420-B:1 Definitions. – In this chapter: I. "Advertising" means: (a) Printed and published material and descriptive literature of an insurer used in newspapers, magazines, radio and television scripts, billboards, and similar displays; (b) Descriptive literature and sales aids of all kinds issued by an insurer for presentation to members of the public, including, but […]
420-B:10 Examinations. – I. The commissioner shall make an examination of the affairs of any health maintenance organization and providers with whom such organization has contracts, agreements, or other arrangements as often as he or she deems it necessary, but not less frequently than once in every 5 years. All examinations shall be conducted […]
420-B:11 Complaint System. – I. Every health maintenance organization shall establish and maintain a complaint system which has been approved by the commissioner to provide reasonable procedures for the resolution of written complaints initiated by enrolled participants concerning health care services. II. Every health maintenance organization shall establish and maintain a full log of […]
420-B:12 Prohibited Practices. – I. No health maintenance organization, or representative thereof, may cause or knowingly permit the use of advertising which is untrue or misleading, solicitation which is untrue or misleading, or any form of evidence of coverage which is deceptive. For purposes of this chapter: (a) A statement or item of information […]
420-B:13 Sanctions. – Upon satisfactory evidence that any health maintenance organization has violated any law or regulation or in any way has failed in meeting its obligations, the commissioner may, in his discretion, pursue any one or more of the following courses of action: I. Suspend the certificate of authority to operate as a […]
420-B:14 Procedure and Appeals. – All procedures under this chapter shall be governed by the provisions of RSA 400-A and any person aggrieved by any order or decision of the commissioner pursuant to this chapter shall be entitled to an appeal in accordance with RSA 541. Source. 1977, 282:1, eff. Aug. 21, 1977.
420-B:15 Investments. – With the exception of investments made in accordance with RSA 420-B:7, the funds of a health maintenance organization shall be invested only in securities or other investments permitted by the laws of this state for the investment of assets constituting the legal reserves of life insurance companies, or such other securities […]
420-B:16 Fees. – Every organization subject to this chapter shall pay to the commissioner those fees required for payment by hospital and medical service corporations under RSA 400-A:29. Source. 1977, 282:1, eff. Aug. 21, 1977.
420-B:17 Taxation. – Every organization doing business pursuant to this chapter shall be subject to the premium tax requirements of RSA 400-A:31 and 32. Except for payments made by the state of New Hampshire, no tax shall be levied on any premiums, fees-for-service and other payments for health, dental, and employee benefit coverages from […]
420-B:18 Regulation of Agents. – All persons engaged in the solicitation or enrollment of enrolled participants shall be duly licensed agents for the sale of health insurance in the state pursuant to the provisions of RSA 402-J. Source. 1977, 282:1. 2000, 315:23, eff. Jan. 1, 2001.
420-B:19 Powers of Insurers and Hospital and Medical Service Corporations. – I. An insurance company licensed in this state, or a hospital, medical or health service corporation authorized to do business in this state, either directly or through a subsidiary or affiliate, may organize and operate a health maintenance organization under the provisions of […]
420-B:2 Certificate of Authority. – I. No person may operate a health maintenance organization without obtaining a certificate of authority from the commissioner. A foreign corporation may qualify under this chapter subject to its registration to do business in this state as a foreign corporation under RSA 293-A. II. Every health maintenance organization, as […]
420-B:20 Statutory Construction and Relationship to Other Laws. – I. A health maintenance organization shall be considered an insurance company, however, except as provided in this chapter, title XXXVII shall not be applicable to any health maintenance organization granted a certificate of authority under this chapter; provided that this provision does not apply to […]
420-B:21 Regulations. – The commissioner in accordance with RSA 541-A may promulgate reasonable rules for the implementation of the provisions of this chapter. Source. 1977, 282:1, eff. Aug. 21, 1977.
420-B:22 Federal Legislation. – Nothing in this chapter shall prohibit any health maintenance organization from meeting the requirements of any federal law which would authorize such health maintenance organization to receive federal financial assistance or enroll beneficiaries assisted by federal funds, or shall be interpreted or applied to prevent qualification of an organization holding […]
420-B:23 Systems Failing to Meet Requirements of This Chapter; Operation, Licensing and Regulation. – Notwithstanding the provisions of this chapter, a person proposing to operate a system of health care delivery and financing which is to be offered to individuals, whether or not as members of groups, in exchange for a fixed payment and […]
420-B:24 Notification of Option to Enroll in Health Maintenance Organization. – I. Each employer, public or private, in this state which offers its employees a health benefit plan and employs at least 25 employees, and each employee benefit fund in this state which offers its members any form of health benefit, shall make available […]
420-B:25 Capital Requirements. – I. Before issuing a certificate of authority under this chapter, the commissioner shall require that the health maintenance organization have an initial net worth of $6,000,000 and that the minimum net worth required under paragraph II is maintained. II. Every health maintenance organization shall maintain a minimum net worth equal […]
420-B:26 Repealed by 1997, 345:8, II, eff. Jan. 1, 1998. –
420-B:3 Application for Certificate of Authority. – Each application for a certificate of authority shall be verified by an officer or authorized representative of the applicant and shall be in a form prescribed by the commissioner, containing such information as the commissioner may require. Source. 1977, 282:1, eff. Aug. 21, 1977.
