NDAC 45-06-01.1-09
Open enrollment
Cite as N.D. Admin. Code ยง 45-06-01.1-09
1.
Any issuer may not deny or condition the issuance or effectiveness of any Medicare
supplement policy or certificate available for sale in this state, or discriminate in the pricing of
such a policy or certificate because of the health status, claims experience, receipt of health
care, or medical condition of an applicant in the case of an application for a policy or certificate
that is submitted prior to or during the six-month period beginning with the first day of the first
month in which an individual is both sixty-five years of age or older and is enrolled for benefits
under Medicare part B. Each Medicare supplement policy and certificate currently available
from an insurer must be made available to all applicants who qualify under this subsection
without regard to age.
2.
a.
If an applicant qualifies under subsection 1 and submits an application during the time
period referenced in subsection 1 and, as of the date of application, has had a
continuous period of creditable coverage of at least six months, the issuer may not
exclude benefits based on a preexisting condition.
b.
If the applicant qualifies under subsection 1 and submits an application during the time
period referenced in subsection 1 and, as of the date of application, has had a
continuous period of creditable coverage that is less than six months, the issuer shall
reduce the period of any preexisting condition exclusion by the aggregate of the period of
creditable coverage applicable to the applicant as of the enrollment date. The secretary
shall specify the manner of the reduction under this subsection.
3.
Except as provided in subsection 2 and sections 45-06-01.1-09.1 and 45-06-01.1-20,
subsection 1 may not be construed as preventing the exclusion of benefits under a policy,
during the first six months, based on a preexisting condition for which the policyholder or
certificate holder received treatment or was otherwise diagnosed during the six months before
the coverage became effective.