1.    Each uniform group insurance contract entered by the board must be consistent with the provisions of this chapter, must be signed for the state of North Dakota by the chairman of the board, and must include the following:

Terms Used In North Dakota Code 54-52.1-05

  • Contract: A legal written agreement that becomes binding when signed.
  • 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
  • State: when applied to the different parts of the United States, includes the District of Columbia and the territories. See North Dakota Code 1-01-49

a.    As many optional coverages as deemed feasible and advantageous by the board. b.    A detailed statement of benefits offered, including maximum limitations and exclusions, and such other provisions as the board may deem necessary or desirable.

2.    The initial term or the renewal term of a uniform group insurance contract through a contract for insurance, health maintenance organization, or self-insurance health plan for hospital benefits coverage, medical benefits coverage, or prescription drug benefits coverage may not exceed two years.

a.    The board may renew a contract subject to this subsection without soliciting a bid under section 54-52.1-04 if the board determines the carrier’s performance under the existing contract meets the board’s expectations, the proposed premium renewal amount does not exceed the board’s expectations, and renewal best serves the interests of the state and the state’s eligible employees.

b.    In making a determination under this subsection, the board shall:

(1) Use the services of a consultant to concurrently and independently prepare a renewal estimate the board shall consider in determining the reasonableness of the proposed premium renewal amount.

(2) Review the carrier’s performance measures, including payment accuracy, claim processing time, member service center metrics, wellness or other special program participation levels, and any other measures the board determines relevant to making the determination and shall consider these measures in determining the board’s satisfaction with the carrier’s performance.

(3) Consider any additional information the board determines relevant to making the determination.

c.    The board may determine the carrier’s performance under the existing contract does not meet the board’s expectations, the proposed premium renewal amount exceeds the board’s expectations, or renewal does not best serve the interests of the state or the state’s eligible employees and the board therefore may decide to solicit a bid under section 54-52.1-04.

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