415-E:1 Definitions. – In this chapter: I. " Bona fide association " means a bona fide pathway I association or a bona fide pathway II association. II. " Bona fide pathway I association " means a group or association that satisfies the criteria established by the United States Department of Labor prior to the […]
415-E:10 Self-Funded Arrangements; Termination of Arrangement. – For self-funded arrangements, if an arrangement is terminated for any reason, it shall pay all outstanding claims, debts, and obligations. The arrangement may retain sufficient funds to provide coverage for such additional period as the trustees of the arrangement consider prudent. In addition, the trustees may purchase […]
415-E:11 Self-Funded Arrangements; Annual Reports and Triennial Actuarial Reports. – For self-funded arrangements: I. Every such arrangement shall, annually within 4 months of the end of the fiscal year or within such extension of time as the commissioner for good cause may grant, file a report with the commissioner, verified by the oath of […]
415-E:12 Maintenance of Records. – Each arrangement shall make available to the commissioner complete records of its assets, transactions, and affairs in accordance with such methods and systems as are customary for, or suitable to, the kind or kinds of business transacted. Source. 1991, 246:1, eff. Jan. 1, 1992. 2019, 346:407, eff. Dec. 1, […]
415-E:13 Qualification for Approval and Suspension or Revocation of Approval. – I. Subject to other provisions in this chapter, the commissioner shall deny, suspend, or revoke an arrangement’s approval if it finds that the arrangement: (a) Has failed to meet the financial requirements of this chapter, RSA 420-G, or has violated any lawful order […]
415-E:14 Penalties. – I. Subject to other provisions in this chapter, any arrangement that fails to obtain and maintain a valid approval from the commissioner while operating or maintaining a multiple-employer welfare arrangement shall be subject to a fine of not less than $5,000 or more than $50,000 for each violation. II. Subject to […]
415-E:15 Rehabilitation, Dissolution. – Any rehabilitation, liquidation, conservation, supervision, or dissolution of a multiple-employer welfare arrangement shall be conducted under the supervision of the commissioner, who shall have all power with respect thereto granted to it under the laws governing the rehabilitation, liquidation, conservation, supervision, or dissolution of insurers. Source. 1991, 246:1, eff. Jan. […]
415-E:16 Rulemaking. – The commissioner may adopt such rules, pursuant to RSA 541-A, as are reasonable and necessary in order to carry out properly the functions and responsibilities assigned the insurance department under this chapter. Source. 1991, 246:1, eff. Jan. 1, 1992. 2019, 346:408, eff. Dec. 1, 2021.
415-E:2 Applicability. – I. No person shall operate a multiple-employer welfare arrangement unless such arrangement is approved by the commissioner. A foreign or domestic MEWA or association shall be subject to the jurisdiction of this state if it provides a health benefit plan that covers the employees of at least one employer that maintains […]
415-E:3 General Eligibility. – I. To meet the requirements for approval and to maintain a multiple-employer welfare arrangement, an arrangement shall be: (a) Nonprofit. (b) Established by a trade association, industry association, political subdivision of the state, religious organization, or professional association of employers or professionals which has a constitution or bylaws and which […]
415-E:3-a Bona Fide Pathway I and II Association Coverage; General Authorization. – Bona fide pathway association coverage as set forth in the United States Department of Labor’s June 21, 2018 amendment to 29 C.F.R. section 2510, 83 Fed. Reg. 28,961 (codified at 29 C.F.R. section 2510.3-5) shall be permissible in New Hampshire provided it […]
415-E:3-b Bona Fide Pathway I and II Association Coverage: Option to Offer Fully-Insured Coverage. – I. A bona fide pathway I association may offer coverage on a fully insured basis if it is a qualified association trust as defined in RSA 420-G:2, XV. II. A bona fide pathway II association may offer coverage on […]
415-E:3-c Bona Fide Pathway II Association Coverage; Benefit Requirements. – I. Each health benefit plan offered to or by a bona fide pathway II association, whether on a fully insured or self-funded basis, shall, at a minimum, provide the following benefits: (a) Coverage for each of the 10 essential health benefits as defined in […]
415-E:3-d Rating Requirements for Bona Fide Pathway I Fully Insured Coverage and all Pathway II Coverage; Rating Requirements. – I. Any fully insured bona fide pathway I association and any pathway II association, whether self-funded or fully insured, or any insurer contracting with such bona fide pathway I or II association to provide a […]
415-E:3-e Bona Fide Pathway II Association Coverage; Nondiscrimination Requirements. – In accordance with 29 C.F.R. section 2590.702, bona fide pathway II association coverage shall comply with the following: I. The group or association shall not condition employer membership in the group or association on any health factor of any individual who is or may […]
415-E:3-f Free Movement Between Bona Fide Association Coverage and Small Group Coverage. – A small employer that leaves the small group market for bona fide pathway I or II association coverage or that leaves pathway I or II association coverage for the small group market shall not be subjected to a waiting period before […]
415-E:3-g Bona Fide Pathway II Association Coverage; Mitigation of Small Group Market Impacts of Pathway II Association Coverage. – I. In order to mitigate potential adverse effects of pathway II association coverage on the existing small group markets, the commissioner shall retain an independent actuarial firm to model and quantify the impacts of pathway […]
415-E:4 Self-Funded Arrangements; Filing of Application. – For self-funded arrangements, the sponsoring association shall file with the commissioner an application for approval of the arrangement upon a form to be furnished by the commissioner, which shall include or have attached the following: I. A copy of the constitution or bylaws of the association. II. […]
415-E:5 Self-Funded Arrangements: Termination Liability Fund. – I. Each self-funded multiple-employer welfare arrangement shall maintain a termination liability fund wherein the fund balance of the multiple-employer welfare arrangement shall at no time, for a consecutive 90-day period, be less than $750,000 or 33 percent of the aggregate premiums billed during the 12 prior months, […]
415-E:6 Self-Funded Arrangements; Financial Condition, Loss Reserves, Reinsurance, or Working Capital; Determination of Inadequacy. – I. Each self-funded arrangement shall maintain specific excess insurance with a retention level determined in accordance with sound actuarial principles and approved by the commissioner. II. Each self-funded arrangement shall establish and maintain appropriate loss reserves determined in accordance […]
