COBRA Law Summaries
North Dakota, COBRA Law Summaries
North Dakota's health care continuation law is codified in the North Dakota Century Code Annotated at Title 26.1, Section 26.1-36-23 and 26.1-36-23.1.
DEFINITIONS
“Accident and health insurance policy” includes any contract policy insuring against loss resulting from sickness or bodily injury, or death by accident, or both (Sec. 26.1-36-02).
COVERAGE
North Dakota's health care continuation law covers all employers maintaining a group policy or certificate of insurance delivered or issued for delivery in North Dakota issued by any insurance company, nonprofit health service corporation, health maintenance organization, or any other insurer that provides hospital, surgical, or major medical expense insurance (Sec. 26.1-36-23).
EXCEPTIONS
North Dakota's health care continuation law does not apply to employers who sponsor group policies for a specific disease or accidental injury only (Sec. 26.1-36-23).
PROCEDURES
An employer must offer continuation coverage to employees and eligible dependents who have been continuously covered for the three months prior to termination of coverage resulting from the termination of employment. Divorced spouses are also eligible for coverage on a limited basis. Continuation coverage is not available to employees eligible for Medicare or for coverage under another group plan (Sec. 26.1-36-23 and 26.1-36-23.1).
The employer must include a notice of the continuation privilege in each certificate of coverage. The employee must elect continuation coverage in writing within the ten-day period following the later of
the date the group coverage ends, or
the date the employee receives notice from the employer of his right to continue coverage.
The employee may not elect continuation coverage more than 31 days after termination of group coverage (Sec. 26.1-36-23).
WHAT THE EMPLOYER MUST DO
North Dakota's health care continuation law requires an employer to offer continuation coverage to employees and eligible dependents who have been continuously covered for the three months prior to termination of coverage resulting from the termination of employment (Sec. 26.1-36-23).
Eligibility requirements.- Employees and eligible dependents who have been continuously covered for the three months prior to termination of coverage are eligible for continuation coverage. Divorced spouses are also eligible for coverage on a limited basis. Continuation coverage is not available to employees eligible for Medicare or for coverage under another group plan (Sec. 26.1-36-23 and 26.1-36-23.1).
Extended election period for subsidy-eligible individuals. Individuals without a state mini-COBRA election in effect as of February 17 (the date of the American Recovery and Reinvestment Act’s enactment) and eligible as “assistance eligible individuals” have an extended period in which to elect coverage. The employer or the group policyholder must provide employees or members with written notice of the extended election period. This notice must be provided within 14 days of the effective date of the state legislation. The employee or member must then elect coverage, in writing, no later than 60 days after the date notice is provided. Notice of the extended election period need not be included in the certificate of coverage (which is normally required under the North Dakota mini-COBRA provisions) (Sec. 26.1-36-23(10), as added by H. 1010, enacted May 4, 2009 and effective May 5, 2009).
Disability of dependent child.- If a group health plan specifies that a dependent child's coverage must terminate upon that child's attainment of a specified age, the attainment of that age will not operate to terminate the coverage of the child while the child is incapable of self-sustaining employment by reason of mental or physical disability and chiefly dependent upon the employee for support and maintenance. Proof of disability and dependency must be furnished by the employee within 31 days of the child's attainment of the specified age and thereafter, as required by the insurer, but not more frequently than annually after the two-year period following the child's attainment of the specified age (Sec. 26.1-36-22).
Conversion to individual policy.- Upon termination of the period of continuation coverage, employees may exercise any option available in the group policy to elect a conversion policy. All policies must also allow former spouses and dependent children of covered employees to elect conversion coverage (Sec. 26.1-36-23 and 26.1-36.23.1).
Deadlines.- The person electing conversion coverage must notify the insurer of the election and pay the required premium within 31 days of termination of continued coverage. Former spouses have 30 days to elect coverage and pay the first premium (Sec. 26.1-36-23 and 26.1-36-23.1)
Duration of coverage.- Former spouse may renew conversion coverage until:
reaching age 65;
covered by another group plan; or
covered under Medicare
(Sec. 26.1-36-23.1).
Duration of coverage: Continuation coverage.- Continuation coverage lasts for 39 weeks after group coverage would otherwise terminate (Sec. 26.1-36-23).
Duration of coverage: Conversion coverage.- A former spouse may renew conversion coverage until:
reaching age 65;
covered by another group plan; or
covered under Medicare
(Sec. 26.1-36-23.1).
Premiums.- The premium charged for continuation coverage may not be more than the group rate charged under the group policy on the due date of each payment, except that insurers may charge divorced spouses 102% of the premium for group coverage (Sec. 26.1-36-23 and 26.1-36-23.1).
Termination of coverage.- Continuation coverage will terminate if a premium payment is not timely made (Sec. 26.1-36-23).
NOTICE
Notice of the continuation privilege must be included in each certificate of coverage (Sec. 26.1-36-23).
DEADLINES
Continuation coverage.- The employee must elect continuation coverage in writing within the ten-day period following the later of:
the date the group coverage ends, or
the date the employee receives notice from the employer of his right to continue coverage.
The employee may not elect continuation coverage more than 31 days after termination of group coverage (Sec. 26.1-36-23).
Conversion coverage.- The person electing conversion coverage must notify the insurer of the election and pay the required premium within 31 days of termination of continued coverage. Former spouses have 30 days to elect coverage and pay the first premium (Sec. 26.1-36-23 and 26.1-36-23.1)
<p>Conversion coverage.— The person electing conversion coverage must notify the insurer of the election and pay the required premium within 31 days of termination</p>