§ 26.1-49-05 — Contract filing - Approval

The health provider cooperative shall file each contract between the cooperative and a
purchaser with the commissioner. The commissioner shall disapprove any contract:
1. In which the consideration paid for health services is unreasonably high in relationship
to the services provided.
2. That fails to include evidence of the specific procedures used to inform prospective
enrollees of any limitations imposed on the enrollee's right to receive care from a
health provider of the enrollee's choice.

3. Under which a health provider cooperative assumes a corridor of risk greater than
fifteen percent in its first year of operation, or greater than thirty percent in any year
thereafter.
Any actuarial costs incurred by the department in review of that filing must be borne by the
cooperative. The commissioner may adopt rules implementing this section.