Buying a short-term health plan in North Dakota
- North Dakota limits short-term plans to no more than 185 days.
- One non-underwritten renewal is allowed, so the plan duration can be up to 12 months.
- North Dakota has regulations for the sale/marketing of plans, and a loss ratio requirement.
- State regulators warn consumers about the shortcomings of short-term plans.
- At least five insurers offer short-term plans in North Dakota.
ND short-term plans limited to 185 days
Long-standing North Dakota regulations limit short-term health insurance plans to durations of no more than 185 days. Although the Trump Administration is allowing short-term plans to last longer, state regulations still apply if they’re stricter than the federal rules.
Only one renewal allowed, for a total plan duration of up to 12 months
The North Dakota Insurance Department published a bulletin in September 2018, clarifying the state’s position in terms of the new federal rules for short-term plans. In addition to longer initial terms, the new federal rules allow for renewals and much longer total plan durations, including renewals. But North Dakota clarified that only one renewal is permitted, so the total duration of a plan, including renewal, cannot exceed 12 months (the renewal process cannot include medical underwriting).
Other state requirements for short-term plans
North Dakota is requiring short-term plan applications to ask the consumer whether they have comprehensive major medical coverage in force, whether they understand that the short-term plan is NOT a comprehensive major medical policy, and why they are purchasing the short-term plan.
Short-term plans in the state are also required to have a loss ratio (claim amounts divided by premium amounts) of at least 55 percent.
The North Dakota Insurance Department has clarified that insurers offering short-term plans must refile updated plans with the Department in order to continue marketing short-term products under the new rules.
The North Dakota Insurance Department published a document in 2017 to warn consumers about the drawbacks of short-term plans, limited benefit plans, and discount medical plans. In terms of when a consumer should purchase short-term coverage, the ND Insurance Department said “almost never.”
Which insurers offer short-term plans in North Dakota?
Louise Norris is an individual health insurance broker who has been writing about health insurance and health reform since 2006. She has written dozens of opinions and educational pieces about the Affordable Care Act for healthinsurance.org. Her state health exchange updates are regularly cited by media who cover health reform and by other health insurance experts.