N.D. Admin. Code 45-06-14-08

Current through Supplement No. 393, July, 2024

Section 45-06-14-08 - Administration

1.Service company. A multiple employer welfare arrangement must contract with a service company for services necessary to conduct the multiple employer welfare arrangement's day-to-day operations, except services and responsibilities reserved to the members, the board, individual trustees, the financial administrator, the accountant, or other contractors unless the multiple employer welfare arrangement has the staff and expertise to perform the day-to-day operations. The service company must have expertise in and be licensed for the coverages provided by the multiple employer welfare arrangement. Subject to the oversight of the board, the service company shall, directly or through subcontractors, provide all services directly related to the administration of coverage. These services include:

a. Accounting and recordkeeping;

b. Billing and collection of premiums and assessments;

c. Claims investigation, settlement, and reserving;

d. Claims payment, including claims wholly or partially subject to stop-loss insurance or member deductibles;

e. General administration;

f. Loss control, safety programs, or both; and

g. Underwriting.

2.Financial administrator. A multiple employer welfare arrangement must contract with a financial administrator for investment of the multiple employer welfare arrangement's assets and other financial or accounting services. A staff member of the financial administrator may not be an owner, officer, employee, or agent of the service company, or of a subcontractor of the service company.

3.Recordkeeping and examination authority. A multiple employer welfare arrangement must maintain all records necessary to verify the accuracy and completeness of all reports submitted to the commissioner under section 45-06-14-16. The commissioner may examine the multiple employer welfare arrangement's records in order to verify the multiple employer welfare arrangement's compliance with this chapter and with other statutes and rules. The provisions of North Dakota Century Code chapter 26.1-03 apply to the commissioner's examination. All records concerning claims, reserves, financial transactions, and other matters necessary for the multiple employer welfare arrangement's operations are the multiple employer welfare arrangement's property and shall be retained for the current year plus the previous five years.

N.D. Admin Code 45-06-14-08

Effective January 1, 2007.

Amended by Administrative Rules Supplement 2017-364, April 2017, effective 4/1/2017.

General Authority: NDCC 28-32-02

Law Implemented: NDCC 26.1-01-07.4, 26.1-07.1