# Title 45 — Insurance, Commissioner of

## Article 45-06 — Accident and Health Insurance

## Chapter 45-06-16 — Short-Term Limited-Duration Insurance

### § 45-06-16-01. Definitions.

1. "Application" includes an application for individual coverage or a group enrollment form.
2. "Short-term limited-duration health insurance plan" means health insurance coverage provided
pursuant to an insurance policy or group certificate of insurance that has an expiration date
specified in the policy that is no longer than six months after the original effective date of the
policy and, taking into account any renewals or extensions, has a duration of not more than
twelve months in total.
History: Effective October 1, 2019.
General Authority: NDCC 26.1-36-38
Law Implemented: NDCC 26.1-36.8
### § 45-06-16-02. Application requirements.

All applications for short-term limited-duration insurance policies must contain clear and
unambiguous questions designed to ascertain the reason for the health condition of the applicant as
follows:
1. Do you have comprehensive major medical coverage in force as of the date of this
application?
2. Are you aware that this insurance coverage is not comprehensive major medical coverage?
3. Why are you purchasing a short-term limited-duration plan? (Please check all that apply)
a. I am not eligible for Affordable Care Act marketplace tax subsidies.
b. I cannot afford an Affordable Care Act marketplace plan.
c. I do not use a lot of health care; therefore, I do not feel I need a comprehensive major
medical plan.
d. Other.
4. Do you understand this policy may not have network doctors and therefore may result in a bill
for additional charges not covered by a doctor that is out-of-network with this plan?
History: Effective October 1, 2019.
General Authority: NDCC 26.1-36-38
Law Implemented: NDCC 26.1-36.8
### § 45-06-16-03. Disclosure requirements.

1. Disclosure statement. All short-term limited-duration policies as defined under North Dakota
Century Code section 26.1-36-49 must contain the following disclosure on the front cover
page of the policy, the certificate of coverage, and the application in large print:

2. Outline of coverage. The outline of coverage must provide the following information:
a. Types of benefits provided.
b. Cost-sharing provisions and maximum limits.
c. Describe how benefit payments are determined.
d. Exclusions and limitations.
e. Renewability provisions.
History: Effective October 1, 2019.
General Authority: NDCC 26.1-36-38
Law Implemented: NDCC 26.1-36.8
### § 45-06-16-04. Standards of marketing.

An issuer through its producers, shall:
1. Provide an outline of coverage to applicants at the time application is presented to the
prospective applicant and shall obtain an acknowledgment of receipt of the outline from the
applicant.
2. Establish marketing procedures to assure any comparison of policies by its agents or other
producers will be fair and accurate.
3. Establish marketing procedures to assure full disclosure is given to the insured.
4. Establish auditable procedures for verifying compliance with this section.
History: Effective October 1, 2019.
General Authority: NDCC 26.1-36-38
Law Implemented: NDCC 26.1-36.8
