Section 45-06-06.1-14 - Special enrollment periods1. Employees losing other coverage. A group health plan shall permit an employee who is eligible, but not enrolled, for coverage (or a dependent of the employee if the dependent is eligible, but not enrolled) to enroll for coverage under the terms of the plan if each of the following conditions is met: a. The employee or dependent was covered under a group health plan at the time coverage was previously offered to the employee or dependent. b. The employee stated in writing at the time coverage was previously offered that coverage under a group health plan was the reason for declining enrollment, but only if the plan required such a statement at the time and provided the employee with notice of the requirement and its consequences. c. The employee's or dependent's coverage: (1) Was under a Consolidated Omnibus Budget Reconciliation Act continuation provision and the coverage was exhausted; or (2) If not under a Consolidated Omnibus Budget Reconciliation Act continuation provision, the coverage was terminated as a result of loss of eligibility for the coverage or because employer contributions toward the coverage were terminated. d. Under the terms of the plan, the employee requests enrollment not later than thirty days after the date of termination of the coverage or employer contribution. 2. For dependent beneficiaries. A group health plan shall provide for a "dependent special enrollment period" if: a. The group health plan makes coverage available with respect to dependents of an employee; b. The employee is a participant under the plan or has met any waiting period applicable to becoming a participant under the plan and is eligible to be enrolled under the plan but for a failure to enroll during a previous enrollment period; and c. A person becomes a dependent of the individual through marriage, birth, or adoption or placement for adoption. 3. For purposes of this section, a "dependent special enrollment period" is a period of not less than thirty days beginning on the later of: a. The date dependent coverage is made available; or b. The date of the marriage, birth, adoption, or placement for adoption. During the dependent special enrollment period, the dependent or, if not otherwise enrolled, the employee may be enrolled under the plan as a dependent of the employee. In the case of the birth or adoption of a child, the spouse of the employee may be enrolled as a dependent if the spouse is otherwise eligible for coverage.
4. If an employee seeks to enroll a dependent during the first thirty days of the dependent special enrollment period, the coverage of the dependent shall become effective: a. In the case of marriage, not later than the first day of the first month beginning after the date the completed request for enrollment is received; b. In the case of a dependent's birth, as of the date of birth; or c. In the case of a dependent's adoption or placement for adoption, the date of adoption or placement for adoption. N.D. Admin Code 45-06-06.1-14
Effective December 1, 2001.General Authority: NDCC 28-32-02(1)
Law Implemented: NDCC 26.1-36.3