A Guide to Health Insurance in North Dakota (ND)

The options available to you when it comes to North Dakota Health Insurance are quite diverse, and depending on which options are available to you, you can end up with very different types of health insurance.

There are two traditional routes that you can go down with private health insurance in North Dakota, and that is either Individual Health Insurance or Group Health Insurance, and I will discuss each in turn.

1/ North Dakota Individual Health Insurance

The first thing to note is that individual health insurance is a direct contract between an individual and the insurance company, and can cover either you alone or an entire family.

If you are currently not in employment then you may not have access to a group health insurance plan, and hence individual health insurance may be your best option.

Typically this is going to cost more than the group health insurance plan that many people have through their workplace.
Individual North Dakota Health Insurance Plans have to go through underwriting procedures at the insurance company directly, because they are essentially assessing how likely or unlikely you are to make a claim.

The insurance companies in North Dakota and elsewhere in the country have access to an almost bewildering array of statistics with regards to almost every permutation of applicant. So they know for example that a man of age 26 – 29 will most likely cost them half as much in claims as a woman of the same age, because those are prime years for women to give birth (with all the attached medical expenses).

Additionally, they are able to get the applicant to undertake a medical exam and so there is a cross-reference against the information that the applicant submitted on their health insurance form.

Because of this the company is able to make a judgment on their actual health, profile based on the data that the company has available, along with any prior medical conditions that they may have had.

And based on those factors, if an applicant has too many red flags, then the health insurance company in North Dakota could well reject their application.

If however the insurance company accepts them, then they cannot subsequently refuse to renew an individual policy, so there are some safeguards.

This is called “guaranteed renewability” in the health insurance industry.

2/ North Dakota Group Health Insurance Plans

The second type of private health insurance in North Dakota is Group Health Insurance.

This is offered directly by companies to their workforces, and is often used as a significant carrot when recruiting new employees.

The number of plans that are on offer will depend on the business. Some businesses are sufficiently large that they will have a wider choice of policies, whilst others will have just one.

Choice is one area where individual North Dakota Health Insurance Plans tend to have the edge, because you can choose to apply to have whatever style and level of cover that you like, which you cannot do with group policies.

Just like Henry Ford who said, “You can have any color as long as it’s black” when talking about the cars he made; with group health insurance policies you are limited to whatever choice your employer makes available.

There is no legal obligation for employers to offer health insurance, but in practice most do because it has now become a standard expected benefit.

If however an employer does offer a group health insurance policy to his workers, then he is not allowed to restrict access to it. So any permanent staff who work over 30 hours a week have to be offered it (temporary staff do not).

It is also common practice for Group North Dakota Health Insurance Policies to be open to the family members of eligible employees.

This means that one good way of saving money off the cost of health insurance is often to compare your own group policy with that of your spouse, and then move the entire family over to the cheaper or better plan.

You should also be aware that there is often a 90 day window at the beginning of employment before workers can join group plans, and so whilst you should certainly enquire about their health plan, don’t be surprised if you have to wait 90 days to join it.

It is also worth knowing that it is up to the business who established the plan as to who they get any insurance with, and they can make changes to the plan if they so wish.

It is therefore always worth periodically checking with your human resources department as to whether any rules of the health insurance have changed, as they may well do.

This slight loss of control does make group policies inferior in some ways to individual policies, because with an individual policy you would immediately be told personally by the insurance company of any proposed changes, as you would be the policyholder, and not just a plan participant (as you technically are when you sign up for a group health insurance plan in North Dakota).

Group Health Insurance is also sub-classified for legal purposes in North Dakota, so that firms who have less than 50 employees are classified as “Small Group Health Insurance”, whilst those with more than 50 employees are classified as “Large Group Health Insurance”.

There are different tax breaks and schemes for each group, so if you are an employer it is worth digging into the differences to a greater extent.

If you have access to a Group North Dakota Health Insurance Plan though your work, then you are likely to find it the most cost effective route to get covered.

But if you don’t currently work, or would prefer more control over your insurance then you may prefer to check out Individual North Dakota Health Insurance Plans which are also commonly available and can offer a good option for healthy people with few or no pre-existing medical conditions that might give the insurance companies cause to reject an application.

Even if your application is rejected then you should enquire about the new Pre-Existing Condition Insurance Plan (PCIP) that has come in as a result of the Affordable Care Act, as well as the Comprehensive Health Association of North Dakota State High Risk Pool Plan (HRP), that should be able to assist you with obtaining cover.

Check out some quotes for both types, do some more research and then decide and take action.

Because getting comprehensive health insurance in North Dakota is important both from the perspective of protecting your financial future, and for protecting your health.


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