Other requirements, N.D. Admin code 45-06-07-07

Other requirements
 
Requires HMOs to give subscribers a list of affiliated providers upon their enrollment or reenrollment and to notify subscribers within 30 days of ending a provider affiliation. Requires the provider list to include notice about primary care provider availability. Requires HMOs to provide a description of their service area to subscribers and to notify subscribers upon changing the service area. Permits HMOs to require copayments and deductibles. Requires HMOs to establish a grievance procedure that contains specified elements. These elements include the provision of grievance forms to subscribers, written acknowledgment of the receipt of a grievance, and prohibiting the termination of a contract prior to the resolution of a grievance. Permits HMOs to make binding arbitration a condition of enrollment so long as they disclose this fact in the contract and evidence of coverage. Requires HMOs to notify subscribers of their rights and duties when resolving a grievance through arbitration.