BISMARCK, N.D. - More than 60,000 North Dakotans have health insurance through the Public Employees Retirement System. Now the legislature is considering making changes to that system.
The first decision would be changing the current, fully insured model to a self-insured model. That shifts the financial risks and reward from insurance company to the state.
The state has a lot of additional housekeeping to do if they decide to switch how state employees get health insurance. Representative George Keiser says a state-backed model over the current insurer-backed model could be profitable.
"The State of North Dakota takes any risks should we fall short. But we also keep all of the reserve or extra money that would be created if we make good management decisions,” said Keiser.
But if the decision to switch is made, new laws would need to be created giving the insurance department the ability to regulate.
"Looking to make sure those consumer protections and that those financial regulations would still be in place if they move from a fully insured plan to a self-insured plan,” said Jeff Ubben, Deputy Insurance Commissioner.
The Public Employee Retirement System surveyed seven surrounding states about how they manage their programs and six of the seven are self-funded. Pat Bellmore with BlueCross BlueShield says the state's system with insurer taking the financial risks for 28,000 contracts is uncommon.
"The smallest group that we have still under fully insured plans has about 700 employees, so every group we have that is larger than that size, they're all under self-funded arrangements and doing it successfully,” said Bellmore
There has not been a final decision made on a switch.