# Title 45 — Insurance, Commissioner of

## Article 45-06 — Accident and Health Insurance

## Chapter 45-06-02.1 — Comprehensive Health Association of North Dakota

### § 45-06-02.1-01. Definitions.

1. "Applicant" means an individual seeking enrollment under the association.
2. "Board" means the board of directors of the association as set forth under North Dakota
Century Code section 26.1-08-03.
3. "Enrollee" means an eligible person who is covered under an association plan.
4. "Grievance" means a written complaint submitted in accordance with the formal grievance
procedure by or on behalf of the enrollee or applicant regarding any aspect of the association
relative to the enrollee or applicant.
History: Effective September 1, 1994.
General Authority: NDCC 26.1-08-02
Law Implemented: NDCC 26.1-08-02
### § 45-06-02.1-02. Grievance procedures.

1. The board of directors of the association shall establish and maintain a grievance procedure
which has been approved by the commissioner to provide procedures for the resolution of
grievances initiated by enrollees or applicants. The board shall maintain records regarding
grievances received.
2. The commissioner may examine the grievance procedures and records.
3. Any enrollee or applicant receiving an adverse determination through the grievance procedure
may request a hearing pursuant to North Dakota Century Code chapter 28-32.
History: Effective September 1, 1994.
General Authority: NDCC 26.1-08-02
Law Implemented: NDCC 26.1-08-02
### § 45-06-02.1-03. Enrollment by certain children.

A child will be deemed an "eligible person" pursuant to subdivision b of subsection 4 of North
Dakota Century Code section 26.1-08-01, despite the lack of eighteen months of qualifying previous
coverage, if:
1. The child was covered under any qualifying previous coverage within thirty days of birth,
adoption, or placement for adoption; and
2. The child has not had a break in qualifying previous coverage which exceeds sixty-three days.
History: Effective December 1, 1997.
General Authority: NDCC 26.1-08-02
Law Implemented: NDCC 26.1-08-02
