining a license:
a. If the functions they perform do not require special competence, trustworthiness,
or the regulatory surveillance made possible by licensing; or
b. If other existing safeguards make regulation unnecessary.