This text of North Dakota § 26.1-36-02.2 (Individual health plans - Open enrollment periods - Rules) 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. As used in this section:
a. "Adverse selection" occurs when an individual who experiences greater than
average health risks seeks to purchase an individual health plan.
b. "Annual open enrollment period" means a period each year during which an
individual may enroll or change coverage in an individual health plan that is not
sold through a health benefit exchange.
c. "Health benefit exchange" means a governmental agency or nonprofit entity that:
(1)Meets the applicable requirements of the federal Patient Protection and
Affordable Care Act [Pub. L. 111-148] and the provisions of the Health Care
and Education Reconciliation Act of 2010 [Pub. L. 111-152]; and
(2)Makes qualified health plans available to qualified individuals and qualified
employers through a state health benefit exchang
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1. As used in this section:
a. "Adverse selection" occurs when an individual who experiences greater than
average health risks seeks to purchase an individual health plan.
b. "Annual open enrollment period" means a period each year during which an
individual may enroll or change coverage in an individual health plan that is not
sold through a health benefit exchange.
c. "Health benefit exchange" means a governmental agency or nonprofit entity that:
(1) Meets the applicable requirements of the federal Patient Protection and
Affordable Care Act [Pub. L. 111-148] and the provisions of the Health Care
and Education Reconciliation Act of 2010 [Pub. L. 111-152]; and
(2) Makes qualified health plans available to qualified individuals and qualified
employers through a state health benefit exchange, regional health benefit
exchange, subsidiary health benefit exchange, or a federally facilitated
health benefit exchange.
d. "Individual health plan" means health insurance coverage offered to individuals,
other than in connection with a group health plan. The term does not include
limited scope dental or vision benefits, coverage only for specified disease or
illness, hospital indemnity or other fixed indemnity insurance, or other similar
limited benefit health plans.
e. "Initial enrollment period" means a period during which an individual may enroll in
individual health plan coverage sold outside a health benefit exchange for
coverage during the 2014 benefit year.
f. "Special enrollment period" means a period that is outside of the initial and
annual open enrollment periods, during which an individual or enrollee who
experiences certain qualifying events may enroll in or change enrollment in an
individual health plan not sold through a health benefit exchange.
2. The commissioner may adopt rules reasonably necessary to mitigate adverse
selection or other undesirable market effect among individual health plans sold inside
and among individual health plans sold outside a health benefit exchange. The rules
may contain:
a. Requirements for the initial enrollment period;
b. Requirements for an annual open enrollment period;
c. Requirements for a special enrollment period;
d. Requirements for an individual who purchases individual health plan coverage
during a special enrollment period; and
e. Any other provision reasonably required to mitigate adverse selection or other
undesirable market effect in individual health plans sold inside or outside a health
benefit exchange.