Comprehensive Health Association of North Dakota (CHAND)
The Comprehensive Health Association of North Dakota (CHAND) was created by the North Dakota Legislature in 1981. The initial purpose of CHAND was to provide health coverage to residents of the state who were considered to be in a high-risk health category and had been denied health insurance or had been offered restricted coverage due to health problems. In 1997, North Dakota’s Legislature opted to utilize CHAND as the federal “fall-back” mechanism for portability, providing its residents with access to CHAND as a HIPAA qualified individual. In 2003, CHAND became an insurance vehicle for North Dakota residents that are eligible for assistance with health premiums through the Federal Trade Adjustment Assistance Reform Act (TAARA) of 2002.
The program premiums and benefits are approved by CHAND’s board of directors on an annual basis. CHAND premiums are limited to 135% of the premiums charged in North Dakota for similar coverage. Benefit design, the levels of health insurance coverage, exclusions and limitations are generally reflective of coverage provided in the state. The medical needs of the pool’s high risk health subscribers and costs they will incur are taken into consideration.
CHAND limits the lifetime maximum benefits to $1 million per individual. Program losses in excess of the premium are paid by all insurance companies who realize a minimum of $100,000 in health insurance premium volume annually in North Dakota and through federal grant funding.
Administrative Services have been provided to CHAND through a Lead Carrier agreement with Blue Cross Blue Shield of North Dakota since 1981.
North Dakota is one of 33 states that have traditional risk pool programs. Other states have adopted special alternative health insurance programs or mandated guaranteed issue in the individual market. You can find information regarding high risk insurance coverage that is available in other states by visiting www.naschip.org.
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