404-G:1 Purpose of Provisions. – The purpose of this chapter is to: I. Protect the citizens of this state who participate in the individual health insurance market by providing a mechanism to equitably distribute the excessive risk sometimes associated with this market and to enable insurers to better protect against the costs of covering […]
404-G:1-a Study and Biannual Report. – The commissioner shall evaluate the impact and effectiveness of RSA 404-G in effectuating the principles outlined in RSA 404-G:1, III. This review shall be based on data collected from carriers in the individual market and from the association, including but not limited to the following data elements: data […]
404-G:10 Severability. – If any provisions of this chapter or the application thereof to any person or circumstance is held invalid, the invalidity does not affect other provisions or applications of the chapter which can be given effect without the invalid provisions or applications, and to this end the provisions of this chapter are […]
404-G:11 Termination of Activities and Dissolution. – Notwithstanding the provisions of RSA 404-G:1-RSA 404-G:7, the association shall undertake the winding down and cessation of the risk sharing subsidy mechanism, the high risk pool and the federally qualified high risk pool, and the dissolution of the association, as follows: I. The risk sharing subsidy mechanism […]
404-G:12 Contingency. – I. Notwithstanding RSA 404-G:11, and if supported by the recommendations of actuarial experts retained by the department, the commissioner may request that the board of directors of the association develop a plan of operation to support the affordability and accessibility of health insurance in the state’s individual health insurance market. The […]
404-G:2 Definitions. – In this chapter: I. "Actively marketing" means actively marketing, issuing, and renewing all of the health coverages the respective carrier sells in the individual market to all individuals. I-a. " Act " means the Patient Protection and Affordable Care Act of 2009 (PL 111-148), as amended by the Health Care and […]
404-G:3 Association’s Powers and Duties. – I. The association shall be a not-for-profit, voluntary corporation under RSA 292 and shall possess all general powers as derive from that status and such additional powers and duties as are approved by the commissioner or as specified below. II. The board of directors of the association shall […]
404-G:4 Association Membership and Governance. – I. The association shall be comprised of all writers of health insurance. II. The initial board of directors of the association shall be the same as that set forth in the order. Except as provided in paragraph IV, each successor board shall consist of 9 individuals who are […]
404-G:4-a Report Required. – The association shall submit an annual report to the commissioner, in a manner and form determined by the commissioner, listing the association membership base, providing a count of covered lives by member, identifying changes in association membership and covered lives, describing the collection of assessments, listing payment delinquencies, and containing […]
404-G:5 Plan of Operation. – The board of directors of the association shall adopt a plan of operation which shall be the same plan of operation as that adopted pursuant to the order. Any amendments to the current plan of operation shall be approved by the commissioner. The plan of operation shall provide substantially […]
404-G:5-a Plan of Operation for the High Risk Pool. – I. The board of directors for the association shall adopt a plan of operation for the high risk pool. The high risk pool shall be funded in part through an assessment mechanism whereby writers of health insurance contribute an amount sufficient to cover the […]
404-G:5-b High Risk Pool. – I. There is hereby created the New Hampshire high risk pool. This pool shall operate subject to the supervision and control of the association and shall offer policies of insurance on or after July 1, 2002. The pool shall offer health care coverage consisting of 4 benefit plans, 2 […]
404-G:5-c High Risk Pool Administrator. – I. The board shall select a high risk pool administrator through a competitive bidding process to administer the pool. The board shall evaluate bids submitted based on criteria established by the board which shall include: (a) The high risk pool administrator’s proven ability to handle health insurance coverage […]
404-G:5-d Premiums. – I. Premiums charged for the policies issued by the plan shall be based on the standard risk rate calculated pursuant to paragraph II of this section. II. The standard risk rate shall be calculated using the average rate, based on the lowest allowable health status factor, for health benefit plans or […]
404-G:5-e Eligibility. – I. An individual who is a New Hampshire resident shall be eligible for coverage through the high risk pool if: (a) The individual has applied to a carrier of individual health insurance for coverage that is substantially similar to the coverage that is available through the pool, and the carrier has […]
404-G:5-f Application of Provisions of the Insurance Code. – I. The pool shall be subject to examination and regulation by the insurance department. II. All the provisions of title 37 shall apply to the pool to the extent applicable and not inconsistent with the express provisions of this chapter, except for the following: RSA […]
404-G:5-g Federally Qualified High Risk Pool. – I. The association shall negotiate and submit to the commissioner for approval a contract with the United States Department of Health and Human Services to create a federally qualified high risk pool pursuant to the Act. This pool shall be known as the "federally qualified high risk […]
404-G:6 Commissioner’s Powers and Duties. – In addition to duties and powers enumerated elsewhere in this chapter: I. The commissioner shall upon request of the board of directors, serve a demand upon the member insurer to pay an assessment within a reasonable time; the failure of the member insurer to promptly comply with such […]
404-G:7 Examination and Annual Report. – The association shall be subject to examination by the commissioner. The board of directors shall submit to the commissioner each year, not later than 120 days after the association’s fiscal year, a financial report in a form approved by the commissioner and a report of its activities during […]
404-G:8 Tax Exemption. – The association shall be exempt from payment of all fees and all taxes levied by this state or any of its subdivisions, except taxes levied on real property. Source. 1998, 340:6, eff. Aug. 25, 1998.
