North Dakota Small Business
Health Insurance Plans 2022

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ND Small Business Health Insurance Plans

North Dakota Small Business Health Insurance Plans

North Dakota Small Business Health Insurance Plans 2022. The following is an overview of the rules that govern small group health insurance plans in the State of North Dakota.

The information that is discussed below includes the laws that have been mandated by the Affordable Care Act (ACA or "Obamacare"), as well as the laws that are required by North Dakota State government.

If you own and operate a ND small business and you already offer small group health insurance or you're thinking about offering small group health insurance - this guide can help you better understand the regulations, requirements and available North Dakota small business health insurance plans available.

Learn how to get North Dakota small business health insurance plans for 1 to 50 employees. The best small business health insurance providers in ND offer affordable rates, flexible coverage options and access to a large network of medical providers.

Below are some answers to commonly asked ND small business health insurance plan questions:


How Much Does North Dakota Small Business Health Insurance Cost?

The average price of a standard North Dakota small business health insurance policy ranges from around $583 to over $1706 per employee per month based on; single or family, location, coverages offered, deductibles and more.

What Are The Small Business Health Insurance Regulations In North Dakota?

North Dakota Small Business Health Insurance Plans

In North Dakota, the regulations that pertain to small group health insurance are more stringent than in most states. For that reason, it is important to understand these regulations so that you can make the right choice for you and your employees.

Some of the most important laws that relate to North Dakota small group health insurance are those that pertain to the policies themselves. One of the most notable is the pre-existing condition exclusion period, which can only be in place for 12 months.

Once this period of time has elapsed, the health insurance policy has to cover the insured's pre-existing conditions. It's also important to note that once North Dakota small business health insurance plans reache their term, the insured has the option to renew their policy for another term.

This is known as the "guaranteed renewability" provision. Lastly, if the insured has a baby or adopts a child their existing policy already covers dependents, the newborn or the adopted child will be covered by the policy for 31 days; thereafter, the newborn or child will need to be added to the policy.

Does North Dakota Participate In The Affordable Care Act?

Affordable Care Act North Dakota

In 2010, the Affordable Care Act (ACA or "ObamaCare") was passed by the United States Congress and was signed into law by Obama. Following its passage, provisions of the law have continued to be phased in, and as of January 1, 2014, the majority of American citizens and legal residents of the United States are required, by law, to have qualifying health care coverage.

If they fail to have coverage, they are responsible for paying an annual tax penalty for each month they aren't insured, which is known as the "individual mandate".

The cost of the penalty for failure to have qualifying coverage is $95 per adult and $47.50 per child, or 1% of your total taxable income; whichever amount is higher - as much as $285 per family. In 2017, the penalty increased, and has continued to increase thereafter.

Qualifying Exemptions For The Individual Mandate

Individuals who meet one of the following are exempt from the individual mandate and the associated tax penalties in ND:

  • Illegal aliens
  • Jailed individuals
  • Religious objections
  • The cost of health insurance coverage is higher than 8% of your household income
  • Those who aren't covered for less than three months during the calendar year
  • Those who have hardship waivers
  • Your income level is blow the 100% poverty level

What Are The Affordable Care Act Requirements For North Dakota Small Businesses?

North Dakota Small Business Health Insurance Plans Claim Form

If you're a small business owner in North Dakota, you must provide your employees with insurance. This is a requirement that was put into place by the Affordable Care Act.

Referred to as the Employer Shared Responsibility provision, all employers must offer their employees at least one of the ACA-compliant North Dakota small business health insurance plans, otherwise then can face fines of up to $2,000 per employee.

North Dakota small business owners can purchase coverage for their employees through the state's Small Health Option Program (SHOP) exchange, or from a private insurance agent or broker.

Affordable Care Act Standardized Essential Health Benefits

As per the ACA, all qualifying health insurance plans must offer 10 standardized essential benefits.

Depending on the state, additional benefits may also be required. The 10 ACA standardized essential benefits are as follows:

  1. Ambulatory patient services (medical care that is offered without being admitted to a hospital)
  2. Emergency services
  3. Hospitalizations, such as overnight stays and surgical procedures
  4. Lab services
  5. Mental health and substance abuse disorder services, including behavioral health treatments, such as psychotherapy and counseling
  6. Pediatric health care services, including vision and oral care; however, adult vision and dental coverage aren't essential health benefits under ACA
  7. Pregnancy, maternity, and newborn care, including before and after birth
  8. Prescription pharmaceuticals
  9. Preventative and wellness services, as well as management for chronic diseases
  10. Rehabilitative and habilitative services and devices, including services and devices for injuries, disabilities, and chronic health conditions

Additional Health Benefits Mandated In North Dakota

In addition to the above-mentioned ACA essential health benefits, in North Dakota, health insurance policies must also include the following health benefits:

  • Off-label prescription pharmaceutical drugs
  • Reconstructive breast surgery following mastectomy
  • Treatment for certain TMJ disorders

Standardized North Dakota Small Business Health Insurance Plans
ACA Metal Levels

In order to make it easier to compare costs and benefits, the Affordable Care Act has designated all qualifying North Dakota small business health insurance plans to be one of four metal colors, including Bronze, Silver, Gold, and Platinum.

Each of these designations is based on the average amount of health care costs that the plan will cover, which is illustrates at percentages of how much the insurance company will cover for health care, as well as the amount the insured will have to pay out-of-pocket.

All insurance companies that are participating in the federal or state health care exchange program must offer at least the Silver and Gold North Dakota small business health insurance plans.

All four of the metal plans have a shared maximum out-of-pocked amount that the insured can be charged during any calendar year. The following table illustrates this information:

Metal Plan Insurer Pays / Insured Pays
Bronze60% / 40%
Silver70% / 30%
Gold80% / 20%
Platinum90% / 10%


Guaranteed Issue

As per the ACA, individuals cannot be denied coverage or charged higher premiums because of their past health history, or their gender.

Additionally, look-back and waiting periods cannot be imposed. Additionally, policies are effective when they are issued and all coverage is renewable if the individual chooses to renew the policy.

However, plans can be canceled if the individual fails to pay their premiums or commits fraud.

How Are ND Health Insurance Premiums Determined?

A premium is the amount the insured must pay out-of-pocket in order to maintain their health insurance policy. The premiums that are charged for any of the qualifying metal plans can be based on the following:

  • Age of the individual
  • Whether or not the individual uses tobacco
  • Where the individual lives, based on a rating area
  • The number of family members who will be enrolling

What Types Of Health Insurance Plans Are Available For North Dakota Small Businesses?

Health Insurance Plan Types

While there are several types of health insurance plans to choose from, the following plans are the most popular among ND small business owners:

Health Maintenance Organization - Simply known as an "HMO", this type of plan offers a variety of health-related services via a network of health care providers and hospitals that exclusively contract with the HMO, or who agree to offer their services to members of the HMO. Employees who participate in this type of plan usually have to choose a primary care physician (PCP), and receive most of their care from this physician. If a specialist is needed, the PCP will recommend one that is affiliated with the HMO.

Preferred Provider Organization - More commonly referred to simply as "PPO", this type of health insurance plan is the most common among North Dakota small business owners. The insurance company provides a preferred list of health care providers, and employees must receive their medical care from the doctors and hospitals on that list for their claims to be paid at the highest level possible - but they also have the flexibility to see any other provider anywhere in or out of state.

Point-of-Service Plan - Known as a (POS), this type of health insurance plan provides access to health care services at a lower overall cost, but with fewer choices. Members can access care from in-network or out-of-network providers and facilities, but coverage is better when you stay in-network. POS plans may vary, but generally, plans are considered a blend of HMO and PPO plans - offering more flexibility than HMOs, but less than PPOs.

Health Savings Account - A health savings account (HSA) is a special type of bank account that allows participants in the insurance plan to save money that can be used specifically for the medical care they require in the future. HSA-qualified health insurance plans are usually PPO plans that are specifically designed to be used with an HSA.

Indemnity Health Insurance - This type of health insurance plan allows members to control their own health care and to visit any doctor or hospital they choose. The insurance company would then pay a pre-determined percentage of the total charges for the services that were rendered. Employees may have to pay for some types of services up-front and then they can submit a request for reimbursement with the insurance company.

North Dakota Small Business Health Insurance Plans - The Bottom Line

We strongly advise business owners to speak with a CPA and a ND health insurance broker before jumping in and getting any type of the North Dakota small business health insurance plans available.

Make sure that you know exactly what each option can do for your company and the potential drawbacks associated with it.

North Dakota Economic Data, Regulations And Limits On Commercial Insurance

Made In North Dakota

Are you an entrepreneur? Are you thinking about launching a start-up business in North Dakota, or are you thinking about expanding an already existing business to the state?

If so, it's important to consider the economic trends and the commercial insurance requirements of the Peace Garden State.

Understanding the economic trends of state is crucial for business owners because this information indicates whether or not the climate is favorable for success.

Being aware of the commercial insurance policies that the state mandates is also important so that you know what types of coverage you need to invest in order to properly protect your venture and ensure you are complaint with the law.

Below, we offer an overview of these two critical factors for related to the state of North Dakota.

Economic Trends For Business Owners In North Dakota

Unemployment rate is a strong indicator of a state's economy. The lower the rate, the more people are employed, and that information is directly related to the success businesses are experiencing in the state.

In December of 2019, the Bureau of Labor Statistics reported that the unemployment rate in the Peace Garden State was 2.4%, which was 1.1% below the national average of 3.5%. This statistic indicates that North Dakota offers a favorable economy for prospective business owners who are thinking about establishing operations in the state.

Additionally, the state is tax-friendly, offers a healthy quality of life, and has a healthy startup environment, making it an ideal location for entrepreneurs.

As in most states, the areas where entrepreneurs can expect to see the most success in the North Dakota are urban locations and the suburbs that surround them. These areas offer access to more regional markets, provide larger markets, and offers a more diverse (both in numbers and qualifications) workforce.

As such, the best locations to start a business in ND include:

  • Bismarck
  • Dickinson
  • Fargo
  • Grand Forks
  • Mandan
  • Minot
  • West Fargo
  • Williston

Organizations in numerous sectors can expect to see success in this state, as there are several industries that are thriving in North Dakota. The top industries include:

  • Agricultur
  • Construction
  • Education
  • Energy
  • Healthcare
  • Hospitality and tourism
  • Manufacturing
  • Mining
  • Retail and wholesale distribution
  • Transportation
  • Utilities
Commercial Insurance Requirements In North Dakota

The North Dakota Insurance Department regulates insurance in ND. North Dakota mandates very few forms of insurance coverage by law. They enforce worker's compensation.

North Dakota requires you to have worker's compensation insurance if you hire even one employee on a regular basis. This includes part-time employees, family members, minors, and immigrant employees. It is not required for independent contractors or domestic employees, though you should check to make sure any contractors you have are true contractors, and not employees.

North Dakota also requires all business-owned vehicles to be covered by commercial auto insurance. Other types of business insurance that business owners should carry depend on the specific industry.

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Also find ND local small businesses by General Liability Class Code and learn about North Dakota small business insurance requirements for general liability, business property, commercial auto & workers compensation including ND business insurance costs. Call us (701) 540-5400.

Small Business Health Insurance Plans By State

You can find more state specific small business health insurance information including requirments and coverage by clicking on the state below:


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