25.0740.02002
Title.04000
Adopted by the Senate Human Services
Committee
Sixty-ninth
March 20, 2025
Legislative Assembly
of North Dakota
Introduced by
Representatives Weisz, Frelich, McLeod, M. Ruby
Senators Lee, Dever
A BILL for an Act to amend and reenact sections 26.1-36-09.12 and 54-35-02.4 of the North
Dakota Century Code, relating to medical services related to suicide and the powers and duties
of the employee benefits programs committee; and to repeal section 54-03-28 of the North
Dakota Century Code, relating to the cost-benefit analysis requirement for health insurance
mandated coverage of services.for an Act to amend and reenact section 54-03-28 of the North
Dakota Century Code, relating to the cost-benefit analysis requirement for health insurance
mandated coverage of services.
BE IT ENACTED BY THE LEGISLATIVE ASSEMBLY OF NORTH DAKOTA:
SECTION 1. AMENDMENT. Section 26.1-36-09.12 of the North Dakota Century Code is
amended and reenacted as follows:
26.1-36-09.12. Medical services related to suicide.
An insurance company, nonprofit health service corporation, or health maintenance
organization may not deliver, issue, execute, or renew anya hospital, surgical, medical, or major
medical benefit policy on an individual, group, blanket, franchise, or association basis unless
the policy, contract, or evidence of coverage provides benefits, of the same type offered under
the policy or contract for illnesses, for health services to any individual covered under the policy
or contract for injury or illness resulting from suicide, attempted suicide, or self-inflicted injury.
The medical benefits provided for in this section are exempt from section 54-03-28.
SECTION 2. AMENDMENT. Section 54-35-02.4 of the North Dakota Century Code is
amended and reenacted as follows:
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ENGROSSED HOUSE BILL NO. 1248
FIRST ENGROSSMENT
PROPOSED AMENDMENTS TO
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54-35-02.4. Employee benefits programs committee - Powers and duties.
1. During each interim, the employee benefits programs committee shall consider:
a. Consider and report on the legislative proposals over which the committee takes
jurisdiction and which fiscally impact the retirement programs of state employees
or employees of any political subdivision, and health and retiree health plans of
state employees or employees of any political subdivision. A majority of the
members of the committee has sole authority to determine whether a legislative
proposal affects a program. The committee shall make
b. Make a thorough review of each proposal the committee takes under its
jurisdiction, including an actuarial report. The committee shall take
c. Take jurisdiction over a proposal that authorizes an automatic increase or other
change in benefits beyond the ensuing biennium which would not require
legislative approval. The committee shall include
d. Include in the report of the committee a statement that the proposal would allow
future changes without legislative involvement. The committee shall report
e. Report the findings and recommendations of the committee, along with any
necessary legislation, to the legislative management and to the legislative
assembly.
2. To carry out the responsibilities of the committee, the committee, or the designee of
the committee, may:
a. Enter contracts, including retainer agreements, with an actuary or actuarial firm
for expert assistance and consultation. Each retirement, insurance, or retiree
insurance program shall pay, from the program's retirement, insurance, or retiree
health benefits fund, as appropriate, and without the need for a prior
appropriation, the cost of an actuarial report required under this section which
relates to that program.
b. Call on personnel from state agencies or political subdivisions to furnish such
information and render such assistance as the committee from time to time may
request.
c. Establish rules for the operation of the committee, including the submission and
review of proposals and the establishing of standards for actuarial reports.
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3. The committee may solicit draft measures and proposals from interested persons
during the interim between legislative sessions, and also may study measures and
proposals referred to the committee by the legislative assembly or the legislative
management.
4. A copy of the committee's report concerning a legislative measure, if that measure is
introduced for consideration by a legislative assembly, must be appended to the copy
of that measure.
5. If a legislative measure affecting a public employees retirement program, public
employees health insurance program, or public employee retiree health insurance
program is introduced in either house without a report from the committee, the
chairman and vice chairman of the employee benefits programs committee shall
request an actuarial report from the program affected and shall provide the report to
the standing committee to which the measure is referred. During the legislative
session, the employee benefits programs committee chairman and vice chairman,
working together, have sole authority to determine whether a legislative measure or
amendment affects a program under this subsection and subsection 6.
6. During a legislative session, if an amendment is made to a legislative measure which
fiscally impacts a public employees retirement program, public employees health
insurance program, or public employee retiree health insurance program, the
employee benefits programs committee chairman and vice chairman shall request
from the affected program an actuarial report on the amendment and shall provide the
report to the standing committee to which the bill is referred.
7. A committee of the legislative assembly may not act on a legislative measure the
legislative management or committee determines mandates health insurance
coverage of services or payment for specified providers of services for the health and
retiree health plans of state employees or employees of any political subdivision
unless the measure as recommended by the committee provides:
a. The measure is effective through June thirtieth of the second odd - numbered year
following the year in which the legislative assembly enacted the measure, and
after that date the measure is ineffective.
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b. The application of the mandate begins with the contract for health insurance
which becomes effective after June thirtieth of the year in which the measure
becomes effective.
c. For the second legislative assembly following the year in which the legislative
assembly enacted the measure, the public employees retirement system may
prepare and request introduction of a bill to repeal the expiration date and to
extend the mandated coverage or payment on the system's health insurance
programs.
d. If the public employees retirement system introduces a bill to repeal the
expiration date under subdivision c, the public employees retirement system shall
append to the bill a report regarding the effect of the mandated coverage or
payment on the system's health insurance programs. The report must include
information on the utilization and costs relating to the mandated coverage or
payment.
8. Legislation enacted in contravention of this section is invalid, and any benefits
provided under the legislation must be reduced to the level current before enactment
of the legislation.
SECTION 3. REPEAL. Section 54-03-28 of the North Dakota Century Code is repealed.
SECTION 1. AMENDMENT. Section 54-03-28 of the North Dakota Century Code is
amended and reenacted as follows:
54-03-28. Health insurance mandated coverage of services - Cost-benefit analysis
requirement.
1.If the legislative management determines a legislative measure mandates health
insurance coverage of services or payment for specified providers of services, the
measure may not be referred to a committee of the legislative assembly unless a
cost-benefit analysis provided by the legislative management is appended to that
measure.
a.If a committee of the legislative assembly determines a measure mandating
health insurance coverage of services or payment of specified providers was
referred to committee without a cost-benefit analysis, the committee shall request
the legislative management provide a cost-benefit analysis. The committee may
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not act on the measure unless the measure is accompanied by the cost-benefit
analysis.
b.If a committee of the legislative assembly determines a proposed amendment to
a measure mandates health insurance coverage of services or payment of
specified providers, the committee may not act on the proposed amendment
unless the amendment is accompanied by a cost-benefit analysis or amended
cost-benefit analysis provided by the legislative management.
2.Factors considered in the cost-benefit analysis must include:
a.The extent to which the proposed mandate would increase or decrease the cost
of the service.
b.The extent to which the proposed mandate would increase the appropriate use of
the service.
c.The extent to which the proposed mandate would increase or decrease the
administrative expenses of insurers and the premium and administrative
expenses of insureds.
d.The impact of the proposed mandate on the total cost of health care.
3.A committee of the legislative assembly may not act on a legislative measure that the
legislative management or committee determines mandates health insurance
coverage of services or payment for specified providers of services unless the
measure as recommended by the committee provides:
a.The measure is effective through June thirtieth of the next odd-numbered year
following the year in which the legislative assembly enacted the measure, and
after that date the measure is ineffective.
b.The application of the mandate is limited to the public employees health
insurance program and the public employee retiree health insurance program.
The application of such mandate begins with every contract for health insurance
which becomes effective after June thirtieth of the year in which the measure
becomes effective.
c. That for the next legislative assembly, the public employees retirement system
shall prepare and request introduction of a bill to repeal the expiration date and to
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extend the mandated coverage or payment to apply to accident and health
insurance policies. The
4. At the conclusion of the process in this section, the public employees retirement
system shall append to the billsubmit a report regarding the effect of the mandated
coverage or payment on the system's health insurance programs. The report must
include information on the utilization and costs relating to the mandated coverage or
payment and a recommendation on whether the coverage or payment should
continue. For purposes of this section, the bill is not a legislative measure mandating
health insurance coverage of services or payment for specified providers of services,
unless the bill is amended following introduction so as to change the bill's mandate.
4.5.The legislative management shall adopt a procedure for identifying measures and
proposed measures mandating health insurance coverage of services or payment for
specified providers of services. The procedure must include solicitation of draft
measures and proposals during the interim between legislative sessions from
legislators and agencies with bill introduction privileges and must include deadlines for
identification of the measures or proposals.
5.6.The legislative council shall contract with a private entity, after receiving one or more
recommendations from the insurance commissioner, to provide the legislative
management the cost-benefit analysis required by this section. The insurance
commissioner shall pay the cost of the contracted services to the entity providing the
services at the conclusion of the process under subsection 3.
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