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Home » US Law » 2022 New Hampshire Revised Statutes » Title XXXVII - Insurance » Title 420-H - Explanation of Benefits

Section 420-H:1 – Purpose.

    420-H:1 Purpose. – The legislature finds and declares that: I. Current and prospective beneficiaries, and enrollees and subscribers of group and individual health policies and hospital service plans, nonprofit health service plans, medical service plans, and health maintenance organizations do not always understand the medical services that will and will not be covered by […]

Section 420-H:2 – Definitions.

    420-H:2 Definitions. – As used in this chapter: I. "Certificate" means a document received by an insured, enrollee, or subscriber from an insurer in lieu of a policy or contract which evidences the coverage to which the insured, enrollee or subscriber is entitled. II. "Commissioner" means the commissioner of the insurance department. III. "Company" […]

Section 420-H:3 – Scope.

    420-H:3 Scope. – This chapter shall apply to all policies delivered or issued for delivery in this state by any company on or after the date such forms must be approved under this chapter, but nothing in this chapter, shall apply to: I. Any policy which is a security subject to federal jurisdiction; II. […]

Section 420-H:4 – Requirements.

    420-H:4 Requirements. – Enrollees, subscribers, certificate holders, and individual insureds shall receive in simple and concise written language at least the following information: I. An explanation of benefits provided. II. Any benefit limitations, reductions, exclusions or exceptions to covered services, including an explanation of any restrictions on a subscriber’s access to network practitioners based […]

Section 420-H:5 – Minimum Policy Language Simplification Standards.

    420-H:5 Minimum Policy Language Simplification Standards. – I. In addition to any other requirements of law, no policy forms, except as stated in RSA 420-H:3, shall be delivered or issued for delivery in this state on or after the dates such forms must be approved under this chapter unless: (a) The text achieves a […]

Section 420-H:6 – Powers of the Commissioner.

    420-H:6 Powers of the Commissioner. – The commissioner may authorize a lower score than the Flesch reading ease score required in RSA 420-H:5, I(a) whenever he finds that a lower score: I. Will provide a more accurate reflection of the readability of a policy form; II. Is warranted by the nature of a particular […]

Section 420-H:7 – Approval of Forms.

    420-H:7 Approval of Forms. – A policy form meeting the requirements of RSA 420-H:5, I shall be approved notwithstanding the provisions of any other laws which specify the content of policies, if the policy form provides the policyholders and claimants protection not less favorable than they would be entitled to under such laws. Source. […]