Section 45-06-01.1-04 - Policy provisions1. Except for permitted preexisting condition clauses as described in subdivision a of subsection 1 of section 45-06-01.1-05, subdivision a of subsection 1 of section 45-06-01.1 -06, and subdivision a of subsection 1 of section 45-06-01.1-06.1, no policy or certificate may be advertised, solicited, or issued for delivery in this state as a medicare supplement policy if the policy or certificate contains limitations or exclusions on coverage that are more restrictive than those of medicare. 2. No medicare supplement policy or certificate may use waivers to exclude, limit, or reduce coverage or benefits for specifically named or described preexisting diseases or physical conditions. 3. No medicare supplement policy or certificate in force in the state may contain benefits which duplicate benefits provided by medicare. 4.a. Subject to subdivisions d, e, and g of subsection 1 of section 45-06-01.1-05 and subdivisions d and e of subsection 1 of section 45-06-01.1-06, a medicare supplement policy with benefits for outpatient prescription drugs in existence prior to January 1, 2006, shall be renewed for current policyholders who do not enroll in part D at the option of the policyholder. b. A medicare supplement policy with benefits for outpatient prescription drugs shall not be issued after December 31, 2005. c. After December 31, 2005, a medicare supplement policy with benefits for outpatient prescription drugs may not be renewed after the policyholder enrolls in medicare part D unless: (1) The policy is modified to eliminate outpatient prescription coverage for expenses of outpatient prescription drugs incurred after the effective date of the individual's coverage under a medicare part D plan; and (2) Premiums are adjusted to reflect the elimination of outpatient prescription drug coverage at the time of medicare part D enrollment, accounting for any claims paid, if applicable. N.D. Admin Code 45-06-01.1-04
Effective January 1, 1992; amended effective July 8, 1997; September 1, 2005; July 1, 2009.General Authority: NDCC 26.1-36.1-02(1 )(2), 26.1-36.1-03
Law Implemented: NDCC 26.1-36.1-02