ND HB1127

Exempts insurance companies offering group or individual insurance subject to Patient Protection and Affordable Care Act lifetime or annual benefit limit restrictions from the 10 percent capital/surplus risk exposure limit.

Applies utilization review rules to grandfathered health plans unless insurers voluntarily extend protections to grandfathered plans, with purpose of promoting quality care, ensuring reasonable standards, and maintaining medical record confidentiality.

Requires independent external review for grandfathered health plans through North Dakota health care review or equivalent peer review organizations, with determinations binding on parties and nonprevailing party bearing costs.

Mandates health insurance policies, contracts, and evidence of coverage comply with federal requirements for external appeals procedures and internal claims and appeals procedures under specified federal law citations.

Takes effect July 1, 2011, and is declared an emergency measure; Insurance Commissioner must provide updates to legislative management and submit proposed legislation for any federally-mandated implementation before January 1, 2013, or between January 1, 2013 and January 1, 2014.