1. Following receipt of an application filed pursuant to section 26.1-17.1-03, the commissioner shall review such application and notify the applicant of any deficiencies. The commissioner shall issue a certificate of authority to an applicant provided that the following conditions are met:

Terms Used In North Dakota Code 26.1-17.1-04

  • following: when used by way of reference to a chapter or other part of a statute means the next preceding or next following chapter or other part. See North Dakota Code 1-01-49
  • Organization: includes a foreign or domestic association, business trust, corporation, enterprise, estate, joint venture, limited liability company, limited liability partnership, limited partnership, partnership, trust, or any legal or commercial entity. See North Dakota Code 1-01-49

a.    The requirements of section 26.1-17.1-03 have been fulfilled.

b.    The individuals responsible for conducting the applicant’s affairs are competent, trustworthy, and possess good reputations, and have had appropriate experience, training, or education.

c.    The applicant is financially responsible and may reasonably be expected to meet its obligations to enrollees and to prospective enrollees. In making this determination, the commissioner may consider:

(1) The financial soundness of the applicant’s arrangements for limited health services and the minimum standard rates, deductibles, copayments, and other patient charges used in connection therewith.

(2) The adequacy of working capital, other sources of funding, and provisions for contingencies.

(3) Any agreement for paying the cost of the limited health services or for alternative coverage in the event of insolvency of the prepaid limited health service organization.

(4) The manner in which the requirements of section 26.1-17.1-17 have been fulfilled.

d.    The agreements with providers for the provision of limited health services contain the provisions required by section 26.1-17.1-16.

e.    Any deficiencies identified by the commissioner have been corrected.

2.    If the certificate of authority is denied, the commissioner shall notify the applicant and shall specify the reasons for denial in the notice. The applicant has thirty days from the date of receipt of the notice to request a hearing before the commissioner pursuant to chapter 28-32.