NDAC 45-06-14-13
Stop-loss insurance
Cite as N.D. Admin. Code ยง 45-06-14-13
1.
Purchase. A multiple employer welfare arrangement may purchase stop-loss insurance to
cover a portion of its losses. If a stop-loss insurance policy is terminated or modified causing a
violation of subsection 2, or otherwise compromising the multiple employer welfare
arrangement's financial integrity, the multiple employer welfare arrangement must notify the
commissioner prior to the termination or modification. The multiple employer welfare
arrangement must inform the commissioner of corrective action that will be taken to maintain
the multiple employer welfare arrangement's financial integrity.
2.
Required stop-loss coverage. A multiple employer welfare arrangement may not retain
liability on any one incident of more than ten percent of its annual premium volume during the
most recent fund year, plus twenty percent of its surplus. A multiple employer welfare
arrangement with less than one year's experience must use the multiple employer welfare
arrangement's estimated premium volume during the first full fund year. The multiple employer
welfare arrangement must purchase stop-loss insurance for liability exposure. The stop-loss
carrier must be licensed to do business in North Dakota.
3.
Return of liability. Liability transferred to an insurer under subsection 2 may not be directly or
indirectly returned to a multiple employer welfare arrangement or a member.