# Title 45 — Insurance, Commissioner of

## Article 45-06 — Accident and Health Insurance

## Chapter 45-06-17 — Self-Insurance Health Plans

### § 45-06-17-01. Definitions.

1. "Board" means the public employees retirement system board created by North Dakota
Century Code section 54-52-03.
2. "Commissioner" means the insurance commissioner.
3. "Fiscal year" means a self-insurance health plan's twelve-month fiscal year.
4. "Runoff self-insurance health plan" means a self-insurance health plan that no longer has
authority to self-fund but which continues to exist for the purpose of paying claims, preparing
reports, and administering transactions associated with the period when the self-insurance
health plan provided coverage.
5. "Self-insurance health plan" has the same meaning as provided under North Dakota Century
Code section 54-52.1-01.
6. "Service company" means an entity licensed under North Dakota Century Code chapter
26.1-27 as an administrator of an entity licensed under North Dakota Century Code title 26.1
as an insurance company, health maintenance organization, or nonprofit health service
corporation.
History: Effective April 1, 2021.
General Authority: NDCC 26.1-36.6
Law Implemented: NDCC 26.1-36.6
### § 45-06-17-02. Purpose.

The provisions in this chapter are intended to ensure the financial integrity and the competent and
equitable administration of the self-insurance health plan.
History: Effective April 1, 2021.
General Authority: NDCC 26.1-36.6
Law Implemented: NDCC 26.1-36.6
### § 45-06-17-03. Scope.

This chapter applies to all self-insurance health plans established by the board as set forth in North
Dakota Century Code chapter 54-52.1.
History: Effective April 1, 2021.
General Authority: NDCC 26.1-36.6
Law Implemented: NDCC 26.1-36.6

### § 45-06-17-04. Ending self-insurance health plan.

1. Termination. The board may terminate its self-insurance health plan as set forth in North
Dakota Century Code chapter 54-52.1. The board shall notify the commissioner of its decision
to terminate within ninety days of its decision to terminate.
2. Runoff self-insurance health plan. A self-insurance health plan must continue to exist as a
runoff self-insurance health plan after its authority to self-fund has ended, for the purpose of
paying claims, preparing reports, and administering transactions associated with the period
during which the self-insurance health plan provided coverage. A runoff self-insurance health
plan must continue to comply with this chapter and with other applicable North Dakota laws
and rules.
History: Effective April 1, 2021.
General Authority: NDCC 26.1-36.6
Law Implemented: NDCC 26.1-36.6
### § 45-06-17-05. Administration.

1. Service company. The board may contract with one or more service companies for services
necessary to conduct the day-to-day operations of the self-insurance health plan. The service
company or companies must have expertise in and be licensed for the services provided to
the self-insurance health plan. Subject to the oversight of the board, the service company or
companies may provide, directly or through subcontractors, services directly related to the
administration of coverage.
2. Recordkeeping and examination authority. A self-insurance health plan must maintain all
records necessary to verify the accuracy and completeness of all reports submitted to the
commissioner under section 45-06-17-07. The commissioner may examine the self-insurance
health plan's records in order to verify the self-insurance health plan's compliance with this
chapter and with other statutes and rules. The provisions of North Dakota Century Code
chapter 26.1-03 apply to the commissioner's examination. All records concerning claims,
reserves, financial transactions, and other matters necessary for the self-insurance health
plan's operations are the self-insurance health plan's property and must be retained for the
current year plus the previous five years.
History: Effective April 1, 2021.
General Authority: NDCC 26.1-36.6
Law Implemented: NDCC 26.1-36.6
### § 45-06-17-06. Reserves.

A reserve must be established for all charges, claims, costs, and expenses of the self-insurance
health plan. This reserve must be set at a level to cover between two and four months of expected
charges, claims, costs, and expenses. The reserve must be adjusted as new information becomes
available.
History: Effective April 1, 2021.
General Authority: NDCC 26.1-36.6
Law Implemented: NDCC 26.1-36.6
### § 45-06-17-07. Reporting.

1. Financial statements. A self-insurance health plan must prepare annual financial statements
containing a balance sheet; a statement of revenues, expenses, and surplus; a statement of
changes in financial position; and a schedule of investments. The statements must be
prepared on forms and according to instructions prescribed by the commissioner. The financial

statements must be filed with the commissioner no later than one hundred eighty days after
the end of the self-insurance health plan's fiscal year. In lieu of self-prepared financial
statements, a self-insurance health plan may submit audited financial statements prepared by
an independent certified public accountant. The auditor's report must be submitted no later
than thirty days after completion of the audit.
2. Quarterly reports. If the commissioner determines a self-insurance health plan's financial
integrity is such that the self-insurance health plan's ability to meet obligations promptly and in
full will be significantly impaired, the commissioner may require the self-insurance health plan
to file quarterly reports with the commissioner no later than thirty days after the end of the first,
second, and third quarters of each fiscal year. The commissioner may remove the requirement
to file quarterly reports when the self-insurance health plan's financial integrity is restored. A
quarterly report must contain statements of the self-insurance health plan's:
a. Current total cash on hand and on deposit, and total investment;
b. Current total reserve for outstanding losses reported and unreported;
c. Gross premiums written during the quarter;
d. Losses paid during the quarter;
e. Current total members; and
f. Any other information that the commissioner requests.
History: Effective April 1, 2021.
General Authority: NDCC 26.1-36.6
Law Implemented: NDCC 26.1-36.6
### § 45-06-17-08. Trade practices.

Self-insurance health plans are subject to the provisions of the unfair trade practices act found at
North Dakota Century Code section 26.1-04-03.
History: Effective April 1, 2021.
General Authority: NDCC 26.1-36.6
Law Implemented: NDCC 26.1-36.6
### § 45-06-17-09. Disclosure.

Each policy issued by a self-insurance health plan must contain, in at least ten-point type on the
front page and declaration page, the following notice:
This policy is issued by a self-insurance health plan. A self-insurance health plan may not be
subject to all of the insurance laws and regulations of your state. State insurance insolvency
guaranty funds are not available for a self-insurance health plan.
History: Effective April 1, 2021.
General Authority: NDCC 26.1-36.6
Law Implemented: NDCC 26.1-36.6
