Section 420-M:11 – Conflict of Interest.
420-M:11 Conflict of Interest. – No officer or board member or director or contract administrator of a purchasing alliance or members of their households may be employed by, be a consultant for, be a member of the board of directors of, or be affiliated with, or otherwise be a representative of a carrier or […]
Section 420-M:12 – Purchasing Alliance Distinguished From Multiple Employer Welfare Arrangement.
420-M:12 Purchasing Alliance Distinguished From Multiple Employer Welfare Arrangement. – Purchasing alliances shall not be risk bearing entities, and shall not enter into a self-insured arrangement. Source. 2010, 346:1, eff. July 20, 2010.
Section 420-M:13 – Qualified Purchasing Alliance.
420-M:13 Qualified Purchasing Alliance. – A purchasing alliance that has a minimum of 500 enrollees may elect to obtain certification from the commissioner as a qualified purchasing alliance. To obtain certification, a purchasing alliance shall demonstrate: I. That the purchasing alliance meets all requirements under RSA 415-E to operate as a bona fide pathway […]
Section 420-M:2 – Definitions.
420-M:2 Definitions. – In this chapter: I. " Commissioner " means the insurance commissioner. II. " Eligible dependents " means "eligible dependents" as defined in RSA 420-G:2, V. III. " Eligible employee " means "eligible employee" as defined in RSA 420-G:2, VI. IV. " Employee enrollee " means an eligible employee, self-employed individual, or […]
Section 420-M:3 – Jurisdiction of the Commissioner; Penalties.
420-M:3 Jurisdiction of the Commissioner; Penalties. – I. The commissioner shall regulate the establishment and conduct of purchasing alliances. II. No person or entity, other than a qualified association trust, shall market, sell, offer, or arrange the sale of one or more health benefit plans to 2 or more employers or their eligible employees […]
Section 420-M:4 – Purchasing Alliance Application and Licensing.
420-M:4 Purchasing Alliance Application and Licensing. – To obtain authority to operate as a purchasing alliance, an application shall be completed and filed with the commissioner by an authorized representative of the corporation or other entity established to operate as a purchasing alliance. An application shall not be deemed filed until all information necessary […]
Section 420-M:5 – Preparation of a Business Plan and Other Required Documents.
420-M:5 Preparation of a Business Plan and Other Required Documents. – I. The application for a purchasing alliance shall include a business plan containing the following information: (a) A detailed, written plan of operations explaining how the applicant intends to fulfill the purposes and requirements of this chapter; (b) The specific steps that the […]
Section 420-M:6 – Revocation of License and Insolvency.
420-M:6 Revocation of License and Insolvency. – I. The following intentional acts shall constitute grounds for denial, non-renewal, suspension, or revocation of an application or existing license, following notice and an opportunity for hearing: (a) Failure to comply with the provisions of RSA 420-G; (b) Failure to comply with the business plan filed and […]
Section 420-M:7 – Powers and Duties of Purchasing Alliances; Restrictions on Purchasing Alliances.
420-M:7 Powers and Duties of Purchasing Alliances; Restrictions on Purchasing Alliances. – I. A purchasing alliance shall: (a) Offer health benefit plans that are available to all member employers; (b) Establish administrative and accounting procedures for operating the alliance, for providing services to member employers and enrollees, and for preparing an annual budget; (c) […]
Section 420-M:8 – Contracts With Participating Carriers.
420-M:8 Contracts With Participating Carriers. – The contracts entered into by the alliance shall: I. Establish performance standards for specific contractual elements; II. Set liquidated damages for breach of the contract; III. Require the insurer to notify the member employers of cancellation of the policy; IV. Require the member employers in the event of […]