Insurance department seeks to dissolve CHAND, sets timeline to move members to ACA marketplace

The North Dakota Insurance Department urged the Senate Industry and Business Committee to approve legislation that would allow the state to discontinue the Comprehensive Health Association of North Dakota, the small high‑risk pool known as CHAND.

Crystal Bartuska, life and health and Medicare division director for the North Dakota Insurance Department, told the committee the department supports Senate Bill 2032 and that the bill creates a new section in chapter 26.1 to allow CHAND to be discontinued and to set deadlines for winding down remaining policies.

The change matters because CHAND is a legacy program created to provide coverage to people who formerly were denied coverage because of preexisting conditions. Bartuska said enrollment is low and the Affordable Care Act has guaranteed issue in the individual market, meaning fewer people rely on CHAND today. “Because they're losing credible coverage, they qualify for an open enrollment window,” she said of people whose CHAND coverage would terminate under the bill.

Under the dates described in testimony: May 1, 2025 would stop any new enrollment into CHAND’s Medicare supplement plans; December 31, 2025 would terminate CHAND major medical and Medicare supplement policies to allow a planned transition; and the bill allows additional housekeeping in the 2027 legislative session if needed. The bill also contains language intended to guarantee issue for consumers seeking Medicare supplement plans after CHAND ends.

Blue Cross and Blue Shield of North Dakota, the administrator for CHAND policies, told the committee it has worked with the department on individual transitions. Megan Ruby of Blue Cross Blue Shield said about six months earlier the carrier’s counts were roughly 42 members in the major medical side and just over 120 in the Medicare supplement side; she said several enrollees who moved to ACA plans became eligible for premium tax credits and some obtained plans with no premium. “They got a better plan, generally speaking,” Ruby said.

Committee members pressed the department and the carrier on safeguards to ensure enrollees are not lost during the transition and on the status of CHAND’s reserves. Bartuska said the department and Blue Cross have been “hand‑holding” transitions and that, based on small caseloads, they expect to be able to assist individuals into coverage. On reserves, witnesses said they would follow up with exact figures; testimony noted the board and committee had removed earlier bill language that would have deposited any excess association funds into the insurance regulatory trust fund, and staff said they would confirm whether legislative counsel’s draft accurately reflected the committee amendment.

No formal action or vote on Senate Bill 2032 occurred during the hearing; the committee closed the hearing after requesting clarifying information on reserve balances and the bill draft language.

What happens next: witnesses said Blue Cross will provide updated enrollment and reserve numbers in written testimony to the committee; the department indicated it would check with legislative counsel to ensure the bill text reflects the committee’s amendment on returning excess assessment funds.

Speakers quoted in this article spoke during the SB 2032 hearing before the Senate Industry and Business Committee.

Ending: The committee left the record open for follow-up data about enrollment counts and reserve balances before taking further committee action on the bill.