Senate passes bill to shift PERS health plan from 'grandfathered' to non-grandfathered

Senate Bill 2160 passed the North Dakota Senate 44-2 with one absent after senators approved an amendment to adjust funding sources and start dates for the health insurance changes.

The bill moves the North Dakota PERS health insurance plan from a grandfathered design to a non-grandfathered plan and includes appropriations to cover the transition. Senator Tim Davison, sponsor, told the Senate the change will allow the state to modify plan design “without regard to limits placed on a grandfathered plan.”

Why it matters: Davison said the bill is meant to give the state more tools to combat medical inflation when the contract is bid in July 2026. “In the past 2 bienniums, our health insurance has risen between 7 to 8% a year. Currently, our premiums are somewhere between $600,000,000 and $650,000,000 per biennium,” Davison said on the floor.

Supporters said the bill also expands certain benefits for state employees. Davison listed examples: copayments will count toward out-of-pocket maximums, preventive colonoscopies and additional well-child and lactation counseling coverage, and routine prenatal and postnatal care covered at specified levels.

Appropriations and committee action: Davison outlined the funding in section 4: $1,900,000 from the general fund, $2,400,000 from special and federal funds, and $4,300,000 from the health insurance reserve fund. He reported unanimous passage in the Human Services Committee and a 15–1 vote in Senate Appropriations.

The Senate clerk recorded the final tally as 44 ayes, 2 nays, 1 absent not voting; the bill is passed.

Less critical details: The engrossed bill amends and reenacts Section 54-52 of the North Dakota Century Code, provides an appropriation and states legislative intent; the bill text also references an effective date.