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North Dakota - Compensation & Benefit Legislation

NORTH DAKOTA - AASHOWME

Demonstrates www.BenefitsReview.com™ site. Illustrates insurance carriers' coverages within the State.

 

NORTH DAKOTA - ADOPTED CHILD HEALTH CARE MANDATE

OBRA 1993 (Federal) requires group health plans to honor medical and child support orders. Also, plans must treat adopted children like biological children covered by the plan, and plans are precluded from applying pre-existing condition exclusions to an adopted child where no such exclusion applies to a newborn biological child. Health plans that covered the cost of pediatric vaccines as of May 1, 1993, and fail to continue that level of coverage, will be subject to an excise tax penalty applicable to plans that fail to meet the health care continuation coverage requirements under OBRA 1993.

 

Mandatory coverage of birth of adopted child included in state's newborn health care mandate.

 

Preventive care for children: Yes, to age 9.

 

(North Dakota Cent. Code Sections 26.1-36.07, 26.1-36-09.2, 26.1-36-09.40, 26.1-36.22)

 

NORTH DAKOTA - ALCOHOLISM & DRUG ABUSE

Mandatory coverage.

 

Minimum yearly inpatient coverage: 60 days; partial hospitalization: 120 days.

 

Minimum yearly outpatient coverage: 20 visits.

 

Minimum lifetime coverage: no statutory requirements.

 

(North Dakota Cent. Code Section 26.1-36-08.0).

 

NORTH DAKOTA - CAFETERIA PLAN TAX LAWS

 

NORTH DAKOTA - CONTINUATION OF COVERAGE CONVERSIONS

Events Triggering Continuation Coverage:

 

NORTH DAKOTA - COORDINATION OF BENEFITS

Requires use of the birthday rule if coordinating benefits. Based on 1986 National Association of Insurance Commissioner Rules model. (North Dakota Cent. Code Sections 26.1-36-04)

 

NORTH DAKOTA - COST-OF-LIVING

ERI's Relocation Assessor™ is a recommended source for U.S./Canadian cost-of-living data and U.S. Automobile Cost Survey.

 

NORTH DAKOTA - DRUG TESTING AND EMPLOYEE ASSISTANCE BENEFITS

State has not statutory requirements.

 

NORTH DAKOTA - GROUP HEALTH CODE ADDITIONS (MANDATED)

Adopted Children: Policies providing family coverage must cover adopted children from the date of physical placement by a licensed placement agency or by the birth parent. (S2230, 1995) (North Dakota Cent. Code Sections 26.1-36-07.)

 

Alcoholism and Drug Abuse Treatment: Group policies must cover 60 days of inpatient treatment per year and 120 days of partial hospitalization services per year. Up to 46 days of inpatient treatment may be traded for partial hospitalization on a ratio of 1:2. At least 20 outpatient visits per year must be covered with no co-payment for the first 5 visits and a 20 percent co-payment thereafter. (North Dakota Cent. Code Section 26.1-36-08.)

 

Coverage Continuation and Conversion: Group policies must provide continuation rights of up to 39 weeks and subsequent conversion rights to employees who terminate employment for themselves and their dependents and continuation rights of up to 36 months and subsequent conversion rights for spouses and dependents who cease to be eligible family members due to dissolution of marriage. (North Dakota Cent. Code Sections 26.1-36-23.)

 

Handicapped Dependents: Coverage for dependent children cannot be terminated while a child is incapable of employment due to mental retardation or physical handicap and chiefly dependent on the insured. (North Dakota Cent. Code Section 26.1-36-09.1.)

 

Maternity: Health care insurers, including HMOs, must provide benefits for at least 48 hours of inpatient care following a normal vaginal delivery and for at least 96 hours of inpatient care following a Caesarean section for a mother and her newborn child may well exceed the stated time allotments if determined reasonable and medically necessary. Early post-delivery discharge for a mother and her newborn child is permissible in instances where an attending physician or health care provider reaches such decision in consultation with the mother and where the mother and newborn child meet the minimum medical criteria for discharge, as stated in specified medical guidelines. Disclosure: Insurers must provide written notification to policyholders of the changes in maternity coverage prior to February 1, 1998. (S2043, 1997) (North Dakota Cent. Code Section 26.1-36.)

 

Mental Health: Group policies (HMOs also) must provide yearly benefits for 60 days of inpatient hospitalization treatment and for 120 days of partial hospitalization treatments or residential service. Up to 46 days of inpatient treatment may be traded for partial hospitalization or residential treatment on a ration of 1:2. Also, coverage must be provided for a combination of mental health services including inpatient hospitalization, partial hospitalization, and residential treatment. (S2040, 1997) (North Dakota Cent. Code Section 26.1-36-09.)

 

Newborns: Policies providing family coverage must provide benefits for newborns from the moment of birth for injury or sickness, including treatment of medically diagnosed congenital defects and birth abnormalities. (North Dakota Cent. Code Section 26.1-36-07.)

 

Phenylketonuria: Effective through July 31, 1999, health policies (HMOs included) which provide prescription drug coverage must cover medical foods and low protein modified food products as determined by a physician to be medically necessary for the treatment of inherited metabolic disease -- maple syrup urine disease or phenylketonuria. The yearly individual maximum benefit is $3,000. (S2194, 1997) (North Dakota Cent. Code Section 26-1-36.)

 

Policies for Small Employers: Small employers are those who employed an average of at least 2 but not more than more than 50 workers during the preceding calendar year and who employ at least 2 workers on the first day of the plan year. (H1168, 1997) (North Dakota Cent. Code Section 26.1-36.3-01.)

 

Pre-existing Conditions: Health care insurers may impose a pre-existing condition exclusion for illnesses for which medical diagnoses, care, or treatments were recommended or received within six months of an individual's effective date of coverage; exclusions may extend for a period of not more than 12 months after an effective date of coverage. Insurers must reduce time periods associated with the determination of a pre-existing condition by aggregate periods of qualifying previous coverage which was continuous until at least 63 days before an effective date of coverage. Pre-existing condition exclusion may not be imposed for conditions relating to pregnancy or to information acquired from genetic testing in the absence of a diagnosis of a condition related to such findings. (H1168, 1997) (North Dakota Cent. Code Section 26.1-36.4-03.)

 

Pregnancy: Policies must cover involuntary complications on the same basis as other conditions. (North Dakota Cent. Code Section 26.1-36-09.2.)

 

Prescription Drugs: Insurers must make available group policies covering drugs and medicines. (North Dakota Cent. Code Section 26.1-36-06.) Group policies (HMOs included) which provide prescription drug benefits must not exclude from coverage a drug which has been used for treatment of a specific indication on the basis that the drug has not been approved by the FDA for use for that indication if the drug has been recognized as appropriate treatment for such indication in standard medical reference and literature. Experimental drugs or those which have been determined by the FDA to be otherwise indicated are not covered. (H1428, 1997) (North Dakota Cent. Code Section 26-1-36.)

 

Prostate Cancer Screening: Group insurers (HMOs included) must provide asymptomatic males aged 50 and over, black males age 40 and over, and males age 40 and over who have a family history of prostate cancer,with annual medically recognized diagnostic examinations which include digital rectal examinations and prostate specific antigen tests. (S2115, 1997) (North Dakota Cent. Code section 26-1-36.)

 

Providers: Registered nurses: Costs for services must be covered if the provider is licensed, the service is within the provider's scope of services, and the service is covered by the policy. (North Dakota Cent. Code Section 26.1-36-05(15).) Chiropractors: Insurers must make available group policies covering chiropractor services. (North Dakota Cent. Code Section 26.1-36-06.) Students: Policies providing family coverage must cover dependents who are full-time students and younger than 23. (North Dakota Cent. Code Section 26.1-36-22.)

 

Tempormandibular Joint and Craniomandibular Disorders: Policies must cover such disorders with a lifetime maximum of $8,000 for surgery and $2,000 for non-surgical treatment. (North Dakota Cent. Code Section 26.1-36-09.3.)

 

NORTH DAKOTA - GROUP HEALTH FOR SMALL EMPLOYERS

For insurance plans offered to small employers:

 

NORTH DAKOTA - GROUP LIFE CODE ADDITIONS

Employer required to pay part of premium: No.

 

Percent of employees who must elect coverage (if employees pay part of premium): No statutory requirements.

 

Percent of employees who must be covered if employer pays all of premium: No statutory requirement.

 

Minimum number of employees in group plan: No statutory requirement.

 

Employer prohibited as beneficiary: No.

 

Grace period (days): 31.

 

Mandatory conversion: Yes.

 

Other provisions: None.

 

(North Dakota Cent. Code Sections 26.1-33-11, 26.1-33-12)

 

NORTH DAKOTA - HOLIDAYS

January 1, Washington's Birthday (or 3rd Monday in February), Memorial Day (or last Monday in May), July 4, Labor Day (or 1st Monday in September), Veterans Day, and December 25 are state holidays in all 50 states and in the District of Columbia. Other holidays under State law include: Martin Luther King's birthday (or 3rd Monday in January), Thanksgiving, Sunday. Other: Every day appointed by the Governor or President as a public holiday. If January 1, July 4, November 11, or December 25 falls on a Sunday, following Monday is a holiday. If any holiday falls on a Saturday, preceding Friday is a holiday. (North Dakota Cent. Code Sections 1-01-01.1 through 1-03-02.1,1-03-06 through 1-03-09)

 

NORTH DAKOTA - IMMIGRATION (PREVAILING WAGE POLICY)

See U.S. Federal General Administrative Letter 1-2000

 

NORTH DAKOTA - JURY DUTY & WITNESS TIME OFF

Employer Restriction For Discharging Employee For Taking Leave For Jury Service: Yes.

 

Remedies and Penalties: Violator is guilty of a Class B misdemeanor. Employee may bring civil action within 90 days of discharge for damages, reinstatement, and reasonable attorney fees. Damages not to exceed 6 weeks' wages.

 

Other Requirements: None reported. (North Dakota Cent. code Section 27-09.1-17.)

 

Employer Restriction For Discharging Employee For Taking Leave to be a Witness: Yes.

 

Remedies and Penalties: Violator is guilty of a Class B misdemeanor. Employee may bring civil action within 90 days of discharge for damages, reinstatement, and reasonable attorney fees. Damages not to exceed 6 weeks' wages.

 

Other Requirements: None reported.

 

NORTH DAKOTA - LEAVES OF ABSENCE

Employers Subject to Leave Laws: State employers.

 

Criteria for Eligibility: Employed by the state for at least 1 year, working at least 20 hours per week.

 

Maximum length of leave: 2 months for part time employees (working 20 hours per week); 4 months for full time employees (working 40 hours per week).

 

Paid Leave: Leave is without pay unless stated otherwise in the employer's policy.

 

Acceptable Reasons for Leave: Newborn/adopted child, care for child, spouse, or parent with a serious health condition; or for employee's illness or disability.

 

Employment Guarantees After Leave: Entitled to reinstatement in the position held prior to the leave or equivalent position.

 

Use of Vacation or other Time-off Benefits: Employee may use up to 1 week of medical leave (if provided by employer) to care for a family member with a serious health condition. For pregnancy leave, employee may first use sick leave.

 

Certification Required: Employer may request certification of a serious health condition.

 

Effect Of Leave on Other Benefits: Health benefits continue, but employee may have to pay premiums.

 

Effect of Seniority Accrual During Leave: Seniority benefits do not accrue during leave.

 

Minimum Requirements for Notification to Employer: Advance notice is required for birth/adoption of a child. For other types of leave, notice is required, if possible.

 

Conditions for Denial of a Request For Leave: When husband and wife work for the same employer, total leave for the couple may be limited to 4 hours.

 

(North Dakota Cent. Code Sections 54-52.4-01 - 54-52.4-10.)

 

See U.S. Federal Family and Medical Leave Act

 

NORTH DAKOTA - LONG TERM DISABILITY CODE ADDITIONS

State does not require employer to provide long term disability benefits; although many employers do in order to remain competitive in hiring/retention of employees.

 

See LEAVES OF ABSENCE (above), WORKERS' COMPENSATION (below) and U.S. Federal Americans With Disabilities Act

 

NORTH DAKOTA - MANDATED PROVIDERS

Optometrists, chiropractors, psychologists, social workers, nurse practitioners, and nurse midwives. Mandatory coverage for registered nurses not working in a hospital or care facility and licensed addition counselors. (North Dakota Cent. Code Sections 26.1-36-06, 26.1-36-08, 26.1-36-09, 26.1-36-09.5, 43-13-31)

 

NORTH DAKOTA - MENTAL HEALTH CARE

Mandatory coverage.

 

Minimum yearly inpatient coverage: Inpatient: 45 days (2 days partial equals 1 day inpatient).

 

Minimum yearly outpatient coverage: 120 visits.

 

Minimum lifetime coverage: No statutory requirements.

 

(North Dakota Cent. Code section 26.1-36-09)

 

NORTH DAKOTA - MINIMUM WAGE

Refer to the Federal minimum wage: $5.15 per hour (effective September 1, 1997).

 

Exemptions: Certain domestics and outside sales. Apprentices and handicapped workers in special environments may be exempt by special license. (North Dakota Cent. Code Sections 34-06-01, 34-06-03.1, 34-06-15, North Dakota Administrative Code Section 46.02)

 

See U.S. Minimum Wage

 

NORTH DAKOTA - NEW HIRE REPORTING

Who is required to report: All employers.

 

Who must be reported: All new employees and rehires.

 

Exempt from reporting: No exemptions.

 

Form(s) to file: W-4 form, state form or employer’s own containing required information.

 

Filing deadline: Within 20 days of hire.

 

Employer information to be included: Name, address, and EIN.

 

Employee information to be included: Name, address, and SSN.

 

Penalty for failure to report: Written notice of delinquency in filing may be followed b fines from $20 to $250 for subsequent violations.

 

(N.D. Cent. Code 34-15-01 - 34-15-08)

 

NORTH DAKOTA - NEWBORN CARE MANDATE

Mandated coverage.

 

Preventive care for children: Yes, to age 9. (North Dakota Cent. Code Sections 26.1-36.07, 26.1-36-09.2, 26.1-36-09.40, 26.1-36.22)

 

NORTH DAKOTA - PARENTAL LEAVE

See U.S. Federal Family and Medical Leave Act

 

NORTH DAKOTA - PRE-EXISTING CONDITIONS

For insurance plans offered to small employers, plans may not limit benefits for losses incurred more than 12 months following the effective date of coverage due to pre-existing conditions. (North Dakota Cent. Code Sections 26.1 -36.301)

 

See U.S. Federal Health Insurance Portability & Accountability Act

 

NORTH DAKOTA - PROTECTED CLASSIFICATIONS

Age:  Yes.

Race:   Yes.

Color:  Yes.

National Origin:  Yes.

Ancestry:    Yes.

Religion:   Yes.

Sex:  Yes.

Pregnancy:  Yes.

Sexual Harassment: Yes.

 

(N.D. Cent. Code Sections 14-02.4-01-14-02.4-06.)

 

NORTH DAKOTA - SALARY SURVEY

ERI's Relocation Assessor™ is a recommended source for U.S./Canadian wages & salaries (covering 3,000 positions).

 

NORTH DAKOTA - SHORT TERM DISABILITY CODE ADDITIONS

State does not require employer or employee participation in short term disability plans.

 

NORTH DAKOTA - TERMINATION & SEVERANCE PAY

Date pay is due if employee is discharged: Within 24 hours at the employer's place of business, or by certified mail to the employee within 15 days or at the next regular pay period, whichever comes first.

 

Date due if employee resigns: Payday.

 

Wages: Yes. (Wages or other compensation.)

 

Vacation Pay: Yes. (Case law and Administrative Code define wages as including vacation pay.)

 

Holiday: No.

 

Sick leave: No.

 

Severance: No.

 

(North Dakota Cent. Code Section 34-14-03; North Dakota Administrative Code tit. 46. Seep Hopfauf v. Bismark Tire Center, Inc., 234 N.W. 2d 224 (1975))

       

NORTH DAKOTA - UNEMPLOYMENT TAX

Employer Contributions:

 

 

Voluntary Contribution Provision: Yes. By April 30.

 

(North Dakota Cent. Code Section 52-04-05.)

 

NORTH DAKOTA - VACATION PAY

See TERMINATION & SEVERANCE PAY (above)

 

NORTH DAKOTA - VOTING TIME OFF

Statute encourages employers to establish a program allowing employees time off from work for voting. (North Dakota Cent. Code Section 16.1-01-02.1.)

 

NORTH DAKOTA - WORKERS' COMPENSATION

Private Employers: Mandatory as to all hazardous employments. Elective as to corporate officers, partners or sole proprietors, and resident family members.

 

Public Employers: Mandatory coverage to all public employments.

 

Exceptions: Farm labor, domestic servants, members of board of directors of business corporation, casual workers, illegal enterprises or occupations, and clergy. Real estate brokers or salespersons and newspaper delivery personnel with written agreements defining them as independent contractors.

 

Special Coverage Provisions: Voluntary as to non-hazardous and excluded employments. (Note: General contractor is reasonable for securing coverage and paying premiums for its sub-contractor until sub-contractor has secured and paid for own coverage.) Injuries caused by intoxicants are not compensable.

 

(U.S. Chamber of Commerce, 1994 Analysis of Workers' Compensation Laws.)