420-G:1 Purpose. – The purpose of this chapter is to: I. Facilitate the portability, availability, and renewability of health coverage for all New Hampshire residents and persons principally employed in New Hampshire who wish to obtain health coverage or maintain it as individuals or as employees of large and small employers. II. To promote […]
420-G:10 Qualified Association Trust. – I. A qualified association trust or other entity, as defined in RSA 420-G:2, XV shall: (a) Comply with the rating restrictions outlined in RSA 420-G:4 for all small employer members with 50 or fewer employees based upon the association’s or alliance’s group experience, except that no rating factor shall […]
420-G:10-a Voluntary Small Employer Health Insurance Purchasing Alliances; Rulemaking. – I. The commissioner shall have the regulatory oversight authority to set standards for the licensure and conduct of purchasing alliances authorized under this section and to enforce such standards. II. Each applicant and each duly licensed purchasing alliance shall file with the commissioner such […]
420-G:11 Disclosure. – I. Health carriers operating in the small employer and/or individual markets shall make reasonable disclosure in solicitation and sales materials provided to individuals and small employers of the following: (a) The methodology by which premium rates for an individual or specific small employer are established. Each health carrier shall state that […]
420-G:11-a Development of a Comprehensive Health Care Information System. – I. The department, the department of justice, and the department of health and human services shall enter into a memorandum of understanding for collaboration in the development of a comprehensive health care information system, the sharing of submitted data fields, and the role of […]
420-G:12 Rating Practices and Filings. – I. Each health carrier shall maintain at its principal place of business a complete and detailed description of its rating practices and renewal underwriting practices, including information and documentation which demonstrate that its rating methods and practices are based upon commonly accepted actuarial assumptions and are in accordance […]
420-G:12-a Health Plan Loss Information. – I. To ensure maximum competition in the purchase of group health insurance, all large employers shall be entitled to receive their specific health plan loss information upon request and without charge. No contract between any health carrier, third-party administrator, employer group, or pool of employers shall abridge this […]
420-G:13 Approval of Rate Filings. – No policy or contract of insurance or any certificate under such policy or contract or other evidence of coverage shall be issued to a small employer or an individual under this chapter until the premium rates have been filed and approved by the commissioner. The commissioner shall approve […]
420-G:14 Rulemaking Authority. – I. (a) The commissioner may adopt rules, under RSA 541-A, relative to: (1) Uniform age rating levels that are consistent with 45 C.F.R. 147.102. (2) Special enrollment periods designed to allow employees to purchase individual coverage on the exchange during their employer’s open enrollment period, even if the employer’s open […]
420-G:14-a Requested Information. – I. As authorized in accordance with RSA 420-G:14, the commissioner may request the submission of such information by carriers as is necessary to better understand the coverage history and choices of participants in the nongroup market. The commissioner shall make every attempt to ensure the reasonableness of such request, both […]
420-G:14-b Prohibited Transactions. – No health care provider shall submit a claim for reimbursement, or otherwise accept payment, for health care services provided to a patient covered by individual health insurance if the provider has paid the premium for such individual health insurance. Source. 1998, 340:16, eff. Aug. 25, 1998.
420-G:14-c Repealed by 2003, 188:17, eff. Jan. 1, 2009. –
420-G:15 Severability. – If any provision 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 […]
420-G:16 Penalties for Violations. – Any health carrier who proposes, advertises, solicits, issues or delivers to any person or entity in this state any form which does not comply with this chapter or who shall in any way violate this chapter may: I. Be prohibited from marketing, selling, or otherwise administering to the individual […]
420-G:2 Definitions. – In this chapter: I. " Actuarial certification " means a written statement by a member of the American Academy of Actuaries or other individual acceptable to the commissioner that a small employer health carrier is in compliance with the provisions of and the rules adopted by the commissioner, based upon the […]
420-G:3 Applicability and Scope of Chapter. – I. This chapter shall apply to any entity licensed, controlled or regulated by RSA 415, RSA 415-E, RSA 420-A, RSA 420-B, or RSA 420-C which offers or provides health coverage for delivery in this state. This chapter shall also apply to any multi-employer plan, trust, association, claims […]
420-G:4 Premium Rates. – I. Health carriers providing health coverage to individuals and small employers under this chapter shall be subject to the following: (a) All premium rates charged shall be guaranteed for a rating period of at least 12 months, and shall not be changed for any reason, including but not limited to […]
420-G:4-a Repealed by 2016, 111:7, I, eff. June 19, 2016. –
420-G:4-b Repealed by 2016, 111:7, II, eff. June 19, 2016. –
420-G:4-c Health Coverage Tax Incentive Plan. – I. Any carrier that offers small group health coverage in the state shall make its small employer group coverage available with a limited open enrollment period to individual employees of small employers when the coverage is purchased through a premium only cafeteria plan that satisfies the requirements […]
