North Dakota Health Insurance Questions on Employers & Policies

My new employer says our health insurance plan is a self-insured group. What does that mean?

A self-insured group is one in which an employer serves as their own insurer, paying claims from corporate assets. Many of these employers hire a third-party administrator to manage the payment of claims for their employees.

Self-insured groups are not regulated by the state but by the federal government under ERISA, the Employee Retirement Income Security Act of 1974. Self-insured plans are also exempt from state taxes on insurance premiums.

I received my long term care policy about two weeks ago. I have decided I don't want to keep it. What do I do now?

If you decide you do not want the polcy, you have 30 days after the policy has been delivered to return it to the company and receive a full refund. This is a good time to read the policy over and over again during the "free-look" period. Here's what to do:

• Keep the envelope the policy was mailed in or insist your agent give you a signed delivery receipt.
• Return the policy to the company with a brief letter asking for a refund.
• Send the policy and letter by certified mail.
• Your money should be refunded within a couple of weeks.

I turned 65 in August. I did not sign up for Medicare Part B at the time, but I have decided that I want it. Can I take Part B now without being penalized?

An individual may sign up for Medicare beginning three months prior to the month of his/her birthday, during the month of his/her birthday, and no later than three months after. This gives a beneficiary an initial enrollment period of seven months.

If you did not sign up for Medicare part B during the initial enrollment period, you may sign up during the general enrollment period--Jan. 1 through March 31 of each year. If you enroll at this time, your Part B coverage will not start until the following July 1. A person could lose up to 18 months of coverage for failing to sign up on time.

You could also be charged a 10 percent surcharge on the Part B premium for each 12-month period during which you are eligible but not yet enrolled. This surcharge increases each year as the Medicare premiums increase.

If a person declines Medicare Part B at age 65 because of health insurance coverage through their work or spouse's employment, they may enroll in Part B later without a surcharge added to the premium. The special enrollment period lasts seven months and begins when a person or his/her spouse retires.