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Committee approves flexibility for state reinsurance pool that aids individual health market
Summary
Senators gave a due‑pass recommendation to SB 2091, allowing the Reinsurance Association of North Dakota (RAND) board to adjust attachment points and coinsurance within $100,000–$1,000,000 and up to 75% coinsurance; the bill includes an emergency clause to allow rate setting for the 2026 plan year.
The Industry and Business Committee on Tuesday recommended a due pass for Senate Bill 2091, which would give the Reinsurance Association of North Dakota (RAND) board the authority to set, on an annual basis, the attachment point and coinsurance percentage for claims submitted to the reinsurance pool — within statutory floors and ceilings.
Matt Fisher of the Insurance Department explained RAND is a state‑level reinsurance pool created by a Section 1332 waiver under the Affordable Care Act. RAND reimburses carriers for a portion of high individual‑market claims: the pool covers 75% of coinsurance for the claim amount between a $100,000 attachment point and a $1,000,000 stop‑loss threshold under current rules. SB 2091 would permit the RAND board to move the attachment point annually so long as it does not drop below $100,000 or exceed $1,000,000, and to set coinsurance at a level not exceeding 75%.
Fisher said the change is intended to give the board flexibility to respond to funding variability. RAND is funded by federal pass‑through dollars (savings from reduced federal premium subsidies after the program lowers state premiums) and by assessments on carriers based on market share. Fisher described the emergency clause as necessary because carriers need clarity to set rates for the 2026 plan year in April–May of the current year.
Blue Cross Blue Shield of North Dakota and Sanford Health Plan both testified in support and said the flexibility will help RAND manage funding volatility and let carriers price products with clearer assumptions.
Senator Kessel moved a due‑pass recommendation; Senator Angott seconded. The committee recorded a 5‑0 roll‑call in favor of a due pass and assigned a carrier to carry the bill forward.
