402-H:1 Definitions. – I. " Administrator " or " third party administrator " or " TPA " means a person who directly or indirectly underwrites, collects charges or premiums from, or adjusts or settles claims on residents of this state, in connection with life, annuity, or health coverage or property and casualty insurance, except […]
402-H:10 Delivery of Materials to Covered Individuals. – Any policies, certificates, booklets, termination notices or other written communications delivered by the insurer to the administrator for delivery to insured parties or covered individuals shall be delivered by the administrator promptly after receipt of instructions from the insurer to deliver them. Source. 1993, 253:1, eff. […]
402-H:11 Certificate of Authority Required. – I. No person shall act as, or offer to act as, or hold himself or herself out to be an administrator in this state without a valid certificate of authority as an administrator issued by the commissioner. II. Applicants to be an administrator shall make an application to […]
402-H:11-a Registration Requirement. – A person who directly or indirectly underwrites, collects charges or premiums from, or adjusts or settles claims on residents of this state, and who is not otherwise required to obtain a certificate of authority or license in connection with life, annuity, or health coverage provided by a self-funded plan shall […]
402-H:11-b Exemption. – An association administering a pooled risk management program operated pursuant to RSA 5-B or conducting business that is exempt from taxation under the Internal Revenue Code, section 115 shall not be required to obtain a certificate of authority or to meet the other requirements of this chapter for services provided in […]
402-H:12 Annual Report and Filing Fee. – I. (a) Each licensed administrator shall file an annual report for the preceding calendar year with the commissioner on or before June 1 of each year, or within such extension of time as the commissioner for good cause may grant. The annual report shall include an audited […]
402-H:13 Examination and Audits. – The acts of the administrator are considered to be the acts of the insurer on whose behalf it is acting. An administrator may be examined as if it were the insurer. The commissioner may designate examiners or consultants, as appropriate, to perform an audit of an administrator when the […]
402-H:14 Grounds for Denial, Suspension, or Revocation of Certificate of Authority. – I. The certificate of authority or license of an administrator shall be denied, suspended, or revoked if the commissioner finds that the administrator: (a) Is in an unsound financial condition. (b) Is using such methods or practices in the conduct of its […]
402-H:15 Rulemaking Authority. – The insurance commissioner shall adopt rules under RSA 541-A as may be necessary to properly administer this chapter. Source. 1993, 253:1, eff. Jan. 1, 1994.
402-H:16 Penalties. – An administrator who violates or fails to comply with the provisions of this chapter or rules adopted pursuant to this chapter shall be subject to suspension or revocation of its certificate of authority or an administrative penalty not to exceed $2,500 for each violation. Source. 1993, 253:1. 1997, 284:14, eff. Jan. […]
402-H:17 Repealed by 2006, 271:14 eff. Aug. 8, 2006. –
402-H:2 Written Agreement Necessary. – I. No administrator shall act as such without a written agreement between the administrator and the insurer and the written agreement shall be retained as part of the official records of both the insurer and the administrator for the duration of the agreement and for 5 years thereafter. The […]
402-H:3 Payment to Administrator. – If an insurer utilizes the services of an administrator, the payment to the administrator of any premiums or charges for insurance by or on behalf of the insured party shall be deemed to have been received by the insurer, and the payment of return premiums or claim payments forwarded […]
402-H:4 Maintenance of Information. – I. An administrator shall maintain and make available to the insurer complete books and records of all transactions performed on behalf of the insurer. The books and records shall be maintained in accordance with prudent standards of insurance recordkeeping and shall be maintained for a period of not less […]
402-H:5 Approval of Advertising. – An administrator may use only advertising pertaining to the business underwritten by an insurer that has been approved in writing by the insurer in advance of its use. Source. 1993, 253:1. 2006, 271:4, eff. Aug. 8, 2006.
402-H:6 Responsibilities of the Insurer. – I. If an insurer utilizes the services of an administrator, the insurer shall be responsible for determining the benefits, premium rates, underwriting criteria, and claims payment procedures applicable to the coverage and for securing reinsurance, if any. The rules pertaining to these matters shall be provided, in writing, […]
402-H:7 Premium Collection and Payment of Claims. – I. All insurance charges or premiums collected by an administrator on behalf of or for an insurer, and the return of premiums received from the insurer, shall be held by the administrator in a fiduciary capacity. The funds shall be immediately remitted to the person entitled […]
402-H:8 Compensation to the Administrator. – I. An administrator shall not enter into any agreement or understanding with an insurer in which the effect is to make the amount of the administrator’s commissions, fees, or charges contingent upon savings effected in the adjustment, settlement and payment of losses covered by the insurer’s obligations. This […]
402-H:9 Notice to Covered Individuals; Disclosure of Charges and Fees. – I. When the services of an administrator are utilized, the administrator shall provide a written notice approved by the insurer to covered individuals advising them of the identity of, and relationship among, the administrator, the policyholder and the insurer. II. When an administrator […]