§ 26.1-36.3-11 — Standards to assure fair marketing

North Dakota § 26.1-36.3-11

• Jurisdiction: North Dakota
• Title 26.1: Insurance
• Ch. 26.1-36.3: Small Employer Employee Health Insurance

Text

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 to refrain from filing an application
for coverage with the small employer carrier because of the health status,
claims experience, industry, occupation, or geographic location of the small
employer.
(2) Encouraging or directing small employers to seek coverage from another
carrier because of the health status, claims experience, industry, occupation,
or geographic location of the small employer.
b. Subdivision a does not apply to information provided by a small employer carrier
or producer to a small employer regarding the established geographic service
area or a restricted network provision of a small employer carrier.
3. a. A small employer carrier may not enter into any contract, agreement, or
arrangement, directly or indirectly, with a producer that provides for or results in
the compensation paid to a producer for the sale of a health benefit plan to be
varied because of the health status, claims experience, industry, occupation, or
geographic location of the small employer.
b. Subdivision a does not apply to a compensation arrangement that provides
compensation to a producer on the basis of percentage of premium, provided the
percentage does not vary because of the health status, claims experience,
industry, occupation, or geographic area of the small employer.
4. No small employer carrier may terminate, fail to renew, or limit its contract or
agreement of representation with a producer for any reason related to the health
status, claims experience, occupation, or geographic location of the small employers
placed by the producer with the small employer carrier.
5. No small employer carrier or producer may induce or otherwise encourage a small
employer to separate or otherwise exclude an employee from health coverage or
benefits provided in connection with the employee's employment.

6. Denial by a small employer carrier of an application for coverage from a small
employer must be in writing and must state the reason or reasons for the denial.
7. A violation of this section by a small employer carrier or a producer is an unfair trade
practice under section 26.1-04-03.
8. If a small employer carrier enters into a contract, agreement, or other arrangement
with a third-party administrator to provide administrative, marketing, or other services
related to the offering of health benefit plans to small employers in this state, the
third-party administrator is subject to this section as if it were a small employer carrier.